We hit the clinic today, with the anticipation that they would discontinue Hannah's Neupogen shots and that we would be clinic free until chemo next Thursday. When the doctor arrived, she said Hannah's counts made a "big jump" from last week-unfortunately they were all down, way down. I was so surprised and not expecting it at all, considering that last week the doctor said her counts were on their way up, shots went to every other day and all looked good. Here are her counts:
WBC white cells- .666 (should be 5-13)
ANC- 211 (should be 1500-8000, under 500 is severely neutropenic)
RBC red cells- 2.75 (should be 3.9-5.3)
HgB hemoglobin-8.36 (should be 11.5-16, transfuse RBC under 8)
Platelets-11 (should be 140-400) dangerously low
I did notice today on the way into clinic that Hannah's teeth were bleeding, but she was eating an apple so I didn't think too much about it. I also noticed the large bruise on her leg from the shot last night, bigger than usual. Both of these are warning signs for low platelets-they are the part of the red blood cells that clot your blood. But, when she got her finger stick today, he had to work to get the blood out, so I thought the platelets were most likely fine. WRONG.
Just when you think you you have a handle on how her body reacts to chemo, things change. I can't seem to predict this at all any more. We were not prepared mentally to stay today. Hannah had to be accessed, and she was not happy about that. And, not being prepared we didn't have Hannah's new beach glass necklace (which we absolutely loved Behr family.) It will definitely be with us next time. At least the platelet transfusion only takes 1 hour (from the time they start it, you have to wait for them to be ordered, delivered and prepared). A blood transfusion takes much longer, 3-4 hours-we would probably still be there.
So what does this mean for her treatment next week? We don't know yet. We have to go back to clinic on Monday to get her counts rechecked. Hannah will also stay home from school tomorrow-her counts are just too low to be around other kids and she will probably be too tired anyway. Here are a few pictures from clinic today that we wanted to share with you. Hannah's typical day.
Our first stop at clinic is with Rob. Rob does all the finger sticks and it's the first stop for all kids coming to clinic. This is the small amount of blood they take to check her counts. It takes about 30 minutes or so to get the counts back. Rob is a favorite with Hannah. p.s. notice the Boston hat.
Next we go over to the next room for blood pressure, weight and temperature. This is the easy part of the visit.
Then we are back over to the first room to get accessed. Hannah insisted no pictures during accessing, and since she always sits on my lap for that with me holding her hands, that would have been impossible anyway. Here is Hannah getting her blood pressure and temperature taken at the start of her platelet infusion.
Then we will skip right over to deaccessing.
Here is Hannah flushing her port herself. Doesn't she look proud here?
And lastly, Hannah with her favorite nurse Antoinella. Hannah decided today that she would no longer be mad at the nurse who accessed her, but instead she would be mad at the doctor who ordered it! Yes, she came up with that one all by herself.