Blood Products

For several days I’ve been lucky to be one of the uninteresting patients on the HEMONC unit, all my blood counts have been either stable or trending upwards and many of my symptoms / chemo side-effects have been clearing up. It’s been in every way a good thing but on some level it’s a little more frustrating being here when you feel like you’re getting closer the healthy. I’ve found having to simply wait through the days without any new medical developments (as fantastic as it may be) can actually be pretty difficult. When things change or go wrong it gives me something to fixate on – I can obsess over whatever short-term obstacle is in front of me. I didn’t realize just how much of a welcome distraction the changing nature of the disease was until it cut it out for a few days.

One must be careful what they wish for – my Leukemia must’ve been listening because in the last few hours I became ‘interesting’ again. Ever since I came in the ER they’ve watched my blood counts very closely, the reason the Leukemia made me so sick to begin with was my bone marrow was so preoccupied producing lymphoblasts (cancer cells, very immature white blood cells) that it basically stopped producing everything else I needed to stay alive – red blood cells, healthy white blood cells, platelets, etc… The doctors liked to explain that I had “a fourth of the amount of blood one would expect to find” along with so few platelets that it was a miracle my body hadn’t begun spontaneously bleeding internally.

Needless to say one of the first things they did was begin to give me transfusions of blood products, all the things that my bone marrow was no longer able to produce on it’s own. It’s a strange thing to understand that your body has simply given up on doing what it needs to in order to stay alive. Even stranger that the only way I was going to get any blood back in my body was to siphon it from someone else, repeatedly. Thanks to all of you who regularly give blood, I’ve been in a unique position to appreciate your contribution lately.

One of the stranger things to get my head around once my chemotherapy started was the fact that it’s essentially designed to kill my bone marrow. Granted my marrow isn’t exactly doing what it’s told but killing it seemed harsh – I mean damn, I need that, right? The chemo has no way of differentiating between whatever tiny bit of productive marrow I have and the vast majority of the rest which is killing me, the hope is that during the course of treatment the healthy parts can begin to take hold while the chemo effectively kills everything that’s busy producing lymphoblasts.

For almost a week now I’ve not received any transfusions of blood products (with one notable exception which was chalked up to a faulty blood draw), something I’ve decided to take as good evidence that at least something productive is happening with the good marrow I do have laying around. My blood is taken three times a day and processed in the lab so any change in my counts can be immediately corrected. Even though my numbers may be trending upward for a HEMONC patient, I’m still so incredibly close to rock bottom that any change is a big deal and needs to be dealt with. Easy to forget when you’re having good days.

This evening my usual midnight blood draw showed a sudden drop in my hematocrit – a measure of the amount of red blood in my system. Just another reminder that my marrow is simply not clear on the subject yet – I freaking need red blood cells dude. Well the midnight draw is usually processed by 2:00 am, so at 2:15 am all the doctors on call want to make sure i’m not bleeding out somewhere (a reasonable explanation for such a large, sudden drop in the amount of red blood in my system). I’ve gotten pretty good at sleeping around the midnight draws but I have yet to sleep through repeated physical exams. So here I am at 5:00 am psyched up waiting for more substitute blood.

For those who’ve never tried going without blood, when you’re really low and receive a sizable transfusion it’s quite the rush, your whole body just seems to wake up all of a sudden and remember it’s supposed to being doing stuff with the blood it didn’t have. I’ll just have to work out some kind of schedule next time so my counts drop before the 3:00 pm blood draw next time because this middle-of-the-night excitement is not something I enjoy yet. It also kind of sucks that my marrow couldn’t maintain though I suppose I should give it credit for the past week – I am going out of my way to kill it with chemo, the fact that it’s still doing anything at all (other than producing cancer cells) is fantastic.

Again – to all of you who donate blood, platelets, plasma and the rest: thanks!


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