Neutra-what?

Last Monday morning I thought that the corner had been turned and I was on the upswing.  I went in for the white blood cell booster shot, enjoyed a half sandwich with my parents for lunch and, despite the nausea challenges, was feeling pretty good.  About 9:00 that night I suddenly didn't feel well and felt a fever coming on. For the rest of the night my temperature hovered around 99 degrees.  I took some Ibruprofen to help with the fever, but I still felt unwell.  In the morning, I struggled to get out of bed, shower and get ready for work.  Miraculously I made it to work, but within 20 minutes of getting there I had to sit on the sofa we've moved into my office because I felt so weak.  I kept trying to get simple things done, but just didn't have the energy for it.  Jana called to see how I was doing and I asked her to come and get me. 

She brought me home and I slept for two hours or so.  I still felt the same.  I tried to eat a bit of food and then moved to the futon for more rest.  We called the cancer center to see what they had to say.  They suggested keeping an eye on the temperature.  I was disappointed.  I knew that at the very least I needed a prophylactic antibiotic.  Meanwhile my temperature started to rise to 101 and then 102.  We called the cancer center again to see if I could take a fever reducer and if they would prescribe an anti-biotic.  They agreed and said to take 2 Tylenol, but if an hour later the fever was still at 101 or higher, that I needed to go to the ER.  I was dreading that, but also recognized the wisdom in it.

Before the hour was up, I knew I needed to go to the hospital.  I just felt that something was fundamentally wrong and nothing I could do at home would help.  Having never been admitted to a hospital before, I was unsure as to what I should take/leave behind.  I left my keys behind, grabbed by cell phone, wallet, and a book; the bare necessities.  I called my mom and asked her to come to the house and take care of the kids when they got home from school, and we were off.

Telling the admittance desk that you are a cancer patient with a high fever works wonders to speed up the normal wait times.  She immediately had me put on a mask, asked if I had been out of the country in the past 21 days (Ebola screening), and told me to have a seat.  Within just a few minutes, I was giving various bodily fluids up for labs and escorted to a bed in an ER room.  The place was hopping.  Some guy had to be tasered because he wasn't complying with instructions.  An hour later a doctor came in and informed me they were admitted me for "neutropenic precautions".  I had no idea what that meant.  She informed me that my normal white blood cell count was around 6.9.  Mine was currently weighing in at a whopping 0.4, but most importantly they couldn't detect any white blood cells that fight disease (apparently not all white blood cells do).  The labs also couldn't detect any infection.  The theory is that the bacteria inherent in the gut aggravate certain linings causing the body to fight back with the only weapon it has left, a fever.  About two hours later they found me a room and off I went.

The first 36 hours was a parade of doctors, nurses, dietitians, etc.  I was very impressed with the doctors who took their time to answer our myriad of questions.  I spent all of time in bed, sleeping or resting while being hydrated and kept on various intervenous courses of antibiotics.  The nausea was still strong from the previous week of chemo and after trying three different anti-nausea medicine we found one that allowed me to keep my all-liquid diet down with some effort. I don't think I could have stomached gelatinized beef broth otherwise, but was grateful for its blandness. 

By Thursday, the moved me to a "soft diet", which allowed me anything I wanted, although fresh fruits and veggies were expressly prohibited due to risk of bacteria.  Everything had to be cooked well.  I was able to handle the food, and by the end of the day the nausea had lessened, but it still took me 30 minutes to eat the tiny portion of food provided.  My white cell count was still at 0.4. 

Friday saw some small improvements.  I didn't just lay in bed all day sleeping/resting.  I could manage to sit in a chair for an hour or so and give my back a break.  My nausea disappeared (more just a matter of time passing after chemo).  I even managed a shower.  We finally had some action from those little white blood cells, they went from 0.4 to 0.6 in the morning and were at 0.8 that evening.  Hey, we'll take any bit of good news we can!  Jana and I had a "move night" and sat in two chairs side by side and watched Monuments Men and Legally Blonde.

Saturday was a significant improvement.  I felt well enough for the first time to actually do something beside sit/lay around.  I picked up the room a bit, checked email and read.  The oncologist reported by white blood cell level had risen to 1.5! 

Hallelujah.

He felt I could be released that day, but needed to get the internal medicine and infectious disease doctors to sign off as well.

I managed to get disengaged from the IV for an hour and took a quick walk outside to see that, yes, the sun was still shining.  It was a glorious autumnal day.  Smelled some roses and back inside we went.  Back onto the antibacterial drip.  The other two doctors initially didn't want me to go home until Sunday.  I tried puppy-dog eyes, but I think they know that trick.  They did listen though and after more discussions, I was released in the evening.

All told I spent about 100 hours in the hospital and am glad I went in.  They never did find any infections (fine by me) but I felt human again by the time I left.  24 hours later, I still feel human, just really weak.   I feel like I could sympathize with an octogenarian about the difficulty of stairs, getting in and of bed, stuff like that.  But I sleep well, and wake up feeling refreshed.  No nausea, no pain, no IV.  I'll take it.