I Want My Chemo!

It is already January 10th, and I have yet to write a piece for this blog in 2011. That is partly because there is not a lot to report.  Last week was, after all, the third week in my three-week chemo cycle, and except for some relatively minor issues, I have been feeling remarkably well.  My energy level has been good, and I worked three solid days last week – one of them was even a seven-hour day, and when I got home I wasn’t exhausted.  As a matter of fact, I am a little puzzled, although not ungrateful, about why I am not more tired.  Everything I’ve read has talked about the major fatigue chemo patients face. Not me, or at least not yet.

So, with the third round of chemo under my belt and a three-week interval, I started preparations this weekend for round 4.  I attempted to drink 64 ounces of water each day, although that is challenging for me to do in the best of times, but more so in the winter.  I also sought out foods with more fiber, to help offset one of the more common side effects of chemo. Last night I prepared my bag of items to take along for the 7 hours or so I would be at the hospital, and Lydia gathered an array of snacks to keep us both satisfied.

My lab work was scheduled for 9:45, which is a couple of hours later than it has been.  It was nice to have a more leisurely morning of it; getting up later, taking time over breakfast, checking e-mails and doing some other things on the computer before leaving at 9:20.  The only downside to the later start was that it meant getting out of the hospital in the very late afternoon and dealing with rush hour traffic.

The 7th floor of the cancer center was a hive of activity. There seemed to be more people there than usual, though perhaps it seemed that way only because I am often in with the doctor or having treatment by that time of the morning, and I don’t usually see the later morning crowds amassing.  First up, as always, was my lab work. The nurse made quick work of drawing blood, and then she left my port accessible for the chemotherapy later on.  I moved across the way to the doctor’s area, which was exceptionally crowded.  They were so busy that medical assistants were calling patients into the examination area to take vital signs and then sending them back out to the waiting area until a room was available.  Uncharacteristically, I was called in at 11:15, nearly an hour after my scheduled time.  After having my weight (up a pound or two) blood pressure (wonderfully low at 108/74 despite my use of salt), pulse, oxygen level and temperature taken and recorded in the computer system, I waited in the wings for a room.  My chemo was supposed to start at 11:30, so I knew that even if I had only a short visit with the doctor, we were doomed to a later treatment start and finish than anticipated.  They were so busy that I also expected a long delay in the treatment center while waiting for the pharmacy to process all the orders for treatments.

Finally a room opened up and I expected that I would see the very punctual doctor almost immediately.  Not so, this time.  We waited and waited and had a snack of almonds and then a banana to stave off hunger -- it was nearly lunchtime.  Finally, a knock on the door, and in came the doctor.  Only it wasn’t my doctor.  It was a fellow, who introduced himself and said he was working with my doctor.  Now this is a teaching hospital, and I am used to all sorts of medical students and residents accompanying my doctor during our visits, but this was the first time that another doctor came along and saw me first.  And he came bearing news I didn’t want to hear:  I couldn’t have chemo today after all.  Not because of delays and overcrowding, but because of my own blood work!  The platelet level in my blood was too low for treatment.  If you are like me and are a little rusty on the role of different elements of your blood, platelets are important because their function is to prevent bleeding.  Normal platelets levels are in the range of 140,000 to 440,000 per microliter of blood.  My reading was 68, or 68,000/mcL.  The threshold for chemotherapy is 75,000/mcL and above.  My reaction to this was an out loud “oh, crap!”  Not because I was scared, because I wasn’t -- they can provide you with more platelets through a transfusion if your numbers get way too low.   My “oh crap” was uttered with a great sense of disappointment because I really truly wanted to have my chemotherapy today in order to stay on schedule and be done with my treatments on February 21st as planned. 

Unfortunately, there was not a thing I could do to change what was, and wanting it wasn’t going to make it happen.  Instead, I was examined by the fellow and then was left in the exam room while he tracked down my doctor and they consulted with the study coordinators to see whether the study protocol was for me to get my weekly infusion of herceptin or to just go home.  In the end, I was given a pass, so we packed up all our bags full of books and puzzles, knitting, a laptop, lunch and snacks and made our way out to the car, then home where we ate our picnic lunch instead of in the treatment center.  Now I am slated to go back in next Monday, and, if my platelet counts are back up above 75, I’ll be good to go for a postponed round 4.  I can’t wait.  Really, I mean it!