Counts Still Low

Dreary day and a dreary visit. The ride up to Guilford was a tough one today - it was pouring and visibility was awful. I was so glad we made it there in one piece!!

As I wrote last week, Catherine's counts were low, particularly her ANC which was 350 and her hemglobin which was 9.8. On this portion of the protocol, if Catherine's ANC is below 500 she is taken off the 6-MP and Methotrexate that I give her at home for one week. I have to admit it was so nice not to worry about taking the meds, and within a couple of days off them, the old Catherine emerged. Her energy level was probably about 90% where it was pre-diagnosis, she didn't throw up once and she didn't complian about being tired or her stomach hurting. Obviously Dave and I had underestimated the power of the drugs we give her at home. With the old Catherine next to me, I truly expected her counts to be back up. I was stunned when Dr. MJ showed me the sheet - nothing had changed (her platelet count went up slightly and her hemoglobin actually went down some more!) On the plus side her reticulocyte count was much higher than last week (a reticulocyte is a young red blood cell. The number of reticulocytes in blood rises when red cell production is unusually vigorous, as after a major bleeding episode or after the bone marrow has been suppressed and is regenerating.)

With her counts down, she must still stay off the 6-MP and methotrexate and now also come off the antibiotic Bactrim that I give her three times a week. Bactrim is given during the entire two years to prevent Pneumocystis carinii pneumonia which is common in people with weakened immune systems. Hopefully this should help Catherine's bone marrow recover. If her counts are still low next Friday, the doctors will perform a bone marrow aspirate just to ensure that the leukemia is not returning. Dr. MJ reminded me that chemotherapy is cumulative in the system and low counts two weeks in a row are very common. As usual, I have been told not to worry (easier said than done!). She also said that they may have to start tweaking the dose of her meds.

Again, Catherine's spirits are great. I never cease to be amazed by her strength and the resilience of all the children I have met at the doctors' office. We should all take a page from their book.

Will let you know how we do.