Blogging in B Minor

Well, I had a CBC run at the lab yesterday in preparation to start back on chemotherapy tonight and I received a call from my neuro-oncologist telling me to wait another week – my marrow hasn’t recovered.  I stopped chemo on Saturday the 14th and was to continue through the 17th.  I would have been off anyway from Wednesday the 18th through Tuesday the 25th but back on again tonight which is why we did the labs.  So, I will effectively be off of chemotherapy for 3 1/2 weeks by the time I get back on providing my lab work comes back ok next week.  As I continue with treatment, it’s taking its toll certainly but when you fold in another cold that also relies upon white blood cells to fight it off, it’s not surprising I find myself waiting.  I also have to consider that I was not even well when the rest of my family became sick (see my post below ”The Infirmary”!) so I was pushing myself anyway to begin with.

This is really the first time I have had to wait because of a really low count.  This just doesn’t happen.  I have generally tolerated Temodar really well.  Regardless, we will wait and next Tuesday I will get a CBC and if all is well I’ll be back on next Wednesday night.  As further detail, when I have a CBC, they take that information and arrive at a calculation called an Absolute neutrophil count or ANC.  The ANC is a measure of the number of neutrophil granulocytes (also known as polymorphonuclear cells, PMN’s, polys, granulocytes, segmented neutrophils or segs) present in the blood. Neutrophils are a type of white blood cell that fights against infection.  The ANC is calculated from measurements of the total number of white blood cells (WBC), usually based on the combined percentage of mature neutrophils (sometimes called “segs,” or segmented cells) and bands, which are immature neutrophils.  A normal ANC is above 1,500 cells per microliter.  An ANC less than 500 cells/µL is defined as neutropenia and significantly increases the risk of infection.   Mine as of now is in the range of 950.  Here is a table that lists the ANC score and the associated risk category (essentially risk of infection) with 0 being the lowest and 4 being the highest.  I’m sitting at the higher end of 3 which is pretty good but not good enough to start back on Temodar which will obviously take the count down again.  We’ll wait a week and see where the ANC is.

As an aside, I have to post this picture of my son Keegan because I think it’s hilarious.  Cheers.

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