Day 49 - June 25th: Zero Neutrophils

ZERO.  Zero neutrophils on Ryan's blood work today.  His WBC is 500 - pretty low, the differential (breakdown of WBCs by type, expressed as a percentage), shows it's almost all lymphocytes - what we want to get rid of.  A few eosinophils (the WBCs involved in allergic reactions) and monocytes (most are stored in the spleen and can move quickly to site of infection to play a part in the bodies immune response).  These are at normal levels of less than 5% each.

His platelets are 20,000.  He's schedule to go to AMC tomorrow for another CBC and a platelet transfusion.

Which mean Ryan's ability to fight infections is almost zero.  His IV site from a week ago was a little bit inflamed this morning - a tiny hard line of superficial thrombophlebitis.  This evening, it's a red area in his skin about 1 X 2 cm and quite tender.  We notified his oncologist who switched his antibiotic and told him to start taking his temperature.  If it's above 100 degrees, he'll need to be admitted for IV antibiotics.

Started the application process for SSI.  ALL (Acute Lymphocytic Leukemia) is one of about 80 diagnoses which automatically qualify for SSI benefits - or so it says on the government web site.  But the civil servant Ryan met with at the Troy Social Security office wasn't particularly helpful with the application process.  So we'll do it on-line.  The good news is that it is retroactive to the date of diagnosis, so she can stall all she wants; he should receive the full benefit anyway. 

All in all a frustrating day for Ryan. 

Although I seem calm on the surface, the minute I have nothing to occupy my mind I feel queasy.  I'll go with him for his transfusions tomorrow.  Just need to make arrangements for the girls to get home from camp tomorrow if we're delayed at the hospital, and for MeiLin to get a ride from her day camp to her basketball camp at 1:00.  Thanks to leftovers and various meals in the freezer, we're all set for food for supper. 

Not sure whether our medical knowledge is a curse or a blessing.  Probably a blessing for Ryan because we can provide some guidance.  But part of me would rather not understand the implications of zero neutrophils with persisting lymphocytes..........
---Barb