Low Blood

I know I shouldn't be but I am.  Surprised, that is, by how quickly things can change.  I really should know better by now.


Yesterday, after several up and down days of feeling puny and struggling with nausea and vomiting, Phil woke up from a great night of sleep and felt like he had turned a corner.  He walked out of the bedroom smiling and was able to advance his diet from ice chips to tea, broth, and frozen yogurt all in the span of an afternoon.  For the first time in days his temp was stone cold normal and he had what resembled energy.  He helped me put in some laundry, did a bit of homework with the kids and even got Olivia's bike out of a predicament in the garage.  May not sound like much but for us this is a cause celebre.


He was well enough in fact that it felt safe for me to take Bennett to baseball practice for an hour or so and leave him by himself.  Once I got home however, the surprise factor showed up.  It was now after 7 p.m. and he hadn't eaten anything yet and had no appetite.  His stomach wasn't quite right either.  I took his temperature and low and behold, 101.5!  A call to our faithful Dr. Kossman bought us a fast track ticket to the ER.


At this point in Phil's chemo cycle he is on day 10, right at bottom out time.  The counts should be down at their lowest and he should be circling the drain so to speak.  A drastically low WBC count is just what Kossman had been trying to avoid with the Neulasta - the WBC booster he gave Phil just prior to discharge at the end of chemo.  The hope was that it would boost his production and help maintain some immune function.  However, once again Phil's system has responded to the chemotherapy perfectly - unfortunately.  


He is now pancytopenic ~ low across the board in terms of blood cell lines.  He is dangerously low on platelets, RBCs, and WBCs and because of the fever he is presumed septic (infected in his bloodstream) until proven otherwise.  His blood sugar is also very high secondary to the infectious process and needs to be in tight control lest the mucor take off again.  By now you won't be surprised either to hear that he was admitted for lots of supportive care.  Fortunately for him, he is in no pain and doesn't feel sick.  He just wants to sleep in his own bed.


As of last night when I finally left his room on 3 South he had received 2 antibiotics to cover him for infection, Neulasta for WBC production and was being prepped to receive platelets overnight.  This morning he will be transfused with 3 units of RBCs, take his Ambisome antifungal, continue the antibiotics and will be awaiting the preliminary results of blood cultures taken in the ER.  An MRI of the brain will likely happen in the next day or so.


Leaving Phil's room to go home last night was hard for me.  As always I felt torn between staying to support him, getting enough sleep to take care of myself, and being available to the kids today (the 100th day of school celebration and their Valentine's parties).  Phil saw the tears in my eyes and told me to go.  I know he would have liked me to stay but after all we've been through with this cancer he knows 1) the kids need their Mom 2) if I don't take care of myself then nobody will and 3) there is unfortunately, more of this to come.  Telling me to go home was a gift from my Iron Man.  My love for him grew last night and made us and our family stronger for dealing with this F-ing disease.