Tuesday, March 11, 2008

Neutropenic Again?

Day + 286

WBC 2.5 K/uL
RBC 3.79 M/uL
HGB 11.7 G/dL
PLT 368 K/uL
ANC 0.6 K/uL

We had our follow up today with Ann's local hematologist and I can honestly say that I am concerned. The reason why is that Ann's absolute neutrophil count (ANC) has dropped below the threshold normal range of 1.0 - 1.5 K/uL. Ann's Hematologist says that this could be a normal reaction to the bug she picked up last week and it may clear itself. Further he indicated that he didn't see a reason to worry because Ann's counts were roughly the same as her last blood test.

I was (and am still) worried, so the first thing we did when we left his office was to call MDA and see where Dr. Kebriaei wants to go with this. In the meantime while we are waiting to hear back from them I am going to be proactive. Ann has enjoyed freedom from neutropenic safeguards for the last couple of months, but that ends today until this situation is resolved.

So it is back to taking her temperature multiple times during the day. No fresh fruits or vegetables to eat. Most of all though, it means that our little excursions to the market or grocery store will have to come to a halt and when in public a mask will no longer be optional equipment.

I would be lying if I said I wasn't worried or scared. I'm very much both. Why would Ann's ANC count cut itself roughly in half from 1.3 K/uL since our last check up to 0.6 K/uL today? What are the baby stem cells up to? Is this all part of a normal fluxuation in the production of blood cells that infant immune systems go through?

I wish I knew the answers. All I do know is that when I look into her beautiful brown eyes I know with absolute certainty that I love her more that anything else I can imagine.

By the way I should add that Ann says she "Feels great!" and doesn't see what the fuss is about.

Note: I do feel fine and I do understand Chris' concern. Let's not forget that I finished a round of anti-biotics last Tuesday because of an indeterminate bug. My local doctor says that my ANC is in keeping with that information. I'll be careful and I'll take all the precautions that I took when neutropenic during chemotherapy.


pj said...

It pays to be careful but given what Ann's been going through lately, it seems reasonable that her infection-fighting cells (neutrophils) are lower than usual. I imagine a person who hasn't had leukemia but has recently battled the flu and a cold virus has a lower than optimal ANC as well. We're all vulnerable to opportunistic infection when our immune systems have been working overtime. Ann's baby system probably takes a little longer to bounce back. Relax.

Ann: clamp your lips together when you see that thermometer coming at you.

Susan Carrier said...

I hope the return of the mask and the isolation are both very temporary.

S Rocks said...

Very nice article!