No Rebounds

July 10, 2006

Things seem a lot quieter around here today. Both sisters and both nieces returned to Garland yesterday. We've shoved the extra mattresses back under the beds, taken Raffi out of the CD player, and returned the borrowed baby equipment (and managed to do it without renting a U-Haul). Erin had great fun with both Emma and Annabelle despite the large age gap among the cousins. We kept it pretty low key for the Fourth of July, but did manage to get some swimming and movie watching in later in the week.

I really had few expectations about Erin's blood counts last Friday. I thought we might see high numbers inflated by antibiotics or steady numbers since we were early in this cycle of chemo. I never expected borderline neutropenic (ANC=500) and self-imposed house arrest for the weekend. I made the tech run the sample a second time (ANC=400). Oops. I talked (bribed) Erin into a venopuncture (ANC=300). Double oops. I tried to convince myself that I just caught her in the trough following an illness and that Monday would bring better number. I even entertained the thought that the machine had validity and reliability issues.

Erin did not take the news well. Believe it or not, Erin was invited to a birthday party on Saturday (not unlike every other Saturday for a long time). Walter and I played the heavy and made her stay home. We rented Wallace and Grommit and some other less palatable kids films. We tried to remember the rules of neutropenia (the only one that readily came to mind was the one about repeat handwashing, so based on the notion of cleanliness being next to Godliness, we proceeded to act like obsessive-compulsive handwashers for the next three days).

We returned for more blood work this morning, convinced we were going to see the biggest rebound since Dennis Rodman retired from the Detroit Pistons. "Uh oh." I looked the print out and then at the technician. "Did you hand me the results from last Friday? These look very familiar. . .Oh, these are today's?" Seeing numbers in the same ranges as last Friday left us with a tough decision. Do we continue the self-imposed house arrest or let Erin attend Creative Arts Camp? What would you do? We armed her with her own personal bottle of hand soap and sent her off to camp. We'll check her blood again on Thursday. In the meanwhile chemo is still on hold.

What does this all mean? First, it makes us a little nervous to delay treatment for a week, but we did it last fall when Hurrican Rita closed down the clinic with no ill effect. Since we have scans scheduled in a little over two weeks, I don't think the decision will have much effect and will hopefully give her counts a chance to recover on their own.

Why did her counts fall? I have three thoughts about that. 


1. Erin has been sicker then usual this summer (first the lung gunk (post Disney) then the ear infection (post DC trip). Her immune system may just need time to recover. 
2. We have been poisoning her with chemo for 14 months ,and her immune system has taken a hit and will continue to drop lower and take longer to recover, regardless of the number of germs she encounters. 
3. Something (tumorwise) is going on causing her counts to drop.

At this point I am pulling strongly for #1, discounting #3 because her other counts like hemoglobin and platelets are normal and don't seem to be crowded out by tumor cells in the marrow, etc., and hoping we don't have to face either #2 or #3 ever or at least for a very long time.

I checked on thomas.loc.gov this weekend and was pleased to learn that Chet Edwards, true to his word to Erin, joined the list of Congressional co-sponsors for the Conquer Childhood Cancer Act of 2006. If your representative is not on this list, you should write or call them and ask why not.

I'll close for now, but will not leave you hanging for a week or ten days before I update the status of Erin's immune system.