cancer – day 144

We had a bit of a scare last week, well, not really a scare, but on Friday I finally called my doctor’s office because this anxiety thing was just too excessive and there just had to be something they could tweak with the meds to make it more tolerable and less freaky for me. But after I talked with the oncology nurse for twenty minutes, Mark ended up taking me in for a blood draw because they wanted to be sure the anxiety was associated with my meds and rule out other problems like my electrolytes being low which could indicate other problems. So we’re there for an anticipated ten-minute blood draw which of course turns into two hours.

One funny story about while we were there. It’s Friday afternoon, right. Mostly the staff is doing end-of-week work, finishing up file notes, that sort of thing, and there are very few patients around. Well, the last time I had chemo was on the Labor Day holiday, so we had it at the other, older, chemo infusion center a couple blocks away at the Sutter Cancer Center. And my physical file was apparently still over there since they would have transferred it over the weekend between the two facilities or something but here I am at the regular infusion center suddenly for this unexpected extra blood draw. So when the techs went in Lombardi’s office across the hall from the infusion center to see if they maybe had my file, apparently Heidi (my oncology nurse) heard them mention my name, and she and Lombardi came over to see how I was feeling, ask about my symptoms, etc., basically everything I’d told Heidi on the phone and filling in some gaps, talking about what may be going on and that it’s probably fine, of course. The funny part of the story is the effect Lombardi’s presence had on the infusion center. All of a sudden they got very quick and professional about getting me set up, and working on my port (which they ended up having to TPA because the blood inside had clotted too solidly in the reservoir, no big deal, just a little hassle from being thin and not having a lot of body fat covering the port). Anyway, you should have seen the professional hustle and bustle of that infusion center when Lombardi was in there! I get the impression they don’t see the actual medical oncologists all that often. J

Anyway, that’s the funny story from the afternoon of the extra blood draw.

I finally saw most of the test results yesterday online . . . my CBC looks fine except for one element that was a little high, and the comprehensive metabolic panel was fine. But today I went online to look at the results again because I’m finally catching up in my journal, and they did more analysis/tests.

Lombardi did a Hematology Review where, in the place where it says “Your Value” he wrote “Note absolute neutropenia.” And he added this longer note: “Circulating immature granulocytes noted. Relative lymphocytosis with some lymphoplasmacytoid forms favors reactive.” Whatever the heck all that means. Looks like I have some research to do today! (And here I thought I was going to spend my morning trying to find the 2004 and 2005 survey results that are missing from my dissertation literature review.)

Anyway, there were a couple other test results noted: a slide review/peripheral smear reviewed by MT showed OCC ATYP LYMPH; and the magnesium test was within normal range.

So the absolute neutropenia thing is fine, that means it’s ok to give me chemotherapy because the risk of infection is considered low. The actual neutrophil count and percentage numbers are on the CBC and are in the lower part of the range but still completely within range. Now, all the lympho stuff . . . best I can figure, lymphocytosis is a feature of infection. Relative lymphocytosis occurs when there is a higher proportion of lymphocytes (greater than 40%) among the white blood cells. Now the “lymphoplasmacytoid forms” I am having a more difficult time understanding. Closest thing I can find is that “lymphoplasmacytoid lymphomas (LPL) are non-Hodgkin’s lymphomas characterized by a proliferation of lymphoplasmacytoid cells or plasma cells with intracytoplasmic monoclonal Ig. The LPL are low-grade B-cell neoplasms closeto B chronic lymphocytic leukemia with plasmacytoid differentiation.” I think we’re just going to have to ask Dr. Lombardi what that one means when we see him on Monday before my next chemo infusion.