Day +41

Things are going well, although not quite as boring as I would have liked. My usual appointment last Thursday went very well and Kate and I were out of the hospital fairly quickly. However, we got a call that night that my neutrophil count was around .500, which is borderline neutropenic. So the doctors wanted us to come in the next day and have my blood redrawn.

So Friday involved me heading to the hospital again and having my blood drawn. I stayed around to hear the results, and the doctors let me know that my neutrophil count had risen since the day before to .688. While that happened, somehow my white blood cells had dropped, from 2.2 to 1.8. The doctors were happy to see the neutrophils rise, since those are the infection fighters, and just warned me to be careful over the weekend and they would reevaluate on Monday during my normal visit.

So over the weekend I felt great and didn't feel any signs of infection...great news. Yesterday during the appointment, everything goes well and the labs show my white blood count had risen back to 2.2. The neutrophil count takes a longer time for the lab to process, but the doctors felt confident that the neutrophils would look good after the white cells rose. So Kate and I head home and are resting nicely around the house before I notice a message on my phone. I call back the doctor from NIH, and not only have my neutrophils dropped, but there weren't any. 0.000 Even during my chemotherapy and before my transplant, the lowest I ever saw my counts go was .006. I always had some floating around, and since I feel so great these days, I shocked that there were none. The dotors were perplexed as well.

So Kate and I made the trip over to NIH for a second time in one day, and had my blood drawn again. I was given a neupogen shot in order to boost my white blood cells and neutrophils, and was asked to come back the next day to have my blood checked again.

So this morning Kate, Isaiah, and I head over to NIH. Driving me around is already a nuisance for Kate, but doing it in the snow around the beltway wasn't exactly her idea of how to spend a morning. It took us twice as long as usual, but luckily the roads weren't too bad. I found out my results from yesterday afternoon, and my white blood cells remained the same, while I had .021 neutrophils. That ruled out an error with the labwork from yesterday morning, and indeed I had an extremely low amount of neutrophils. I had my labs done this morning, and it came back that my neutrophils held pretty much the same at .020, while my white blood cells dropped further to 1.2. The plan for now is to take the neupogen shots for the next week and see how my cells react. I stopped taking Bactrim, which is the prophylactic antibiotic that I've been given.

Apparently that medication at times can cause reactions with the immune system. I'll head back to NIH for my regularly scheduled appointment on Thursday, and hopefully this issue starts to work itself out. I had told the transplant team that I had decided to have my Hickman line removed, and the procedure was scheduled for tommorow. That will be put off for now while this is going on.

Although I feel good, it feels like somewhat of a step back to be neutropenic again. I was feeling pretty good about how I was doing, but now have to be extra cautious about what I touch and washing my hands. Although this is a little bit of a hiccup in the process, this seems like it is probably something minor compared to everything that could happen. The doctors say the results of my bone marrow biopsy were excellent, and everything looks to be growing well.