Two Weeks of Chemo: Day 2

This is part of an ongoing two-week series. For more info, see this introductory post.

One of the paradoxical side effects of chemo is sleeplessness over the first few nights, this before and even during the characteristic fatigue. After getting little sleep last night, I am exhausted and will probably have to take a nap to get through the day. Even if I could sleep, I can't sleep-in forever on Day 2 because I need to be at the hospital, usually by nine for a Neulasta^® shot.

As I mentioned yesterday, one of my early treatments was put on hold due to low blood counts. Chemo is designed to attack any rapidly dividing cells in the body. Though great at targeting cancer, this technique produces widespread collateral damage including killing hair follicles, taste buds, the lining of the GI tract, and the cells in the bone marrow that produce blood cells. The specific blood cell counts that diminish vary by person and treatment. Some lose platelets and are at risk of excess bleeding, others lose red blood cells and become anemic, and lastly many people see a severe drop in white blood cells (WBCs) and become at risk for illness and infection.

After my first treatment, my WBC counts dropped to 1.4 from the normal range of 4.8-10.8 (units of 10⁶/ml). To make sure my immune system had time to recoup on its own, we delayed the next treatment by a week and added a biweekly Neulasta shot to be injected into my arm on the day after my chemo.

Since then I have attended what I lovingly refer to as the Breakfast Club every other Saturday with the other Friday leukopenic chemo-ers. The office is closed aside from one doctor who comes in to administer the injections, but you've never seen such a lively waiting room. We all catch-up on how life in general and chemo in specific have been treating us. We welcome newcomers and celebrate the last visits of the veterans. It's a wonderful little community and my favorite part of the week. These Neulasta^® days have shown me that not only am I not alone in this struggle, but that I have become one of the veterans.

I love easing the fears of the new patients and imparting the knowledge that I've picked up both from experience and from the tales of my predecessors. Yes, your hair might fall out, but for some people it doesn't so wait a few weeks to be sure before you cut it all off. The third day seems to be the worst for most people. Emend^® is the best nausea medication. Etc.

Neulasta^® is what's known as a colony-stimulating factor, a compound that stimulates hemopoetic stem cells to produce more of certain types of blood cells. My WBC counts are now frequently in the mid-teens, plenty high enough to continue treatment and ward off infection. In fact, we joke that I have had a healthier winter than Jenni (or most people that I know for that matter).

This is especially surprising considering how poorly I've avoided the guidelines given to immunodeficient chemo patients. To be fair, it's a lot easier to avoid large crowds when you're a geriatric patient than when you're in college. Also, when you've had tickets to the Book of Mormon for 9 months, you go, come hell, high water, or germy Manhattan tourists.

Back to Day 1.
Ahead to Day 3.