Terrible Timing

What a crazy summer it has been!  I can’t believe I’m sitting here preparing to start clinicals for the Nursing program in exactly one week!  Yesterday was a pretty exciting day as my books started to arrive and I got my stethoscope!  I’m sure the excitement will wear off after the first week or so but the anticipation is killing me!  The last two weeks have been busy with orientation, CPR certification, drug testing and getting everything in order like paying tuition (ick!), buying books (more ick!), and ordering my uniform.

Other than that most of my summer has been spent working.  As most of you know I have maxed out my student loans so the next year and a half of school I am paying out of pocket.  Translation: SAVE! SAVE! SAVE!  Even though we were unable to go to the Dells this year, Ed and I still managed to do a lot of fun stuff!  We made it to some festivals, fairs and visited the Art Museum.  We went to a day of Packers training camp and walked around Lambeau Field.  We found new trails to blade on and are going to try to make it to Devil’s Lake to do a few hiking trails.  All in all, it was another great summer that went by too quickly!  

One of my goals this summer was to get back into shape and shed the dreaded “prednisone pounds” (as I called them) as well as the weight I gained because I got lazy.  I’m happy to announce that I have lost twelve pounds and a few inches in my waist and hips.  It definitely feels great to set your mind to something and accomplish it!  I’m in the best shape of my life and that feels really great.  It doesn’t hurt that I fit into my favorite pair of jeans again either! 

Since I had been feeling so great, you can imagine my surprise when I went in for my three month check-up and my test results were a bit concerning.  Before I get into the nitty gritty, there are a few terms I wanted to define as I will be referencing them and not everyone who is reading may know exactly what they mean…

Taken from http://www.nhlcyberfamily.org/tests/blood.htm

White Blood Cell Count (WBC) is the count of white blood cells called leukocytes. WBCs defend the body against infection and make up part of the immune system. Like other blood cells they are produced in the bone marrow. The total number of white blood cells has a wide range from 4,000 to 11,000 per cubic millimeter in the average healthy adult.  A low WBC might mean there is a problem with production in the bone marrow, which could be the result of various chronic diseases. It can also be a side effect of various different drugs, particularly chemotherapeutic drugs for cancer treatment. 

Complete Blood Count Differential is a breakdown of the different types of white blood cells and is usually expressed as a percentage of total WBCs.

Neutrophils are WBCs involved in fighting bacterial infections, and they are the most common of all the white blood cells.  With a lifespan of just about 8 hours your body has to produce about 5 billion neutrophils every hour of the day. 

Neutropenia is a drop in the absolute neutrophil count to below 1000 and places the patient at increased risk of infection and is defined as follows:

• Neutropenia in general = ANC < 2000 (slight risk of infection) 
• Mild Neutropenia = ANC > 1000 & < 1500 (minimal risk of infection) 
• Moderate Neutropenia = ANC > 500 & < 1000 (moderate risk of infection) 
• Severe Neutropenia = ANC < 500 (severe risk of infection)

To remind everyone, back in May, I was having issues with my WBC levels, they had dropped to 2,500 so I was put on prednisone to bring them back up.  The medication worked and by the end of May, my levels were up to 5,600.  After my levels stabilized, I was taken off the prednisone (thank goodness!) and was finally starting to feel like my normal self.  I had hoped that it was just a fluke thing and since I had been feeling so great and had so much energy I was excited heading into summer happy and healthy!

Fast forward to last week…  In just about three months, my WBC levels have managed to drop to 1,900 and my absolute neutrophil count is at 700.  I almost fell off my chair when my doctor called because I have been so active without any significant issues.  I’m mean sure I got tired easily but that has been something I have dealt with since my diagnosis.  While my WBC has always been low (I think my normal is around 3, 000 usually), I have never had any issue with my ANC and that is where the concern lies.  Right now, I’m in the “moderate risk” category for infection, meaning that the lower my ANC goes, the less ability my body has to fight off infection (i.e. cold, flu, sinus infection, etc.).  

So what does this all mean?  Good question, I wish I knew.  Right now the plan of attack is to wait another week and rerun the blood work.  Yesterday when I went in for repeat blood work from last week, my levels were lower.  So if on Tuesday, they are still the same or lower, I will then be referred to a hematologist.  In the meantime, I have to take my temperature every morning and if it goes above 100.5 degrees, I have to go the ER.  I have to stay away from people who are sick and wash my hands consistently (as if I wasn’t anal about that already!).  My doctor wants me to also go for weekly blood draws to keep an eye on my levels.  

Strangely, I’m more frustrated and annoyed than concerned at this point.  I have lots of questions that nobody seems to have answers to and it’s really irritating to not know why this is happening.  I have worked really hard to stay active, eat right, get enough sleep, drink water, not drink alcohol (excessively) and this is what happens.  Heck maybe I should go back to the days where I treated my body like shit (excuse my language) – at least then I was “healthy” and not sick all the time.  

Saying that this is the worst possible timing could be the biggest understatement. The fact that in one week I will be in a clinical setting, possibly exposing myself to illness, is my main concern at this point. I just wish it would've happened earlier so I had time to recover. My biggest fear is that this is somehow going to affect my participation in school.  I’m trying to remain optimistic but that thought does creep in the back of my mind.  Oddly, my health isn’t my main concern but rather school and just finishing.  To come this far and have something go wrong at this point would devastate me.  

So I guess I just sit and wait and do a happy dance to try to get those WBCs circulating!  In the meantime, I’ll just take advantage of energy when I have it and rest as much as possible to prepare for the start of the semester on Tuesday.  I will definitely keep you posted and I hope my next entry will be filled with positive news!  As always, thanks for taking the time to read

Till next time…