Wednesday, December 10, 2008

Thankful for Cheap Gas--And Inaccurate Information on the Web


First off, the gasoline prices have kept going down? Is that because Blagojevich was arrested? Over the weekend, Rose prompted me to fill the tank, because 153.9 seemed like such a good price. Knowing when to buy and when to wait is a bit of a funny game, but I decided to wait. This morning I filled up at 144.9. Yoohoo! It doesn't seem that long ago that we were paying close to $4.00 per gallon. My 401(k) has lost so much value I should rename it as my 201(k), but gasoline is cheaper. For that, and for so many other things, I am thankful.

I'm also thankful that not all of the information available on the internet is accurate. I'm thinking of some specific health information having to do with chemotherapy. Rose was zapped full of poison (taxotere and cytoxsan to be specific) on November 24. Since she had contracted a little bit of a cold the week before, we were wondering if they might postpone her chemo treatment, but all of the important levels were within range, so she got the treatment. We went back in for blood work on Dec. 2, and again on Dec. 8. Her white blood cell count was low on both of those dates, making her susceptible to any infection that might come her way. We have been pretty careful about trying to shelter her from anyone who is sick. The lab reports come back with 20 different reports, most of which are unintelligible to uninformed people. So . . . what does an inquisitive sort of a person like me do? I go online to try to figure out what all this stuff means.

Of all the stuff that comes back (20 categories), some are more important than others:
WBC (White Blood Cells)
Platelet Count
Absolute Grans
are among some of the more important categories.

The White Blood Cells are the cells that fight against infections, so a person with a low count of white cells is particularly vulnerable. On November 24, her WBC was within normal range: 5.5 out of a normal range of 4.4-11.3 K/uL. The value on Dec. 2 was 2.4 (below normal range); the value on Dec. 8 was 3.5 (still below normal range, but climbing).

The Platelet Count has not been a problem. On her first day of chemo treatment, we were told that they want the platelet count to be above 100 to receive the treatment. The normal range is 160-400 K/uL. On Nov. 24 her platelet count was 321. The platelet counts on Dec. 2 and Dec. 8 were 392 and 538, respectively.

The takes us to the strange category of Absolute Grans. The real term for this category is Absolute Granulocytes. Sometimes this is reported as ANC or AGC. Granulocytes are a special category of white blood cells. The Absolute Grans is a very important report. Though the normal range is 2.00-6.90 K/uL, we were told on the day of her first chemo treatment that a person has to be above 1.5 to be infused. On Nov. 24, her level was 2.15 (within normal range). This category has been one of the lowest values on her lab reports. On Dec. 2 it was 0.284, and on Dec. 8 it had actually descended to 0.271! There are other categories where her levels had risen considerably, so when they looked at the report, their explanation was that her body is working very hard to get better.

Rose has actually felt much better than her lab reports might indicate. She has been working just about every day (there are only two other people in her office, and they are pretty well spread out--plus they try to disinfect everything for her). In fact, she has felt incredibly better than what she should feel, based on something I found when I tried to figure out what this Absolute Grans category was all about.

Remember, to be infused, she needs to get to 1.5. She's got a ways to go between now and the next infustion date (next Monday). But what happens to a person with a low Absolute Grans level? Read this, and understand why I am thankful:

In some patients percentages might be misleading so absolute values of the types of WBC , i.e., the number of white blood cells multiplied by the percentage seen are valuable in diagnosing illness or following therapy. Persons receiving chemotherapy often have decreased WBC. If a patient’s absolute granulocyte count (ANC or AGC) goes below 2,000 cells, then physicians become concerned about the possibility of infection. A number below 1,000 is cause for greater concern and less than 500 usually lands the patient in the hospital.
Source: Hematology Tests from the American Society for Clinical Laboratory Science.

Rose has been considerably below that level of 500 (0.500 on the scale used in our reports), which usually lands the patient in the hospital--for the past two weeks, during which the only day she did not go to work was on Thanksgiving Day itself!

That makes me very thankful! We don't really know what the near future holds. We are in uncharted (for us) waters. I'm reminded of the words from an old gospel song, written by Ira Stanphill:

Many things about tomorrow,
I don't seem to understand,
But I know Who holds the future,
And I know Who holds my hand.

Thanks be to God!


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