The Effect of Neupogen

1/30/07 Day 20

The day started out with more lab and blood work. I was pretty worried about how the day was going to go because Ann had allot of trouble walking from the apartment to the bus. The effort left her winded for over two hours and the distance is less than 100 yards.

When she gets weak she also tends to get nauseous. However, I think we found a way to combat it by using ice chips. Ann says that when she feels like that it helps to have something cold in her mouth. Lucky ice and cups are easy to get just about anywhere in MDA.

On to the big news of the day. I was really worried about the blood test results from yesterday. So when we got the results back from today's blood work I was almost in a panic. Ann's WBC was 34.7 K/uL, that's another 24 K from yesterday! When I asked the Physicians Assistant at the lab today to explain the results from yesterday and today she really put my mind at ease.

The high WBCs and LDH numbers are a result of the chemo being purged from her system and the Neupogen shots. The chemo was suppressing the fast dividing cells in her immune system (marrow, blood, ect) while the Nuepogen was stimulating those same cells to reproduce. What I am given to understand is that previously those two factors where keeping her in equilibrium. Now that the chemo is less of a factor the effect of the Neupogen is much more visible.

We even have the go ahead for Ann to stop taking the Neupogen for the time being. She is pretty happy about that. No more injections or bone pain, for the moment at least. We will have to start taking it again later, but the break will be nice for her.

Bottom line is that they say Ann is reacting exactly like they expect her to, so this is good news! Her appetite is even a little better, she managed to keep breakfast down and even wanted a smoothie ("Caribbean Way" again) on top of it.

Update 1: It turns out the smoothie was too much for her stomach after all. She says she is feeling better now though.

Update 2: Ann complained that her CVC line was itchy. So we stopped by the infusion therapy clinic and asked them to take a look at it. Turns out there was no infection or problem with the dressing, but the CVC itself was sutured in place very loosely. A very nice nurse from fixed it for us. As it turns out she was from Thailand and was just tickled to bits that Ann was born there also.

Update 3: I got the full differential count from Ann's blood work back. Some of the values on it look really scary to me, but the nurse at the clinic assured me that what we are seeing is the Neupogen in action. We have another Bone Asperation and a Doctor's vist thrusday, so I will try to take a deep breath and remain claim until then.