Monday, November 28, 2011

After Round 2 -- Rising to His Feet Again

Today marks ten days post chemo-therapy for Steve. He has experienced a relatively good recovery after the second dose of chemo last Friday. He has found out that the worst days for him, when the side-effects are the most difficult, are on days 5 and 6 post chemo. For some reason, it is on those two days he feels the weakest.

Yesterday was day 9 post chemo and Steve began to feel as if his energy level was beginning to increase once again. He tells me that on his lowest days he feels as if he just wants to lay around and feels as if he could sleep all day. Although he may feel that way, Steve has done anything but that. Except for taking the day of chemo off of work, he has worked every day since then. Having the chemo on Fridays seems to work well for Steve. He takes the Friday off for the chemo, then gets his fluids and hydration the following Sunday. He also begins to receive the Neupogen injections to help raise his white blood cell count.

Steve's white blood cell count was 3.3 on the day he received his chemotherapy. He received two Neupogen injections following the chemo; one on Sunday and another on Tuesday. He got a CVC on Wednesday and it was noted that his white blood count rose to 18.3. That level was way beyond the normal range of 4.5-10. The nurse that saw Steve on Wednesday decided that Steve should receive another dose of Neupogen on Thursday (Thanksgiving) as planned. She felt that the level may have been high simply because he received a Neupogen shot the day prior. She said it wouldn't hurt him to get another shot.

As Steve's medical advocate and deeply devoted wife, I have to question decisions that could affect Steve's health. There have been many occasions where my advocacy and questioning have changed the course of Steve's treatment or brought things to the surface that may have been overlooked, had I kept silent. The decision to give Steve an additional Neupogen injection when his white blood cell count was outside of normal range, even outside of an elevated range (13-14) just didn't sit well with me. So I took matters into my own hands and texted Dr. Liao on Wednesday evening. I really didn't want to disturb him on the eve of Thanksgiving, but I just couldn't see Steve's count continue to rise beyond where it was.

I was so thankful when I saw Dr. Liao return my text message within a couple minutes of me sending mine. I gave him the background, told him Steve's levels, and asked for his advice. His reply confirmed my suspicions. He advised us to hold off on Thursday's Neupogen dose and come in on Saturday to receive another lower dose to help maintain his levels. I really didn't want to step on the toes of the Nurse Practitioner, but I needed to be sure that Dr. Liao would have advised us as she did. In the end, I am glad I took the initiative to contact our doctor.

Neupogen is a fascinating drug. It is made using the bacteria e-Coli. Just thinking of that makes you a little cautious. Too much of it can be fatal, causing the spleen to rupture or giving one acute respiratory distress syndrome (ARDS). Too little of it can lower one's white blood cell count making the patient more susceptible to infection and illness, which also can lead to hospitalization and even death. Even the drug manufacturer said that it is important to discontinue use when one's blood count is outside of the therapeutic range.

Today Steve got his counts taken again and he was within a normal range -- 6.3. He is scheduled for another injection on Wednesday just to be sure his counts do not slip below 4. We are finding that managing his white blood cell count is a big part of his recovery.

We had a lot of family at our house over Thanksgiving. Everyone pitched in to help us cook, clean, and tend to the house. We were so grateful for the expressions of love that were evident everywhere we looked. It can be difficult to lower your pride, humble yourself and allow folks to help you in your hour of need, but I must say, it is such a welcome relief! In addition to all of the practical support from my family this weekend, we have been continuing to receive ongoing support from people at my workplace, our family, and friends. Meals, gifts, and random acts of kindness continue to bless us each and everyday. It would be so easy to say we are doing fine and don't need anything, but that is not the truth. Each act of kindness and generosity are received with humility, gratefulness, and love. As difficult as it is to admit we are in need; we will not turn away the many blessings that come from people who love us and are standing with us in this battle. We are so grateful for every act of love offered to Steve and I during this time: each prayer offered, word of encouragement spoken, every card or email sent, every meal made, the flowers and gifts. Each and every act of kindness means more to us than you would ever imagine. Thank you, thank you, thank you!

Steve's next round of chemo is scheduled for next Friday, December 9th. Please continue to pray for his strength to continue to increase, his blood counts to be in a normal range, and his cancer to be fully cured!

1 Timothy 1:17 Now to the King eternal, immortal, invisible, the only God, be honor and glory for ever and ever. Amen!

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