Today when I went for chemo I started the day by reporting to the hospital to have a STAT blood count done. this has been required every time my lab test on the prior Thursday show a white cell count or hemoglobin (red cell) count that is too low to allow receipt of the chemotherapy. Which means it has happened essentially every week (every week except for 1) for the last nearly 2 months. Every since before my first transfusion.
This Thursday my hemoglobin had been low enough that I was required to go in for another transfusion (the third) last Saturday. And the white count was low enough that I had to repeat it this morning before I could get chemo.
But this morning for the first time I had blood counts that were too low to get chemo. Ironically not the white cell count, which was 2,200 which is higher than it has been for some time. (it has to be at least 1,500 before they will give me chemo). And my hemoglobin was so high that I did not even qualify to get the shot of erythropoitin that I have gotten nearly weekly for some time.
But the platelet count was low - 85,000. Normal is over 100,000 and that is what is required to receive the chemo treatment. Below 50,000 there is real danger of bleeding problems since platelets are important to help blood clot.
So the start of cycle 6 has been delayed a week to let my blood counts recover.
This may be a good thing. The neuropathy (numbeness and tingling in my hands and feet) has been getting worse and interfering with my ability to open packages sometimes. Hopefully with a week of no chemo it will improve a bit before I start poisoning the system again.
Also, while the original sporothricosis lesions have cleared up on therapy, I noted Saturday night some new lesions on my right thumb. So maybe it is good to give a full week of Itraconazole treatment for the sporotrichosis before I knock my white blood cell down again. It can spread widely in immunocompromized hosts and I don't really thing that would improve my exprience, so happy to do whatever I can to keep it contained.
Of course this will delay my completing the course by a week, as well as my returning to work by a week.
In the big picture I am quite lucky to have gotten this far without delays, and this is really a rather small thing overall. I am just getting impatient to finish and move on to the next phase.
Well, I can manage one more week.