Given that little episode, I was pretty surprised when I received a card in the mail a couple of weeks later, thanking me for my donation, and giving my specimen an A+. I swelled with pride. Good job, me. Until I realized that the A+ was my blood type, and not a grade.
Since that day, I've probably had to have blood drawn for testing over 100 times. If ever I was squeamish at all, I got over it long ago. Most of you probably don't know this, but every time they draw blood they ask you if you have any history of problems with blood draws...I lie every time.
So while I've only ever given blood one time, I've been the recipient of it on numerous occasions. First, in the hospital when I was diagnosed with CML and undergoing leukapherisis (I think that the process pulled out too much of the "good cells" along with the bad.) Now, once again, over Memorial Weekend they topped off my blood supply.
Pretty sure that my doctor hates me. Why else would he send me to the emergency room over the Memorial Day weekend? Oh, yeah, hemoglobin 7.1, and the feeling that my chest was caving in - that's probably why. My appointment on the Friday before the holiday weekend left much to be desired, as my red blood cell count fell again. Platelets and white blood cells held at pretty much the same marginally crappy levels from the week before, but the hemoglobin keeps going down down. Hemoglobin at 7.1 is pretty darn low. Most people get a blood transfusion at 8.0, but I seem to feel well enough at 8. Below 8.0 is considered severely anemic, and below 6.5 is considered life threatening. So at 7.1 I was flirting with disaster. To be fair, my doctor did try to send me to the hospital to get "typed and crossed" that afternoon, but considering that it was 3pm on the Friday preceding the holiday weekend, everyone at the transfusion center had left for the day. As my hemoglobin level seemed to be falling .2-.5 weekly, my oncologist did not want for me to have to wait until the following Tuesday to get a transfusion, so he told me to go to the Emergency Room over the weekend.
I tried to get out of it. Told Keith that I was feeling fine. But when you're panting for breath after folding a load of laundry, that "I'm fine" line is a tough one to sell.
I completely expected that the Emergency Room would be expecting me. Thought that my doctor would have made some kind of arrangement to get me in and out fast. Thought wrong.
When we got there on Saturday, they were mercifully not busy. There were only a couple of people waiting, and by the time I had signed in and used the restroom, they were calling me back. I waited in a triage room for about half an hour, when a Doctor finally came over to interview me. I gave him the spiel. "I have leukemia. My hemoglobin was at 7.1 as of the 20th, and instead of waiting until Tuesday to come in for a transfusion, my oncologist told me to come to the emergency room." Yeah, I don't think that he was listening. Or else he didn't believe me. I look pale, but otherwise remarkably healthy for a cancer patient with severe anemia, so he ordered a chest x-ray, an ekg, and a blood test. I submitted, with a little irritation, fully aware that this little trip was most likely going to take all day.
And it did. After jumping through most of his hoops - I refused to pee in his cup, but I submitted to everything else -finally my blood test comes back, and the doctor comes up to me, honestly looking a little alarmed, and says that they are going to give me a unit of blood. My hemoglobin level is at 6.8. Super. Make that two and I'll be out of your hair.
He refuses two. Really? Depending on height and weight, one unit of blood will generally raise your hemoglobin about 1 full point. So at 6.8, one unit is only going to get me to 7.8. Considering that I've been trending down as much as .5 weekly, that will mean that I'll be right back around where I started in a little over a week. And I definitely did not give up my Saturday to be right back in the hospital again in a week.
So they give me a bed, and they give me a gown (if you're in a bed you've got to wear a gown) and a nice nurse named Jordan puts in an IV, and I wait for my blood. Did you know that it takes anywhere from 2-4 hours for each unit of blood transfused? Me neither. The last time I went through this, getting blood was the least traumatic of everything that was happening to me, so I wasn't really watching the clock. They hook me up, and everything goes well. No reactions. And the pressure on my chest begins to lighten, and my color begins to return. (I've been looking a little ghostly.)
As the last bits of the bag are pumped into me the doctor comes over and asks how I'm feeling. "Better," I say. "It would be nice, if you could give me another unit, though. I understand if you guys are busy, and you need the bed, but I feel like if I don't get two, I'll be right back in this position next week. My doctor did want me to have two." He gives in. So that'll be another couple hours I don't want to spend there, but I'm considering it the lesser of two evils. Better another two hours in the emergency room,than another whole day.
They start the next bag at about 7pm. We've been there since around noon. Since I didn't have any complications, they were able to transfuse me quickly, and it only took about 2 hours for each unit. When I'm done, they unhook me, flush my line, and pull my IV. Dismissed. Literally. No escort to the door, no spotter to make sure that I can walk. That is literally that.
As we walk to the car, I notice that all of my chest pressure is gone. I check myself in the side mirror, and my lips are actually pink. While the thought of getting someone else's blood pumped into you is pretty gross, the reality of it is a blessing.
So the past week I've been amazed at how much better I feel. I can actually breathe deep breaths and my heart doesn't race when I walk out and get in my car in the mornings. I even took a hike. A very slow, out of shape, heart pumping hike - but it feels good to be able to exercise a little bit again.
Given how much better I've been feeling, I was a little shocked that my numbers this week were so bad. Or "sucky" as my doctor called them. After an entire 12 hours at the emergency room, and two units of blood, my hemoglobin this week is at 8.3. We were both hoping for something better. Even worse, my platelets have plummeted to 22, and my ANC has hit an all time low at 699. If it's not one damn thing, it's another damn thing.
The choices are pretty limited at this point. Choice one are stimulating drugs like procrit for the low red blood cells and neupogen or neulasta if my whites get too low. There are some pretty scary risks associated with accepting these drugs, so understandably, I'd like to keep my use of them to an absolute minimum, if at all possible. Choice two are transfusions. There are also risks associated with red blood cell and platelet transfusions, like allergic reaction, or contracting something from the blood product that you've been transfused with, ranging all the way from the big scary HIV or hepatitis, to a less scary virus. And choice three, stopping Sprycel for a period of time to allow my counts to regulate/come back up. The biggest issue with this one, is that while my healthy cells will hopefully rebound, so will the leukemic cells, and the cancerous cells may once again multiply unchecked. Like my blood counts, my choices are pretty sucky.
Doctors plan of action for this upcoming week has been to change my appointment to Tuesday, instead of Friday in case I need another transfusion. That way, one can be arranged before the weekend. Personal plan of action for this week - soldier on.
Oh joy.
"Down, down, down. Would the fall never come to an end!" - Alice's Adventures in Wonderland, Lewis Carroll
No comments:
Post a Comment