July 29, 2009
Blood Counts
As a chemotherapy patient, Portland Firefly has her blood drawn and her blood counts checked at least once every week. This is in addition to the Chemotherapy that she receives. The entire blood drawing process is made much more tolerable by the use of the portacath that she had surgically inserted the end of March. This saves my veins because the blood is drawn through the portacath which is buried inside my chest.
Chemotherapy kills cancer cells by breaking the DNA chain so the Cancer cells cannot grow and multiply. Cancer cells are rapidly dividing cells and the chemo drugs attack all rapidly dividing cells in my body. This includes not only the unwanted cancer cells, but also hair cells (that is why I lost my hair), and the bone marrow cells that manufacture my blood. The attack on my bone marrow is the reason for the weekly blood counts.
Up until now, with one exception, my weekly blood counts have been acceptable. Two days prior to my major surgery, my white blood counts were a little low and so I was given a very expensive injection of Neupogen to hasten he production of white cells prior to surgery. That one injecton cost about $2,000.00. Neupogen is a fast acting drug that increases the white blood count within a matter of a few days. The white blood cells protect the patient against infection and since my surgery had the potential to “lay me open from stem to stern”, my Doctor wanted to have me in the best possible infection fighting shape for this major surgery.
I thought that the $2,000 injection was expensive until last Friday. My Chemo was on Thursday and as the chemo Nurse disconnected my portacath from the chemo tree holding my chemo drugs, she mater of factually stated ” We’ll see you tomorrow afternoon for your shot.” I looked questioningly at her and asked “What shot? Why do I need a shot?” She explained that my blood counts were low and since I have a few weeks reprise before my next chemo that they want to give me a long lasting injection to raise my white blood levels since they are a little low today.
So I went home on Thursday and returned 24 hours later on Friday for the injection which I thought would be the same one I received just prior to my surgery. Wrong! This is quite a different injection. The Neupogen (given a few days prior to surgery) was an injection given rather quickly into my arm muscle. And it cost only $2,000.00. It was a short acting drug designed to rapidly raise my white blood count prior to surgery and it did with minimal side effects.
The injection I was given 24 hours after my chemo is called Neulastin and it is designed to work over the period of 11 to 14 days to raise my white blood counts. It is a lot more expensive, running around $7,000.00. Yes, that is for just one injection! And it is not given into the muscle. It is given slowly into the abdomen. And the side effects are much more intense. Just three days after the shot, I am terribly fatigued, and my bones are hurting. I also have a constant dull headache and shoulder-ache. My neck and upper back hurt occasionally and when I get up the pain in my pelvis is palpable. Every so often, I will experience pain in ony one of my bones –I just never know which one! Yes I am taking something to relieve the side effects, but they are still there. This is just one more thing to endure for a longer life expectancy. And though I am experiencing some discomfort at this time, I am really not complaining. It is more a matter of explaining for others what to expect if they need to go through this.
I forgot to explain the reson for the bone pain I am experiencing. Blood is manufactured in the bone marrow. The marrow is inside the bones and the drug Neulastin stimulates the production of blood producing - bone marrow cells. This rapid cell production is what causes the spurts of shooting pain particularly in the larger bones where more marrow is produced. Time for another Advil!
Following is what the white and red blood cells do in our bodies:
