Neutrophils, Neutropenia and Neutropenic.

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I like learning new “big” words. My vocabulary has increased significantly since being diagnosed. My whole life, I have always been rubbish at word games – I would choose a game of Backgammon over Scrabble any day! Maybe in six months time, I will feel more confident in the Scrabble arena. Let’s just hope “chemo brain” doesn’t get the better of me.

So, some further insight into why I ended up in hospital on Sunday. The purpose of chemotherapy, is to kill cancer cells. Unfortuantely, along with cancer cells, white blood cells are also affected – this is not a new development…it’s a heavily researched and proven fact.

Ten days after your first round of chemotherapy, a blood test is taken to measure your ‘neutrophil’ levels – neutrophils are a type of WBC, whose job is to fight off bacteria and infection. If they are dangerously low, you qualify for an injection that will help boost your WBC’s, so they don’t get dangerously low again. This is all well and good, but you have to get through your first round to see if you qualify, and I had to learn the hard way about HOW dangerously low your WBC’s can get. I ended up in hospital ON day ten! When I went to hospital with a fever, my neutrophil levels were ZERO! Zip, nil, cero, nada…my body had no defence mechanism to fight off any nasty germs or bugs. I was told many times I was suffering from ‘neutropenia’, or I was ‘neutropenic’…same same. Two more big words – tick.

So how many neutrophils does a healthy person have? In the context of the figures I am working with, a healthy person should register with a count between 2.0-7.5 (there is an equation to work out per litre…but let’s keep it simple). After 24 hours in hospital my levels had risen to 0.16. You are usually kept in hospital until your levels reach AT LEAST 0.5, as this is the minimum your body needs to be able to do their job of fighting infection (this could take another 48 hours!). After much discussion, and since I was “feeling well” they decided to let me continue my isolation at home, and the medical team would come to my house to continue with blood tests and monitoring. Minor Win.

After another 24 hours at home they had risen to 0.4, let’s hope by tomorrow they have surpassed the 0.5 mark, and I will hopefully be discharged from my house arrest…just in time for the weekend.

Although it was very worrying for a lot of people to know I was in hospital, it’s all too common after your first round of chemotherapy – my Oncology team came to visit and assured me of this. There is no way of knowing exactly how your body will react to chemo, the first round is the “guinea pig round”. It’s safe to say I definitely qualify for the WBC booster – hopefully this shouldn’t happen again.

Lesson learnt for myself: Day 7-10 – stay away from public places as much as possible.  This is when your WBC’s are at their lowest. They tell you these things, but it’s hard to grasp to what extent you need to be cautious, especially when you are not feeling sick!

I had started to think that maybe they hadn’t given me enough drugs during my first round, as I hadn’t experienced many major side-effects. I can banish those thought now. It’s secretly nice to know that the drugs are working and killing any nasty cells that may be playing hide-and-seek.

Side note: I hope this blog gets the tick of approval from all my medical friends.

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