Neutrophils, Neutropenia and Neutropenic.


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.


Hospital Stays VS Long-Haul Flights

After 56 hours and approx 8 unfinished movies (I always fall asleep before the end), I couldn’t help but feel I could have completed a round the world journey. There are many similarities to being stuck in a hospital and stuck in an airplane.

Apologies to my non-flying friends if you don’t get as much amusement from this as the others.

My observations on both…

The Cabin: In hospital you are provided with a nice comfy bed, a touch of a First Class no matter what your budget. I was a private patient in a public hospital, I am not sure how beds would differ if I was in a private hospital – better quality plastic covering? My bed was so old-fashion that it had to be wound up and down with a lever at the end of the bed, technology upgrades definitely required. As I was in isolation, I was lucky enough to have my own room…oh the luxury!

The Food: Hands down hospital food is economy class standard…actually worse. I would happily eat (and I have many times before) a tasty economy curry, however in hospital, I found it hard to finish my meals. People know I like to eat, and I’m not too fussy either, so that’s saying something! Also, a drinks trolley came around between each meal service – this is what Qantas likes to call “continuous refreshment”.

The Call Bell: There is a rule of thumb about using the call bell on flights – unless you are stuck by the window, with an inability to get out, or having a medical emergency, then it is advisable to stretch your legs and take a walk to the galley to make your request. We honestly do have your best interest at heart, DVT is a serious issue, you really should move around more. Well, in hospital, I was forced to press the call bell. It goes against everything I believe in, but when you are in isolation, you don’t have a choice. I did feel for the nurses when I could hear the call bells going off all through the night..

The Entertainment: Having entertainment issues on a long-haul flight can really make-or-break the journey. Hospital stays are no different. Since I have private health (thank you Bupa), my TV usage was free. The 5 movie channels plus standard TV made the 56 hours fly by. The picture quality wasn’t the best, and the sound would randomly stop every now and then – complaints I have had to deal with many times before. I was a little jealous when a nurses told me Ward 5 had flat screen TV’s! Say WHAT! I was hatching a plan to get transferred to Ward 5, until I found out Ward 5 was ICU and CCU…NO thanks!

The Service: We all know this is the backbone of it all. I had a rotation of 7 different nurses care for me during my stay, and all but 1 were amazing. I know this is no different with cabin crew – there a lot of people still in the profession that really don’t want to be there, and if you are their passenger, you’ll know about it. The rest of us, are happy to look after you.

As much as I would have preferred to fly around with world instead of lying in a hospital bed, I am happy not to have jetlag, cankles or suitcases to unpack.


Unlucky Seven

Warning: the following may cause people to worry. This is not the intent. Just facts.

If you had read my blog about my horrible first round of chemo, in chair 7, you may remember that 7 was forever going to be known as my unlucky number. Today has cemented this.

Firstly, here are a few facts for you.

Fact #1: 10 days after chemo is when your white blood cells are lowest. That is today.

Fact #2: if everyone is wearing summer clothing, and you’re in jeans, jumper and scarf…and shivering…something’s not right.

Fact #3: if your temperature reaches 38 deg during chemo, call the ambulance.

This morning I went for a lovely brunch with my girlfriend. I was feeling Ok, just couldn’t get warm. I knew when I got home I should check my temperature. 37.9. Mum and I decided a trip to Emergency was probably wise.

Emergency on a Sunday – no need to say more. I was given a mask to wear and a seat away from everyone else to ensure I didn’t pick up and extra germs while waiting. The wait wasn’t too long until I was seen too – wristband on, gown on. Looks like we will be here for a while. My temperature spiked to 38.7 and I could feel every decimal of that.

To cut the long story short, I have been given some antibiotics and my temperature is slowly dropping. Unfortunately I have to stay overnight to be monitored. It’s very common for this to happen, just unlucky.

Getting back to my point about number 7 being unlucky. My first round of chemo was 17th, today is the 27th and mother and I had a chuckle when we realised I was in cubicle 7 in Emergency. The joke continued when we heard the Doctor say I was going to be transferred to ward 7B. My next round of chemo is scheduled for November 7…should I be worried?

Please know that I feel fine, just a smaller bed and TV than I’m used to tonight. We were supposed to cheer my sister on as she completed her 60km walk today – sorry, Anja.

Reality check #2.

(Oh, and for all those who have been sending positive vibes that I get a hot Nurse…they worked! Hunk-a-Rama)