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You are welcome to apply any part of this article to your own personal use. Please do NOT publish any part of the article or apply any part of it to any non-personal use without the express written concent of the author.
Following each chemotherapy cycle are the Nadir Days, those days where the blood counts fall to below the minimum normal amounts until they come back up to that minimum level. For most in my treatment protocol the Nadir Days start about 10 days after the first day of infusion and last about 3-5 days. These are the days when we patients are most susceptible to infections. Any fever in that time is a major concern.
Doctors can send blood samples to the laboratory for blood counts, requiring periodically having a blood sample drawn for the lab. In between I can monitor my status with a simple oral thermometer.
On the 10th day following the start of my chemotherapy I began to notice a soreness on my tongue. At first I thought it was just that I had perhaps bitten it slightly during sleep. I didn't have any fever so I wasn't too concerned. But by the end of the 11th day it was so sore that I was having difficulty swallowing and talking. And my temperature began to rise.
I went directly in to the Seattle Cancer Care Alliance office on Friday morning, day 12. I was very weak and nearly passing out. My blood counts were quite low.
How bad was it? Neutrophils are those parts of the white blood system that fight off infections. A healthy adult male usually has a count between 1.8k and 7.0k (1,800-7,000). My neutrophil count was 0.03k (30).
They put me immediately on some intravenous (IV) fluids and a hefty dose of IV antibiotics. By mid afternoon I was back in the University of Washington Medical Center (UWMC) hospital.
The next few days are a blur for me. Lots of fevers, lots of antibiotics, lots of sleeping... But at least the counts were slowly coming up. On Saturday my neutrophil count was 0.1K (100), Sunday 0.6k (600), Monday 2.85k (2,850).
One of the treatment options was to have blood transfusions - about half of the patients in this protocol require several. So far I've managed to avoid those.
This period was, of course, quite stressful for Kit. The stress finally showed up in physical symptoms. Monday morning she took herself to the emergency room with a pain in her right wrist that radiated up her arm to her neck and head. The tests all came back negative, indicating stress as the significant factor. She'll be addressing that for my next rounds of chemotherapy.
I was sent home Monday afternoon, my counts having come up above the minimum acceptable level. That was a total of 10 days in the hospital out of the past 15 being either infused or treated for the side effects of the infusions.
Even at my lowest I was able to enjoy friends' stories of their cruises and other interesting events in their lives. One sent me an email describing their Memorial Day Weekend cruise. Another wrote of tossing a bottle in the ocean two years earlier and receiving a response from a young woman who found it on a beach on another continent, earning a 90-second spot on the local evening television news program. Knowing that folks are having bright spots in their lives really brightens my day and helps to make it bearable.
This morning when I woke up, it was as if a switch to my internal battery had suddenly been reconnected. I no longer feel as if I have lead weights strapped to my arms and legs. The Nadir Days for my first chemotherapy cycle are now in the past.
So now I rest and build up my reserves for my 2nd chemotherapy infusion, scheduled to begin on June 14.
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