Neulasta Injection - April 19 2012

Jani drove me to UCH this morning for a Neulasta injection in the back of my right arm which will help recover my bone marrow from all the chemotherapy I had with the 2nd Cycle of VD-PACE 13-17 April 2012. I was careful to remember to take Claritin 10 mg prior - hopefully, to reduce the bone and muscle pain associated with Neulasta.

We were in and out in 20 minutes and the Valet Parking had our car close, so we were home before 11 AM. I told Jani we should buy a Lotto Ticket with this kind of luck.


Came home and walked 0.52 miles in 16 1/2 minutes up and down the street here. Kemmer walks with me so nicely without the leash. 

Neulasta HURTS - March 25 2012

I had a Neulasta subcutaneous injection on March 22 2012 and I have been suffering with bone and muscle pain in my back, ribs, and hips. I finally remembered that I took Claritin when I was receiving Neupogen pre-autologous stem cell transplant for apheresis to prevent the pain of Neupogen. So, Jani went out at o'dark thirty this morning to get me some Claritin. I really think it helped diminish the pain I've been having that Percocet barely touches. Neulasta is a long acting Neupogen which stimulates the bone marrow to make neutrophils. I just hope the pain I've been experiencing means my bone marrow is pouring out the neutrophils to relieve my neutropenia (low white blood cells making me susceptible to infection).


Walked 0.42 miles this afternoon slowly.

Labs Plummet and a Platelet Transfusion - March 24 2012

Jani and I left for UCH at sunrise for our 8:15 AM appointment at UCH. It takes us just over an hour to make the trip one way.

They drew my blood out of my PICC Line. It is nice to have line so I don't have to worry about how many pokes it will take to access my blood. We had to wait a LONG TIME for the blood results to come back. I was cozy in the recliner...

 and Jani in the chair...not so much...

My white blood cell is even more CRITICALLY LOW than it was March 22 2012 at 0.5 (norms 4-11.1). My platelets are just 17 (norms 150-400) which will require a platelet transfusion this morning. My hemoglobin hanging in there at low, but okay at 11.0 (norms 12.1-16.3). My absolute neutrophil count (ANC) is dangerously low at 0.3 (norms 1.8-7.8). So, I'm wearing the mask!

The wait for the lab values was probably because they could not do an auto-differential (done with a machine) on the complete blood count (CBC) since there were so FEW white blood cells. It required a peripheral smear which is done by hand via a microscope. My Absolute Neutrophil Count (ANC) is CRITICALLY low at 0.3 (norms 1.8-7.8) so I have to be extra cautious not be exposed to anything.

 My comprehensive metabolic panel was good overall.

 My LDH (lactate dehydrogenase) was good at 117 (norms 98-192).

My serum protein and albumin are getting back to normal which indicates that I am eating well despite my raw gastrointestinal  tract.

They ordered my platelets and RN Christine was very organized and ready to hang them. The platelets that I received today were obtained from a volunteer donor who went through apheresis (hooked to a machine that takes your blood out and separates the platelets from the other components and then replaces the other components back in to the donor). 

It is only suppose to take about 15 minutes for platelets to run in by gravity, but for some reason, mine took more like 45 minutes. I declined the Benadryl that they usually pre-medicate patients receiving transfusions with, but I took the pre-medication Tylenol (650 mg).

RN Christine cautioned me not to bump or cut myself, avoid dental floss, brush with a soft toothbrush, and to call if I got a nose bleed.

We left UCH around 11 AM and drove back o Greeley - I snoozed in the back of Bart on the way home. I don't have to return to UCH until Tuesday, March 27 2012. Hopefully, the Neulasta injection that I received March 22 2012 will have kicked in by then. The Neulasta has certainly caused my back and rib to ache.

PICC Line Dressing Change and Labs - March 22 2012

Went to the UCH BIC today to have my labs drawn and PICC Line Dressing Change. I am still not steady on my feet and used Jani's arm to get around. My mind is clearer today, but needs to clear some more. My guts continue raw, but I'm eating. I have decided the burning pain in the back of my left leg is neuropathy and the pain over my old shingles site on my right kidney area continues. My throat is sore, but I have no visible lesions. I told them that I would not be taking any more Thalidomide.

During the dressing change, my fat lady loose skin got caught up and pinched and I HOWLED LOUDLY in the BIC Room getting EVERYONE's ATTENTION - but, it REALLY HURT. 
The finished PICC Line Dressing Change.

My labs were abnormal as expected. My white blood cell count is way down at 1.1 (norms 4-11.1), my platelet count abnormal at 39 (norms 150-400), but they don't give you platelet transfusions until the the platelets dip below 30. My hemoglobin is only slightly abnormal at 11.1 (12.1-16.3).

My Absolute Neutrophil Count (ANC) is critically low at 0.8 (norms 1.8-6.6). So, they gave me a Neulasta Subcutaneous Injection in my left arm. I will return to have my blood checked again on Saturday, 24 March 2012. I will stay away from people and wear my mask when I got to UCH for my appointments.

My serum Protein and Albumin levels dipped while I was hospitalized - the food is terrible in the hospital and I just didn't get enough protein. Now that I've been home, the values are on the rise.

On the way home, I laid down in the back of Bart while Jani drove to Greeley. Such luxury.