On the Rebound

Your blogger is feeling MUCH better.  I get quite emotional when I say it, but it feels like I have walked through the valley of the shadow of death.  Luckily my valley was quite steep and relatively short, but it was profound.  I am glad to have that part of my journey behind me.  I am incredibly grateful to the medical staff and support team for getting me through it.  [Pause while I clear some salty water from my eyes.]

Some of the story can be seen in graphs of my blood counts.  Randy Goldberg, the intern who checks me every day, points out that the medical staff relies upon different data than what I showed in my graphs before.  The first graph from before shows my white blood cell count.  Here is a version Brian spiffed up to show the data on a log scale and to add some event annotation.

But the WBC is not what the medical staff follows.  They follow the Adjusted Neutrophil Count, which is the white blood cell count times the percentage of neutrophils.  Apparently there are some types of white blood cells that don’t actually participate in the immune process.  These are the ones that do.

Gone are the log scale and the annotations, but you can probably figure out when I was feeling pretty lousy.  These are the numbers of useful white blood cells per micro liter.  That is 1 millionth of a liter.  You or I normally have 6 or 7 liters of blood in our bodies.  So if 4000 is where I came in at on 10/26, that is 4000 times 1 million for each liter or 4 billion per liter, which totals out to 24 billion Neutrophils for the whole body.  Amazing!

The medical staff does follow the platelet count.  The numbers shown in the following graph are not just my platelets.  When my platelet count got below 30, they infused me with “bags” of platelets.  So the bouncing along the bottom is the result of infusions, not my own system producing more platelets.  Yet.

The net result is that they no longer give me a Lovanox shot each day.  Those were given instead of Coumadin to prevent over-coagulating, which apparently my body does.  And I am told to be careful blowing my nose, to avoid bursting any blood vessels in my nose.  My nose periodically drips, and often there is blood as well.  Apparently part of the process.

Again the numbers are staggering.  The units are K (thousands) per micro-liter.  So if I was at 462 on 10/26, that is 462,000 per micro-liter or 462,000,000,000 per liter.  That totals out to 2,772 billion in a 6-liter body.  Good thing they are pretty small.

I showed the red blood cell count before.  The medical staff relies upon the Hematocrit Percentage instead.  Apparently this is a better measure of the oxygen-carrying capacity of the blood.  The number of red blood cells is staggering.  I came in on 10/26 with a red blood count of 4.14.  The units are m/uL or millions per micro liter.  4.14 million per millionth of a liter means 4.14 X 10¹² per liter or 24.84 X 10¹² in my whole body.  And each red blood cell carries 270 million hemoglobin biomolecules.  I won’t do the math, but the numbers are really large.  Somehow the count is not as important as the overall percentage, so the hematocrit percentage is what they pay attention to.

I was just below the minimum when I arrived, and I have continued downward ever since.

When I finish this post, I am going for a walk!  They said my numbers were high enough yesterday for me to leave the room, so long as I didn’t overdo it and stayed on the floor within the unit.  I watched football games instead, and then it was too late.  So today’s the day!  More on the details of what happened in days 6-12 later.  Today is day 13 (since the stem cell transplant), and things are definitely looking up.  Again, I am incredibly grateful.