Thursday April 1

Numbers





wbc 4.7 range 6-17


mid 0.5 range .1- 1.1


Gran 3.4 range 1-8.5


rbc 3.09 range 3.1- 4.5


hgb 7.8 range 10.5 -13.5


plt 6 range 300-750





Last Thursday Riley received one unit of red and one platelet. He needs platelets again. Red is marginal. We could push it until next week or get another unit. Every unit gets us closer to that horrible moment when Riley's body starts rejecting transfusions. These are not bad numbers for Riley. I just remember how freaked out the ER was to see these kind of numbers and they are in the business of seeing bad numbers.





The reference range keeps changing on us. I think it is to keep us from being freaked out ourselves. Riley has been invited to a special summer camp. It is put on by the American cancer society. Nurses and a doctor from Doernbecher attend and are on hand with meds. He can take his brother with him. The problem is its the week before we are to leave for NY. That is a lot to do.



The doctor is still encouraging. He said at worst Riley could take a transfusion right before we leave on our trip so his body is stoked up. Hopefully though, that will not be necessary.



We are really encouraged about the wbc. The doctor adjusted the blood booster shot to every other day. I only wish the platelets and reds would hold consistently also. It is just amazing how researchers have been able to target that exact cell growth so successfully. If they could do it for the other two segments as well life would be smooth sailing. The Gran going up is encouraging. It represents the percentage of new cell production.



The doctor worked on getting Riley involved in our conversation. He wants to make sure Riley is proactive with his treatment. Riley needs to be responsible for his meds and his own future.

Riley sits curled up in the recliner in our cubicle while the doctor visits. His knees are up to his chest. He listens and responds, but you can tell he would rather not listen too closely. He doesn't want to hear anything negative. Its all good, so he uncurls. The doctor has him move to the examination bed so he can check his stomach. He looks for enlarged organs, but all is well. Riley giggles as the doctor presses on his abdomen area. Riley is very ticklish.



Jen is visiting. She asks, with Riley's improving white blood cells, can people who might be sick or getting over being sick, be around Riley. The answer is no. Riley may be improving, but his numbers are no where near normal, and we must remember that. Before the platelets, Riley received an antibiotic drip that will protect him for a month from pneumonia . Next month if his numbers are still better, they will switch to another kind of antibiotic. This stuff is pretty potent and hard on the organs.



Tom had a list of questions for me to ask. He had to work. The doctor missed him at our visit. I think he appreciated the knowledgeable conversation and questions that Tom would put to him. The first question was would another bone marrow aspiration (biopsy) show anything definitively. Not for a year was the answer. I think Tom would have Riley poked every month so he could chart it just like running a trial on his machines at work.



I also ask for a clarification. The numbers in May, will they stay there or continue to go up? Tom thought they might settle. The doctor tells me the numbers will continue to go up even after May. May was the time to discuss whether we do this treatment again, hold off and wait some more, or go looking for that donor and begin the marrow transplant process. Riley is disinclined to do marrow. Patience is my mantra. The problem is those red cell transfusions, he can only take so many. He has to get beyond red transfusions or else. The doctor also says to tell Tom to put off that discussion until the end of May, not the beginning as originally discussed. There is no rushing the numbers.



The Doctor had said 1 to 3 months minimum to see signs of improvement. That was just to see signs not the improvement finale. It all comes back to how many and how often Riley gets red transfusions. He had two units of red the last weekend in February, in one transfusion, before we were discharged from the hospital. He has had two other transfusions since then, single units each, both last week; the ER and at clinic on last Thursday. I would say once a month, but Riley's numbers at 7.8 rbc indicate that he may need another transfusion next week. I would have hoped it would last longer. Red blood cells are supposed to last 100 days in a normal person. Figure a half life on the transfusion, since the blood received is already aged a little. So, 30 to 50 days doesn't seem unreasonable.



I called the Red cross about donating blood. Monday, the high school in Canby is doing a blood drive. I am going to donate in the morning. Have a big breakfast then go in. I was warned it may not be the peaceful quiet you may find at other locations, but the convenience is worth it. Tom said they get a blood mobile at work several times a year.



I asked about donating platelets. I was told it had been so long since I donated blood, pre children, that they needed to check my whole blood to see if I made a good candidate. They look for people with high platelet counts to donate platelets. So, I am to tell them to check out my platelets when I donate, to see if I am a good candidate.



I tell Tom this. His theory is that since I am so accident prone I am probably a great candidate. My body must produce a lot of excess platelets to compensate for my clumsiness, where as he has not had a paper cut in years. He might have a very low count himself due to lack of need. We shall see come Monday. I am looking forward to donating blood for once.