Sunday, August 22, 2010

a cold+cancer=no fun//Shadyside ER

Knowing my history of colds, a cold was bound to find me between February and September.  Sure enough, it did.  I woke up Saturday, August 7th with a sore throat that persisted for 3 days.  At first, I had thought the sore throat was an extension of the dry mouth that I commonly suffer in the days following chemo, but when it turned into congestion on day 4, it was evident it was a cold.  Runny nose, stuffy nose, headache, eugh eugh.. you know the symptoms of a cold.  It's been taking me long enough to come around between treatments, let alone with a cold on top of it.  I had called Dr. Marks' PA to see if I should treat a cold with cancer any differently that a cold any other time..  She told me to watch if it settles in my ears, lungs, or turns into a fever, and if so, that would be the scenario to act upon.

Sure enough, Thursday evening I took my tympanic temperature and it was fluctuating between 100.2 and 101.9.  While this may not be a red flag for the non-cancer patient, according to my bloodwork pre-chemo 10, my neutrophils were at 0.8, making me neutropenic and my red flag for immediate medical attention 100.5.  By this time, the Hillman was closed so I called their after-hours line, speaking to the oncologist on-call who said the SAFEST thing to do would to go to Shadyside ER and get admitted for a few days with IV antibiotics.  The lifespan of neutrophils are typically 7-10 days, so knowing that I had chemo on Wednesday, and this was the following Thursday, chances were that my neutrophils were A LOT less that 0.8 at this time.  To have a fever while neutropenic is a VERY serious situation because it is an indicator of infection at a point when my body is not able to fight that infection.  

Preparing myself for the worst-case scenario, I packed my bag with a few changes of clothes, toothbrush, laptop, etc etc etc.  In a matter of minutes, my parents and I were on our way to Shadyside ER.  It was best for me to go to Shadyside versus a hospital closer to home because they were familiar with my port, the neutropenic patient and protocol to protect me from other germs.  They gave me a mask upon arrival, got me in relatively quickly, and put me in a room clear at the end of the hall, away from other patients.  Even though the room was already clean, then washed it down again to be sure I didn't catch anything.  Upon arrival at the hospital, my oral temperature was normal, but for some reason, my tympanic was still high.  Regardless of my temperature at the time, the doctors proceeded with care to be safe.  They took a CBC, a blood culture from my port, a blood culture peripherally from my arm, a urine culture, and a chest x-ray.  After all of this, watching the newest episode of Project Runway, and some waiting, we got great news.   The results of the CBC came back and I was not neutropenic.. my neutrophils were 3.2!!! woooo.  Since I was not neutropenic, I was able to go home and wait for the culture results there.  If I was neutropenic, they would have admitted me for the night and treated me with empiric antibiotic therapy.  The culture results took 72 hours and came back clear.  We had quite a scare, but everything is great now.  Both my tympanic and oral temperatures have been normal and hopefully it'll stay that way for through my last treatment.  :)


SUPER BONE MARROW!!! (it's looking to be that my neutrophil lifespan is 14 days.. they're high on every non-chemo week, and low again at pre-chemo blood draw.)


I'm smiling under my mask. 
(and I'm reaaaally looking like a cancer patient in this picture.. so glad this will all be behind me soon.)

My cold symptoms persisted for a few more days, and by my next treatment, August 18th, I was regaining my energy and feeling good again.  Thank goodness it turned out to be nothing.  Thanks for all of the amazing friends and family who were willing to drop everything to be there for me during the scare.  I'm so lucky to have all of you. :)

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