Tuesday, February 5, 2008

Blood Counts

Finally, I'm posting something just because I want to, not because something new happened.

In the spirit of passing on all the education we're getting, here's a quick lesson on blood counts as they pertain to Jacob.

CBC: complete blood count. Right now, Jacob gets a CBC twice a week--once when he gets chemo and once when a home care nurse visits our house. His port is accessed and blood drawn through that.

There are 4 numbers that we follow closely from the CBC. They are:

1. White Blood Count (WBC): white blood cells fight infection.

2. Hematocrit (Hct): red blood cells; without enough, you're anemic.

3. Platelets (Plts): help your blood clot.

4. Absolute Neutrophil Count (ANC): this is the big one. No, I'd never heard of it before, either. The ANC measures the body's ability to fight an infection, particularly a bacterial infection. This is the number which determines if Jake has little or no restrictions on where he goes, or if he needs to wear a mask in public, or if he needs to stay isolated.

Why do these numbers fall? Chemotherapy kills all fast-growing cells. Like cancer cells. Also hair follicles (this is why he's bald) and blood cells in bone marrow. His blood counts are mostly affected when he receives the once-every-3-weeks inpatient chemo treatment; the numbers bottom out between 10-14 days after that treatment and then start to rise again.

What are normal values?

WBC: 4.5-13.5
Hct: 35-45
ANC: 1.5-8

It can get confusing with the normal values, because they're referenced to the 3rd power, so, for example, ANC can be given as either 2.6 or 2600.

Transfusions are given if counts fall too far and I give Neupogen shots to Jacob after his inpatient chemo (it helps stimulate the growth of white blood cells)--those shots are given once a day until his ANC is greather than 2.0 (or 2000).

Of course, the reason we do all this is that Jacob's greatest enemy these next months isn't the cancer so much as the threat of infection. His body could easily be overwhelmed if he gets an infection without having the ability to fight it off. That's why we draw blood twice a week. That's why we end up in the ER in the middle of the night for a fever.

There now, don't you feel smarter? Oh, and FYI, Jake's counts on Friday night at the hospital showed an ANC of 3.0--perfectly normal and why they let us come home.

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