Last Wednesday I did my weekly blood draw at the lab. Usually I get the results back the next morning or afternoon at the latest. This time it took until Monday to come back. I knew something must be up, and my suspicions came true when the Oncology nurse called me to give me the results. My WBC fell back down to 1.0 from 12.0 the previous week. Normal range is 4.0 to 11.0 and to do chemotherapy I have to keep it 4.0 or higher. The other number that is important to look at in the lab report is the Absolute Neutrophil Count or ANC. A neutrophil is a specific type of white blood cell that is responsible for fighting off infections and the higher your ANC count is the better chance you have of not getting the secondary infections common to patients undergoing chemo. My Oncologist has wanted my ANC to be 1.5 or higher in order to be high enough to be able to withstand the harsh toxicity of chemotherapy. My ANC value on Monday was 0.1 meaning I had less than 100 of these cells in my blood when you are supposed to have 1500 or more. The nurse on the phone knew how frustrated I would feel and I could tell that she was trying to muster as much encouragement as possible with her voice. She told me to continue to take my Neupogen shots that I have to give myself daily in my stomach. This helps to boost my WBC levels including the ANC. I told her I would continue taking the shot even though it’s one of the most uncomfortable things I have to do. I was stunned and still in shock mode as I said goodbye and hung up the phone. Just (expletive) great! I had hoped that I would be able to keep going with chemo this week because it is the only treatment that has brought results and relief from the pain. I knew I would have to share the news with Eric and my family, but I really didn't want to. It really sucks having to call them and give them bad news. Lately I have been calling with bad news more often than with good news. So that was Monday's events- not the quick, painless events I had hoped for.
Tuesday brought more challenges. As you are probably aware I have had a rather large tumor growing out of my left thigh. I have named it Billy to keep things light and humorous. While Billy continues to shrink from the chemotherapy treatments I noticed that there was additional swelling, redness, and pain not with Billy, but just to the left a few centimeters. I quickly realized that the tegaderm I had been using to cover and seal in any leakage was beginning to cause in grown hairs. I began to worry that the now infected ingrown hairs were not only infected, but infected with MRSA. I have had MRSA a handful of times and these spots started to look and feel exactly like the MRSA spots I had dealt with in the past. I knew what would be required to get rid this- a trip to the ER, possible debriding, and IV antibiotics. The only positive I imagined would be the dose of IV pain killers. Fun for a short while, but the relief would only be temporary. I knew it would only be a matter of time- minutes and hours, not days or weeks; until I was back in the Emergency Room and dreading what would come next.
I was able to manage the pain for a day and a half until finally it became unbearable. I had not had the typical fever associated with MRSA infection like I had during previous bouts with the infection. Until now. Drs have told me at 100.3 that I must go to ER and by 100.4 I had better be at the ER. I had taken my temperature during the night and had spiked to 100.9. I took some aspirin to break the fever, drank a glass of water and went back to sleep knowing that when I woke up next I would immediately have to get ready and go.
When I awoke to the sun shining through the slightly opened blinds it was all I could do to keep from pulling the blankets back over my head and hiding from the world. As easy as that would be, I knew that I had to get up and get moving. Morning person I am not, but bed head and all, I did exactly that. Actually my stomach needed my immediate attention, but I promised everyone that I was headed in the direction of the hospital. I wasn't going to sit in the ER hungry so I forced Eric into getting lunch. He chose Chipotle against the other close fast food joints we like to frequent around Mission Valley. His choice was just fine with me because of my ever-growing addiction to good, authentic Mexican food. I can honestly say that I have never met a burrito that I didn't like. After eating until we were both stuffed, we made our way over to UCSD ER and spent the next two hours in the waiting room. I will spare you the details of my visit, but nine hours later I was released. The Drs said that I could be released only if I went home and hooked myself up to the IV Vancomycin 3 times a day until the infection healed. I had hoped that this would be the case, but honestly didn't expect it because usually they find something obscure that doesn't look right or is a little off that requires me to be admitted into the main hospital. Another positive was that I had all of this medicine at home that was going to expire if I didn't use it. Being able to use it up and regain precious refrigerator space was in my mind a win-win.
So I have been doing the IV Vancomycin like instructed. Honestly, as much as it is a burden having to hook myself up three times a day for two hours each time, the antibiotic really does well against the MRSA infection. In only two days since going to the ER, my thigh is doing much better. I was feeling less pain, less swelling, less redness and no fevers to report. Hallelujah! I was going to follow up with the Home Healthcare Nurse through my UCSD chart online, but my unread lab results stole my attention. And when I finished looking over the results I felt so discouraged because my values were high enough to do chemo had I not had MRSA. The values were not anything to write home about, but the WBC and ANC levels were both within the normal range. This was terribly upsetting because I had wanted to have chemo because of how it helps the KS, but MRSA got in the way of my plans. Now I have to wait another week as the pain returns and my legs begin to swell again. At least there is some small consolation- this weekend is a three day weekend because of the Memorial Day holiday. I plan on honoring the brave men and women who fight to protect our liberties and our freedoms as American citizens. Enjoy the long weekend friends and be well.
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