ANC drop. Again. (or ) Life Sucks then it Sucks More. /Att:: Goofy

[jmjm530]

The problem with frequent labs seems to be frequent bad news. I thought my ANC had bounced back, but this week it bounced the other way to 472 with WBC at 1.4. My increased Procrit also seems a little slow on the draw and remains in the low 12's in spite of two weeks of increased Procrit.

Goofy...was it you that mentioned your doctor doesn't intervene with Neupogen until ANC is below 400?  Really not thrilled about injecting any more drugs into my system. Also wondering if anyone else had similar problems mid-treatment with decreasing ANC. My NP led me to believe that it doesn't happen that often later in treatment and they rarely use the stuff. I guess they might have to dust off a few vials. :)

-- Jim

[FlGuy]

The blood taking is just like in a lab. Venus blood in a vacuum tube. The machine look like a printer.  A little door opens, tube goes in, the machine sends a probe into the tube, in a about 45 seconds, voila!  I'll get the name of the machine monday, there a manufacturer's label right on the front.  Gives 16 specific reading (WBC, PLT, HGB, RBC - all), patient ranges, and histograms for WBC, RBC, PLT.  Long time ago I talked to the tech about the machine.  They do regular calibrations and test it against known sample values.  Also talked to the Quest people (when in for a PCR) and asked them how they process CBC's.  They said they use CBC machines at a central location in this area.  Who knows the absolute accuracy of any machine?  I figure that even if it's 10% off - that's ok for the decisions I need to make.

[jmjm530]

When you say "if meds are required, they're in the next room" -- are you referring to Procrit and Neupogen or anything else?

I thought about seeing a hemotologist (still might) but I know it will be stepping on my hepatologist's toes (which I already have more or less used up my quota. :) )

The advantage, of course, with the hemotologist is this is their speciality and the special services you describe. The disadvantage, as I see it, is that my hepatologist has treated literally hundreds (many thousands) of hep c patients and bases intervention on this very specific population group.

Also, from what I've read here and on other boards, it appears that that those that use hematologists tend to get quicker dose reductions/drug than those that don't. Not sure how this holds in your case. At what ANC level does your doc intervene with Neupogen?

-- Jim


-- Jim

[jmjm530]

I thought the office machines used finger pricks? Sounds like yours uses venus blood.

Do you happen to know the name of the machine and now accurate it is compared to a commercial lab?

I have heard finger-***** CBC's are not as accurate but your system sounds very good. Like my doc wants me to do an ANC on Friday but of course the results won't be ready until Saturday when he'll probably be playing golf. :) I might as well just wait until Monday then and get results Tuesday. With your system, we could have drawn blood and made a decision the same day.

But the next best thing to your own hemo-oncol is setting up a system to get lab results the next day. This is especially important regarding Hgb during the first six weeks when anemia tends to raise its ugly head.

[FlGuy]

No doubt, quick lab results and immediate action are critical. Each Mon I have a CBC in the Hemotologist ofc. Process is: sit down, blood draw (using that butterfly thing), without taking a step nurse pops it in CBC machine. Out pops 2 copies of the report, we both look, decide if any meds, then I'm outta there. If I'm in the bldg more than 10 minutes it's a lot.  If meds are requied, the stuff is in the next room.  Since it's also oncology there is always a Dr. to read results and make a fast decision, if needed.

I you are able to use such an office, like a hemo-oncol with one of those machines you may be able to cut some time out of your routine.

[tina-b]

Ferritin levels over 1000 are toxic. But hey, so are the meds.

Glad your feeling better already ;)

[GoofyDad]

Cougar says, "We really need to stop doing that to ourselves, it's like with our blood chemistry going all crazy - we might just be victims of spontaneous combustion one day"

LOL, Cougar - I have a mental picture of me walking towards the office one morning and Ka-blam. Like the big guy in Monte Python's Meaning of Life. Goofy splatted up to the third floor windows!

You're right though. We do more to ourselves fretting over this and that. But who's going to stop? Not me, I'm afraid.

Well maybe I'll give it a go. Tomorrow's my 4 wk VL & maybe I'll just scratch off that FAX PATIENT sticker and not worry about it. Let whatever comes, come. Discover strength from within. Go with the flow. Find my center. Accept that which I can't control. Like the Lotus flower, be one with the wind.

And maybe the Veggo will have us all over for a weinie roast in February!