Midway

• Hemoglobin 9.1 (normal 14.0-17.3)
• Absolute neutrophil count 1.0 (normal 1.4-7.5)
• White blood cell count 1.3 (normal 4-10)
• Platelet count 246 (normal 150-450) — NORMAL

New charts of my blood counts.

Yesterday was my 2-week followup with Dr. B. He showed up 2.5 hours after our scheduled appointment, but apart from almost falling asleep in my chair, I didn't mind. Now I know to always try for a morning appointment with him.

The best news: I'm out of the danger zone for opportunistic infections. My neutrophil count has climbed higher (1.0) than before I started treatment (0.7). That's still below normal, but anything 1.0 and above is OK. Lymphocytes, the second most numerous type of white blood cell, are at 0.2 (normal 0.8-5.0). Dr. B said lymphocyte counts might stay depressed for 2 years. Fortunately this has few or no clinical consequences, so the neutrophils (see the picture) are the thing to watch.

Now I can finally go out in public, stop worrying so much, and drop some of the more draconian precautions. No more face masks. I actually went to the YMCA with Gabrielle to pick up Luka from day care — first time I've done that in 5 weeks. But with family coming for Christmas in just four days, in general we'll continue the cordon sanitaire through the holidays.

For one thing, my hemoglobin's unchanged, at 9.1.

Hemoglobin, also spelt haemoglobin and abbreviated Hb, is the iron-containing oxygen-transport metalloprotein in the red blood cells of the blood in vertebrates and other animals. In mammals the protein makes up about 97% of the red cell’s dry content, and around 35% of the total content (including water). Hemoglobin transports oxygen from the lungs or gills to the rest of the body, such as to the muscles, where it releases its load of oxygen.

At 2.82, my red cell count is just a hair higher than last week's 2.79 (normal 4.5-5.9). So I'm oxygen-starved until that number comes up. Red cells live about 120 days. They travel 200-300 miles during their lifespan. The body normally replaces them at the rate of about 1% new red cells each day. We can see this happening now, since reticulocytes — new, immature red cells — make up a higher proportion than normal of my total red count. The figure I'd seen in the literature was 8 weeks from start of chemo to normal hemoglobin. In any case, it'll be at least another week or two before I have real energy again. Disappointing, but that's leukemia for you. Also a good reason not to get sick anytime soon. I feel crummy enough without having a cold.

From now on, I'll only get blood tests every 2 weeks. I won't see Dr. B again for 2 months. Then it'll be time for another bone marrow biopsy, to see exactly how well the treatment worked. Fingers crossed.

While I wait, I won't be posting so often to this blog. I need to start working again, anyway, though until that hemoglobin comes back, concentrating on anything for more than five minutes feels like swimming in molasses. I'm not too good at keeping a reduced schedule — it's more of an all-or-nothing thing with me — but I guess it's time to learn.