Numbers Game

Here is a picture of the whiteboard hanging on the wall at the foot of Sue's bed -- right above David Friesen's miracles poster. They use it to track Sue's blood counts. They also have a chart which is the official record.

The left column shows: WBC - White Blood Count; ANC - Absolute Nuetrophil Count, which is a subcategory of the white blood specifically critical to/responsible for the body's immunity system; HCT - red cell count; and Plat - platelets. They monitor a lot of things here, vitals, urine, stools, how you feel about everything, emotional state, etc etc. -- but these blood counts are the ones the doctors watch most closely.

They administered the Melphalan late on Sunday 8-30 (between 10:30 and 11:30 p.m. The counts on 9-1 were post Melphalan and by that time the bone marrow had basically shut down. On 9-2 they intravenously gave Sue back her blood which had been previously harvested and frozen. That brought her counts back up for a day. The next day (yesterday) the counts were dropping rapidly again. Today the WBC and ANC counts are pushing on toward zero.

ANC is the critical number the docs watch. My source for medical information, Wikipedia, discusses Neutropenia. According to my source,bolstered by a teaching session by Nurse Jennifer, when the ANC drops below 1.5 the patient is mildly neutropenic; When the ANC drops below 1.0 the patient is moderately neutropenic; and when the ANC drops below 0.5, the patient is fully neutropenic and at severe risk of infection. They expect that to happen in the next day or two.

Think of Sue's condition like this. Her white blood cells are in the white blood cell killer roller coaster called BIG MEL. They've been over some of the low easy drops and curves. Now the car carrying the while blood cells is grinding to the top of BIG MEL and it's time to get a little scared because pretty quick its ... going ... to ... droooooop reeeeeealllllllllly faaaaaaasssssst!