It looks like I've hit the nadir on my platelet count. They tallied up at 32 this morning. Still 50% higher than the same point last cycle, but low enough to warrant some intervention. I'll have a platelet transfusion this evening.
I've queried Dr K on why I was given only one dose of Neumega two nights ago. Personally I would have started a more aggressive approach to avoid bottoming out. I thought maybe five days worth and then reappraise things from there. His answer was that there is no way of knowing how the drug will affect any one individual patient and he wanted to see how I reacted to a single dose. I could have told him. He must have forgotten that we went through the same thing last cycle. (Remember last cycle when I warned him he'd miss the window, and he came into my room saying "sorry, sorry, sorry")
I think yet again we have missed the window and blown the opportunity to build a parachute that would prevent platelet free-fall. Oh well.. a transfusion will come to the rescue, Great!.
If the previous pattern repeats, my counts will again drop at around day 14, not giving us enough time to administer Neumega before I return home. Therefore I'll need another transfusion, possibly just before departure. I've told both the doctors that I want to start a five day course of Neumega by Thursday at the latest. I wonder how many other patients make those sort of demands... I can't see him taking my advice any way, but at least I've said it.
Don't get me wrong, the treatment I'm getting is first class. Back in NZ they were only doing blood tests weekly and I was left for six weeks with no treatment at all and a count below 20.
It's just that I have marrow that has been described as being like "Snow on the desert sands". Conveying this seems to be the biggest problem. Ultimately I'm sure no harm will come of it. But just for once I'd rather we were in front of the eight ball, rather than behind it.
It looks like I will have the last dendritic cell vaccine on Sunday now. The lab has promised to have it ready for that time. Good, will save me from running a fever on the flight home.
5PM: I've just finished the platelet transfusion. So far I'm not seeing any signs of another histamine reaction like I had the previous two times. I also spent some time in the gym this afternoon as I was not allowed out for a walk in case I injured myself and bled to death on the side of the road.. somehow I just can't see that happening.
Nurse Biljana now trusts me completely with my IV's. Today she laid the whole lot out in the order she wanted them to be administered and told me how fast each could be delivered. I usually slow them down anyway, too fast and I get a doughy feeling in my head. Selenium is given first and Vitamin C last, there has to be at least an hour between these two.. The reason for this has not been fully explained, but some research shows that it's to do with the way the two interact, causing the selenium to change into a form not able to be absorbed by the body.
Since the base drugs were left in my room for the first time ever. I got to read the labels and do some research on the net. (usually I only see the IV bottles with the drugs already mixed in saline). Google is our friend.
First up is Selenium, then Tationil followed by Actovegin and lastly Pascorbin (Vitamin C).
It looks like most of them are for reducing the toxic effects of the chemo and helping reduce both liver damage and neuropathy.
I'm not entirely convinced that any of them make a huge difference, but the doctors believe they do, so I'm happy to go along with that. Any little thing that gives you an edge..
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