Day 22 and final day of Consolidation

With yesterday’s CBC results it looks as if Courtney’s blood counts are finally starting to return to normal on their own. Her WBC’s are still slightly above normal, due to the lingering effects of the Neulasta. She never did receive Procrit, but with her RBC’s close to normal and her platelets well within normal on their own, she won’t be needing it. (Unfortunately, this validates the insurance company’s propensity to baulk at the approval of this drug. Oh, well).

	Wednesday	Thursday	Monday	Normal Range
WBC	5.1	15.3	17.9	4.1 – 11.1
RBC	2.70	2.62	3.52	4.01 – 5.31
HGB	8.2	8.2	10.8	12.1 – 16.1
Platelets	15	74	202	140 – 440
Neutrophils	3.5	13	NA*	2.0 – 7.5

*Neutrophils and other WBC differentials weren’t available at the time we left the clinic.

So, because her counts looked so good, Dr. V said Courtney didn’t have to return until the 26th. On that day, Tracy will also go to the clinic for her pre-evaluation. If all looks well on that day, the next trip to the medical center will be December 3rd, when Courtney will have the PICC line removed from her arm and a Neostar catheter (similar to the Hickman) placed in her chest. Then on December 4th she’ll be admitted to the hospital for the bone marrow transplant.

Physically and emotionally, Courtney is doing ‘OK’. For the most part, she sailed through this round of chemotherapy with relatively mild side effects. (“relatively” being the key word.) Her main issues are gastrointestinal. These are difficult, if not impossible, to relieve, due to the myriad of possible and likely causes. These are the three most likely culprits of Courtney’s current discomforts: 1) The gastrointestinal toxicity of the chemotherapy drugs. They affect not only the motility of the digestive process, but the taste of food as well. So, even if Courtney wasn’t feeling nauseous or crampy, food generally doesn’t taste or sound as good as usual. 2) The anti-bacterial medication she’s been taken can all have bad side effects relating to the stomach or intestines. At least she doesn’t have to receive the anti-fungal drug (Mycamine) any more. 3) Anxiety. I found the following passage in an old college textbook and have to quote it because it exactly applies to what Courtney’s been increasingly feeling the past few days.
“A substantial proportion of patients develop nausea and vomiting in anticipation of treatment, after one or more courses of chemotherapy have been given. Antiemetic agents do not provide complete protection from anticipatory nausea and vomiting.” - Krause’s Food Nutrition & Diet Therapy

In other words, Courtney is naturally nervous and anxious about the upcoming stem cell transplant and lengthy recovery. So please continue to keep her in your prayers. Pray that she has peace of mind and body, especially during these next couple of weeks as she prepares for the transplant. The better she feels going in, the better she’ll be coming out.