Thursday 7th May

Good morning, says me at 11:45 and still in my pyjamas.  I went to the Dr yesterday and have a bad bout of Bronchitis.  Suppose this had to happen at some stage or the other.....I've been pushing my body for far too long.

Apart from anti-biotics he also gave me Celestamine which works wonders for drying up post nasal drip etc.  I took 2 when I got home and within half an hour I couldn't believe how well they worked.  Everything felt drier.  Within in hour my mouth was as dry as anything and even my eyeballs felt like the were trying to move around in the socket with no fluid.  This morning when I took the next dose I saw it says 1 tablet twice a day and not 2 like I had taken last night.  I think I'm lucky I didn't shrivel up like a dried prune.

Jimmy had his bloods done again yesterday and his platelets have now dropped to 17 so he went into the clinic this morning on his way to work to have a platelet transfusion.  Hopefully this one kicks in nicely and pushes his count up.

It's wonderful to see how positive Jimmy is since we have seen Prof.  He is so much more of the old Jimmy that we all know.  I didn't realise until know how quiet and withdrawn he had actually become.  He is loving being back at work and so far, not finding it too tiring.  I think he is really looking forward to his first business trip at the end of the month after being stuck at home for more than a year.

Yesterday morning he even got up and made me coffee in bed and then phoned our doctor to make an appointment for me and then he took me to the doctor yesterday evening. He then went and got some fish and chips for supper so that I didn't have to cook.  It feels really nice to be looked after again.

I have decided that I am going to put up a little chart like the one below at the beginning of the blog with Jimmy's counts from now on.  Probably a bit boring for most my blog readers but I have a couple of other Multiple Myeloma patients and carers following the blog and it is interesting to follow these counts when in and out of remission.

WBC (white blood cells) 4.2.....Normal 4.0 to 11.0  
NE (neutrophils) 1.18.....Normal 2.00 to 7.50  
RBC (red blood cells) 3.32.....Normal 4.50 to 6.50    
PLT (platelets) 17.....Normal 150 to 400
BA (basophils) 0.4....Normal 0.0 to 0.5

And here is a blood count explanation - it is close to a year since I explained this all:-

Red Blood Count

Red Blood Count (RBC) is the count of red blood cells These cells carry oxygen throughout the body. Normal RBC values for men are higher than for women and range from 3.6 to 6.1 million per cubic millimetre. Too many RBCs (or platelets) in the bloodstream may cause slow blood flow and compromise circulation. A low RBC may signify anaemia, a shortage of red blood cells, or haemoglobin the oxygen- carrying part of the RBC; this usually reflects underproduction or premature destruction of the cells.   

Haemoglobin
 
Haemoglobin (HGB) is a protein that enables RBCs to carry oxygen from the lungs to the rest of the body. The amount of haemoglobin determines how much oxygen the RBCs are capable of carrying to other cells. Normal haemoglobin levels for adult males range from 130 to 180 grams per litre for men and approximately 120 to 160 grams for women. Levels for children vary with age but are generally 1 to 2 grams lower than adult female values. Smokers often show an increase in their haemoglobin level. Epogen is an injectable drug that stimulates the production of red cells. It is used in anaemic patients to reduce the frequency of transfusions.

Platelets

Platelets (PLT or PT) are important for clotting, and are formed in the marrow. Low counts of platelets is called thrombocytopenia, and is quite common during chemotherapy. During thrombocytopenia the risk of bleeding and bruising is higher. Dangerously low platelet counts (<10; 10^9 / Litre )can put the patient at risk for brain Haemorrhages. High levels of platelets can cause circulation problems as the blood becomes too "thick".

White Blood Count

White Blood Cell Count (WBC) is the count of white blood cells called leukocytes. WBCs defend the body against infection and make up part of the immune system. Like other blood cells they are produced in the bone marrow. The total number of white blood cells has a wide range from 4,000 to 11,000 per cubic millimetre in the average healthy adult. While it can mean many things, a high WBC may mean you are fighting an infection, or that your immune system has been activated for some other reason. A low WBC might mean there is a problem with production in the bone marrow, which could be the result of various chronic diseases. It can also be a side effect of various different drugs, particularly chemotherapeutic drugs for cancer treatment. 

Neutrophils

Neutrophils are WBCs involved in fighting bacterial infections, and they are the most common of all the white blood cells.  With a lifespan of just about 8 hours your body has to produce about 5 billion neutrophils every hour of the day. Neutropenia is a drop in the absolute neutrophil count to below 1000 and places the patient at increased risk of infection and is defined as follows.

• Neutropenia in general = ANC < 2000 (slight risk of infection) 
• Mild Neutropenia = ANC > 1000 & < 1500 (minimal risk of infection) 
• Moderate Neutropenia = ANC > 500 & < 1000 (moderate risk of infection) 
• Severe Neutropenia = ANC < 500 (severe risk of infection)    

Basophils
 
Basophils (Bas) are WBCs usually involved in fighting parasitic infections. Increases reflect a possibility of parasitic activity in the body. If you have an abnormal basophil count and are experiencing diarrhoea, loose stools, gas or stomach bloating, you may want to ask your doctor to be tested for parasites. Basophils are the least common of the WBC's and a count of zero is quite normal.