Learning about a CBC.
The thing about cancer and the chemotherapy that is used to help rid the patient of the cancer, is that it is hard to measure progress. It’s not like if you have a broken arm, and you set the bone, put it in a cast and wait a few weeks for it to get all better. With chemotherapy, you have to wait until there have been multiple infusions until you can begin to see if it has made a difference. Then and only then, after CT scans and other examinations do they begin to see if the chemo has done more good than harm. For Joanie and I, it made each trip back down to Minneapolis for another round more anxious, not knowing if what they were doing was working or not.
Joanie weathered the first round of chemotherapy well, and she hadn’t started to lose her hair yet. That was a concern of hers, and after every time she took a shower after she had started chemo, she was careful to check the amount of hair that was surrounding the bathtub drain. She knew it was going to happen, she just didn’t know how fast it would start, or how quickly she would lose it all.
As she worried about her hair, she got a call from Cathy Schmitz, a good friend of ours, and Cathy told her that she and Orell wanted to buy her the wig she would surely be needing in a few weeks. When Joanie told me about what Cathy had said, she was overwhelmed. She had been overwhelmed many times by the generosity of her friends, and this time was no exception. She and Cathy made an appointment to seek out a wig she could live with, and get it fitted.
Turns out, it didn’t take long before she would need it, when after her second round, her hair loss accelerated to the point where she went to the person who always did her hair and had what was left cut off. This was a hard thing for her to do, but by doing so she accepted the fact she was going to have to wear a wig, at least for a few months.
Meanwhile, immediately after the first round of chemotherapy, I began to get a crash course in the reading of a Complete Blood Count (CBC). As part of the treatment, Joanie had to have weekly blood draws to monitor the effect of the chemo on her blood, most importantly, the White Blood Cells, Red Blood Cells, platelets and Hemoglobin.
It became my job now to get the figures after each blood draw, which was done in Dr. Bury’s office, and keep an eye on those figures. If you should ever be faced with a situation like this, the Internet is your best resource. All you have to do is search for CBC, and you will get many sites that will give you the information you need to interpret the numbers you will get from the blood work. It is also helpful to ask the doctor for the ranges they use, as there can be slight variances from lab to lab.
In Joanie’s case, I would call Dr. Bury’s office and talk to her nurse, I called her Nurse Nancy, and she would give me the numbers, and inform me if there was anything I should watch for. For each category, there is a range, and when someone is receiving chemotherapy the numbers you get will show a trend in movement of the numbers as more chemo is received.
Briefly, if White Blood Cell count is to low, the patient may be more susceptible to infection, if the Red Blood Cell count is to low, the patient may develop anemia, and fatigue will be a factor and if the platelet count is to low, the patient may bruise or bleed more easily because of the affect on clotting. Those were the basic numbers I paid attention to during the duration of the clinical trial. Joanie never asked me about them, or seemed to care. She seemed determined, once she got past a couple of days of fatigue, in getting back into her job with new energy, regardless of what the numbers were.
Over the six months of the clinical trial, our routine was the same. Drive to St. Paul, stay with Ginny and Ed, meet with Dr. Carson the next day, and spend six hours or so at the infusion center at the Masonic Cancer Center. More often than not, we were always the last to leave. The next day I would wake her very early for Kytril, and later we would get up and head right back to Bismarck.
The trips were uneventful, and we were never sure about what was going on. Joanie had a CT scan in late September, the results of which were encouraging, and in Dr. Carson’s words, “I personally reviewed her CT scan from Bismarck, and saw no evidence of disease in the chest, abdomen or pelvis.” That gave us new hope, because that news came after just three of the six treatments were complete. There were three more to go, and there would be another CT scan in about a month.
Because the news came before the October round of chemo that day, we didn’t have a chance to go to Sally’s and celebrate. Instead, we were able to tell Ginny and Ed when we got back to their place that night, and even though Joanie didn’t want anything, the rest of us enjoyed a celebratory cocktail. She was okay being left out of the wine.
Dr. Carson’s words were the ones we had been hoping to hear since Joanie started on chemo, and right then, Joanie didn’t even mind wearing a wig at all. As far as she was concerned, there were only two more rounds to go, and this would all be over, and her hair would start growing back.