Neutropenia
Definition
Neutropenia is an abnormally low level of neutrophils in the blood. Neutrophils are white blood cells (WBCs) produced in the bone marrow that ingest bacteria. Neutropenia is sometimes called agranulocytosis or granulocytopenia because neutrophils make up about 60% of WBCs and have granules inside their cell walls. Neutropenia is a serious disorder because it makes the body vulnerable to bacterial and fungal infections.
Soooooo, here we go. Poppy got up this morning and felt very well. I slept in the spare room again after he was up at 3:00 a.m. The kids were going mad in the sunroom. He said the bird feeder was swinging so something must have been after the fritos and cubed up hot dogs buns I put in it. The only thing I could imagine it could have been would be a raccoon as squirrels don't do that at night. Sooooo, when all the excitement was over and Poppy finally got settled, I vacated our bedroom for some quiet time.
When we arrived at clinic and got the labs back, his nurse started making a lot of calls and we kept hearing his name. When she came back with the news, we were just as surprised as she. He is quite neutropenic. His WBC is at .70 and his platelets at 20 and his hemoglobin at 7.9 and CRP (infection) doubled since yesterday to 47. In case you have forgotten, all these counts are NOT good. He is suppose to drop, but we weren't expecting it until Wednesday or Thursday. He got an infusion of Invanz (antibiotic), a bag of blood, and a bag of platelets. He is in the mask stage. He hates masks... Too bad, Katie...
We came home with an infuser of Cefepime (antibiotics) because the clinic is for certain his fever is going to spike. If it gets to 101 I have to call the myeloma night doctor and they will advise me to connect the infuser to his IV hanging out of his chest. This doesn't freak me out, but I'm just always afraid I will do something like get air in the line, push too fast when cleaning it or cause a bigger infection.
The rule is S.A.S.H -- Saline, Antibiotics, Saline, Heparin... Kinda like riding a motorcycle around curves. Look, Slow, Push, Roll... If you're a biker you will understand. Just keep repeating it. And, don't forget the alcohol pads to clean the tips real good before connecting the infuser, then the saline, then the heparin... I DON'T want to do this!!!! But, I learned it eight years ago and I gotta put my big girl panties on.
Been checking fever every hour and the highest has been 99.8... When he came upstairs to bed it was 99.2. I'm sure it will go up in the middle of the night. Isn't that how it always happens? Even when our kids were little...
We didn't get home from clinic today until 1:00. I made myself busy with fixing a pot of beef stew and picking up huge rain soaked limbs that have fallen from being so dry. Each one has been about 15 ft long and as big around as a 4x4. They sound like a war zone when they hit the ground. God is keeping me occupied because He knows how I want to control Poppy's health. He is showing me who's boss. He laughs at me a lot about my control.
Please pray Poppy continues his good attitude and the way he feels. The transplant sometimes causes depression. He is very concerned about his job right now. He had one of his managers give notice yesterday while he was in the office. Poppy had planned to work much of the week; that's out now. Go figure. We thought he would be able to work a few days before he dropped.
Please pray Poppy continues his good attitude and the way he feels. The transplant sometimes causes depression. He is very concerned about his job right now. He had one of his managers give notice yesterday while he was in the office. Poppy had planned to work much of the week; that's out now. Go figure. We thought he would be able to work a few days before he dropped.
I changed sheets tonight and I am going to bathe the kids tomorrow, BUT I don't plan to even let them out of the sunroom until his counts come back up. We confined all our pets on his first transplant and I'm not going to take any chances. He doesn't like it, BUT....
After our argument about the thermometer the other night and I read him all the precautions from the melphalan, I have been reading him bits and pieces of the Word for the Day definitions. As I read tonight about the fungal infections and bacterial infections he informed me he didn't really want to hear all that depressing stuff. I guess you can only imagine my response.
I let him know he needed to know he had to wear a mask for precautions. I also read him the following: The most common types of infection seen in neutropenic patients (patients with low white blood cell counts) are caused by bacteria normally found on the skin (such as Staphylococcus aureus) or from the gastrointestinal and urinary tract. Fungal infections are also more frequent in patients with neutropenia. The infections may be limited to certain areas of the body (commonly the oral cavity, genital area, and skin) or may spread via the bloodstream to the lungs and other organs in severe, prolonged neutropenia.
I read this to a man that has an appointment with the dentist the second week of November to get a cavity filled. The last of September he had his teeth cleaned and had a new crown put in. All this after I alerted him of the consequences. So, I'm putting that worry on his shoulders now, too.
All-in-all we had an enjoyable day. He sat in the recliner while I did my roaming around inside and outside the house. I made him get up and help me with the kitchen after we had our soup. I think he really didn't want to, but I reminded him that our nurse told us he needed to move around, stretch and do some coughing. Doesn't need to get pneumonia down in his lungs...
He has gotten growth factor shots the last two days and will until he begins recovery. Growth factors stimulate bone marrow to produce blood cells. He will be aching, along with all of the above I have mentioned. He may feel like he has the flu.
Sooooo, you see why I have begun sharing all of this news and side effects (burden) with him. It gives me some relief and helps me to sleep at night knowing he can help me if he notices any of the side effects while I am asleep or if I'm in the spare room. I haven't shared any of this information with him in all these years. I guess I wanted to protect him. I mean, Really... He has enough to worry about just having that word branded in his brain --- Cancer.
I guess 'burden' wasn't a good choice of words. But, then maybe it is. It's the drugs that are a burden. He is a joy. He stays positive, makes jokes, doesn't complain and helps me around the house. I can see he is tiring with the neutropenia. So, I never complain when he doesn't feel up to helping out.
With that...... We are at Day 2 of 17... (maybe a shorter distance since he dropped early). We are still planning our biker trip November 6. Don't worry... We won't be riding the bikes. We are going to wait to the absolute last minute to cancel our reservations, IF we have to.
Thank you for listenting... Whomever you are.
Good Night and Love --- Pepper
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