Another cancellation today. This time, I didn’t get upset because I knew I was already doing all I could to avoid this situation. Basically, I reacted just as I told Dr. M I would in this situation. Point: Alicia.
I knew as soon as the nurse told me Dr. M was coming to talk to me that I wouldn’t be getting chemo today. My blood counts?, I said and she told me, yes, just wait here and the doctor will be with you soon.
Dr. M was there shortly. So your counts are low, she told me. I told her I guessed as much and asked her how low. Point five eight, she said. I was actually incredulous. Point five eight? Point five eight? To give you an idea of how low that is, the last treatment was delayed because my neutrophils were 1.2. Also, the way my chemo works, my blood counts are usually at their lowest point somewhere around the 10-day mark which means I likely had an even lower number last week. Why I haven’t caught every disease going around, I don’t know. I could probably catch the clap from a toilet seat with the immune system I have now. So I have to watch myself and take my temperature several times a day to make sure I don’t develop a neutropenic fever (which can be life-threatening) and avoid yogurt and sketchy restaurants and grubby children and people who are sick. It’s hard to believe that I am so immune-compromised when I feel fine (other than the fatigue).
Speaking of the fatigue, Dr. M was asking me about side effects and I told her the only new thing I was experiencing was fatigue. I’m so tired, I told her, I’m tired all the time. She asked me if I wanted to keep going. With treatment? I asked. I’m not so debilitated that I feel I need to stop. It’s almost over.
I guess I don’t really know how debilitated one has to be to consider stopping chemo. I imagine Dr. M was considering the beating my body is taking right now. Even on a reduced dose, even with five days of Neupogen injections, I’m still destroyed. It’s not just my neutrophils; my platelets are low, too. Not low enough to need a blood transfusion yet, but low enough that she’s concerned. I’m giving myself another five days of injections now with the hopes that they will raise my blood counts for next week (though in raising the neutrophils, the drug could end up lowering the platelets further — apparently your bone marrow can only do so much and sometimes it has to pick and choose which cells it will produce). My counts are so low right now that they might not rise enough for chemo next week. I need to be over 1.5 to get chemo. That’s a bit of a push, even with help from the Neupogen.
I’ve pretty much resigned myself to the idea that I might be stretching this process out into July. We’re going to lower my next dose of chemo, whenever that happens, but I’m already on a reduced dose and it doesn’t guarantee my neutrophils won’t be annihilated. Or my platelets, since they are a contender for Cells That Might Delay Chemo. I am, however, switching to a different injection, one that does the work of 10 Neupogen injections (and apparently hurts even more, so I now have prescription pain killers, thanks Dr. M!)
I don’t know what to say about all this. I can only laugh. The Neupogen has given me a headache, the kind that makes it hard to read (I keep enlarging everything on the screen to make it easier for me). I can already feel twinges in my bones again. I have yet another delay in treatment and could have another next week. But I’m in a better mood than I was before. Maybe it’s because Dr. M reminded me that this is still my choice; I don’t have to do any of this if I don’t want to. Maybe it’s just that I’ve been napping more and spending time sitting under the sun in the park. Or maybe it’s just that absurd things — even shitty absurd things — can’t help but be amusing after a while.