Tuesday, September 18, 2012

Neutropenia: A Vulnerable Time for Infections

This article is brought to you by: Better Medicine

Neutropenia is a condition that effects many people that have cancer, but these tips will certainly help everyone stay healthy!

What Is Neutropenia?

There are many types of white blood cells, each with specific roles, but their main job is to fight infection. Neutropenia is a condition in which a person has very low amounts of a type of white blood cell called a neutrophil in their body. Since white blood cells attack harmful bacteria, viruses, and fungi, neutropenia increases the risk of infections.

Who Is at Risk?

Neutropenia is often seen in people receiving chemotherapy or radiation, which can temporarily weaken the immune system or cause myelosuppression, the slowing down of normal production of blood cells.
The specific type of treatment influences neutropenia. It also depends on the disease, the stage of the cancer, and where it is located. Also at high risk are those undergoing bone marrow transplants (BMT) that require myelosuppressive chemotherapy treatments, sometimes with total body irradiation (TBI).
Neutropenic effects can accumulate over the years. If you've received round after round of chemotherapy, you are at risk. If you start the current treatment with an already weak immune system, you're also at risk. Age and nutritional status are other contributing factors.

How to Protect Yourself if You Are Neutropenic

Good personal hygiene and avoiding things that promote the growth of bacteria lower the risk of infection. The following suggestions are for people with neutropenia who are outside the hospital:

a.. Avoid people with signs of infection and avoid large crowds. Wear a face mask if you cannot avoid crowds.

b.. Avoid people who are sick with communicable (contagious) diseases, including a cold, the flu, measles, or chicken pox.

c.. Stay away from children who have recently been given "live virus" vaccines such as chicken pox and oral polio, as they may be contagious to people with very low blood cell counts.

d.. Bathe daily and wash your hands frequently, especially after using the bathroom, after touching animals, and before eating.

e.. Use lotion or oil if your skin becomes dry.

f.. Clean your rectal area gently but thoroughly after each bowel movement. Let your doctor know if the area becomes irritated or if you develop hemorrhoids.

g.. Brush your teeth after meals with a soft toothbrush. Rinse your mouth twice daily with a solution made of water and either salt or baking soda. Temporarily avoid flossing, which can open new wounds and create an entry for bacteria.

h.. Avoid accidents and injuries. Be careful not to cut yourself in any way, including the cuticles of your nails. Use an electric shaver instead of a razor to avoid cutting yourself while shaving.

i.. Do not squeeze or scratch pimples.

j.. Clean any cuts and scrapes with soapy warm water right away and apply an antiseptic.

k.. Avoid gardening, cleaning bird cages, cleaning fish tanks, or changing cat litter, all of which can expose you to bacteria.

Consequences of Infection

People with neutropenia may have diarrhea, mucositis (irritation of the lining of the mouth), problems with body organs, and fever. A fever requires immediate medical attention or septic shock, a potentially serious and deadly condition in which bacteria quickly spread in the blood, can occur.
Patients may be told to check their temperature twice daily and report any temperature of 100.5 degrees Fahrenheit or higher to their doctor right away.

Friday, September 14, 2012

Bcr-Abl Stable; Life-Crazy and Fabulous!

During the next two months I continued to feel more on the crappy side, a little more fatigued and more “flu-ish” on a daily basis. I went to my appointment fairly optimistic and hoped for the best. Two weeks later, I got the news; my PCR is improved a bit, meaning we were back on track at 1.15 x 10-4. Our thought is; the negative test result must have been a fluke. By removing the negative test I am still in downward slide toward negative. This is good news!

Notice the U-Haul?
Really good news since life picked up steam and entered “whirlwind” mode; we sold our house in one day, drove to Boise with a truck load of belongings, bought a house, drove back to Ca. to finish packing and then drove another truckload of belongings to Boise, Idaho. We then settled in for three weeks and drove back to Palm Springs and got married.

Of course, this is where one might be thinking honeymoon, relaxation; time to recoup. Nope, not for us, instead of a honeymoon, we opted to load my youngest child (18 years old), and our three granddaughters; aged six, five and three, into my Ford Expedition, hauling a U-Haul and drive to Boise! We enjoyed the kids for about two weeks when the rest of the family showed up; my son and his wife, plus my youngest grandchild (on year old), and my daughter with my oldest grandchild, ten years old.

For the next few weeks we played in the yard, had bonfires with ‘Smores, watched the elk, went swimming and floated the river; the kids had a great time running amuck and we had lots of visitors. I haven’t a clue why I am so exhausted!!

Eventually the tribe began to dwindle, and we found ourselves left with only two boys. After a few weeks, we drove them back home to southern California and taught at a West Coast Swing event. By the time I saw my doctor and had my blood drawn; I was whooped, and figured that my PCR was going to be whatever it was going to be. I was hoping for a continued decline, but wasn’t going to be too surprised if there was an increase.

Of course, my doctor and I both attributed my increased fatigue, to my recent shenanigans; he actually told me to take a five day reprieve from my medication, in order to give my body a break. This was extremely great news for me, as Joe had planned a “special”, slow drive, up the coast of California, full of surprises, and I was thrilled to be able to enjoy it without the added side effects from my Sprycel.

The break was just what I needed; I felt great for the first time since my last break, almost a year ago. My PRC test results weren’t going to be available until we reached home, so there was no point in fretting about those; so we just drove up the coast and had a great time!

Friday, September 7, 2012

Legos for Leukemia: September is National Leukemia Awareness Month

As many of you already know, I was diagnosed with Chronic Myelogenous Leukemia (CML) on February 9, 2011. It has been a year and a half since that diagnosis and life has been full of twists and turns, ups and downs, goods and bads! I have been diligently following my oncologist’s treatment plan and am making progress.

Living with Leukemia has definitely encouraged me to look at life a little differently; I feel more blessed each and every day and understand that every day is a gift. It does not take much to brighten the day of another person; sometimes it only takes a smile or a touch.

Since September is National Leukemia Awareness month, I thought it was the perfect time to put a smile on the face of a child, that is suffering from Leukemia. Legos for Leukemia is an organization that is based purely on volunteer participation. The hospital that will be receiving the Legos for Leukemia is St. Luke’s Children’s Hospital, in Boise, Idaho.

Please help me to honor and humor these brave little warriors with a set of Legos. Legos will help them pass the many hours of isolation that these kids spend waiting for and then recovering from a bone marrow transplant. Many children that are diagnosed with Leukemia will receive a bone marrow transplant. The “cure” rate of children with leukemia is generally higher than it is for adults; Thank God. But ask any child that has leukemia and they will be certain to tell you that the treatment to cure them is no “walk in the park”!
You may want to become a “fan” of “The Leukemia Slayer”; Jacob. Jacob is an inspiration to any and all that have managed to find a way into his world. He has been battling Acute Lymphoblastic Leukemia (ALL) since December 2, 2010 and will be in treatment until March of 2014. Please stop by and become a fan; you will be glad that you did!

Anyway, back to Legos for Leukemia; there are three easy was you can join me.
         1.       Purchase a set of Legos and either drop it off, or mail it to me.       
         2.       Purchase a gift card from either Walmart or Target and mail it to me; I will shop for you!
         3.       Shop at Amazon and have your choice sent directly to me; many of the Lego sets offer Prime Shipping    at no charge. I put a few suggestions here: Legos for Leukemia

As you can see, shopping online would probably be the easiest way for you to join my Legos for Leukemia drive. The kids and I appreciate all of you donations!

Thank you, in advance: 
Please send Legos to:
Michele Tschirhart
83 Falcon Dr
Boise, Idaho 83716

Tuesday, September 4, 2012

I Have Weathered the "Cold Sore" Storm; Now to Face Reality!

With my wicked –bad cold sore behind me, and two days of feeling great; I must now concentrate on accepting my new reality; I really do have leukemia, and it is not going to go away. For the past year I have been looking forward to the day that my oncologist would finally tell me that he could decrease my Sprycel medication, due to the fact that I had a continuing and steady negative response to my PCR test. You see, I had been making great progress in reducing my Bcr-Abl counts; Bcr-Abl is the gene that essentially causes my leukemia. The Sprycel was doing its’ job, consistently and steadily, up until about nine months ago.

Just after the New Year, my Polymerase Chain Reaction (PCR) test, the test that measures the Bcr-Abl gene, came back negative. Negative, meaning that the Bcr-Abl gene was undetectable, in other words, it was still present, but in such a minute amount, it was undetectable by the PCR test; at least for now. A consistent, negative PCR test would eventually mean a decrease in my “make me feel crappy” medication. Negative #1 test; Check!

This was not only an unexpected result; it was a very exciting and happy day. To have a negative Bcr-Abl response is the best possible news that I could ever hope for. Having a negative or undetectable result does not mean that my cancer is gone; it only means that for the moment, we have it completely under control and are able to enjoy the fact that the Sprycel is winning the war, and controlling my leukemia. Of course, my Doctor told me that there was a mediocre chance that the negative test result could be a lab error, as I had reached this milestone very quickly. Erring on the side of caution, I kept this news to myself; not wanting to get too excited prematurely, and not wanting to spread false, negative results.

As suspected, my next test was a bit elevated; showing my PCR results to be in the positive range again, at 8.90 X10E-4, on March 19, 2011. I must admit that I wasn’t surprised, but I was totally disappointed. Once again, I began the waiting game. I was waiting for another three months to pass, to see which way my PCR was going to travel; in a continued downward slide, with one false negative blip, or an upward trend, which would not be good, and would be totally depressing. It would mean that I had taken a U-Turn and was headed in the Wrong direction!

What I began to realize, was that because every test that I had taken thus far had been in a downward trend, I now expected nothing less.  I had totally jumped aboard the train that was heading straight down the tracks to Negative-ville. I was riding that train, in a totally cocky manner, never even considering that it may make a left, or right hand turn. I just simply believed that I was going to ride my way directly into a complete molecular response, aka; negative for the Bcr-Abl gene. Of course, I now know that that probably is not going to happen, as my doctor often reminds me; “Michele, you DO have cancer.” I suppose that I am just going to have to accept the fact that my train ride is going to be full of site seeing, side trips and detours.

A year and a half has passed since my diagnosis, and I guess that now is as good a time as any to visit the area of my brain that I have locked this leukemia diagnosis in. I have decided that I must re-visit it, in a more accepting manner; living in denial most days will be alright, but I need to have days where I accept the fact that I will be living with leukemia for the rest of my life, and when I need to, I will accept its’ challenges and meet them head on. I will accept that fact that my next PCR test will likely be the deciding factor, as to whether I am going to have to make some changes to my treatment, or not. My Bcr-Abl will either be going up, or coming down and I am certain that if it is still going up, my doctor will be increasing, not decreasing my meds.

Here’s to hoping for the best and preparing for the worst; living every day in an accepting, yet in a fashionably, deniable way!

Saturday, September 1, 2012

The Never Ending Cold Sore!

It really amazes me sometimes just how much pain, of any kind, affects your day to day life. My life, these days, is a constant and continual guessing game; I never know whether I am feeling crappy from the leukemia, the drugs, or one of the side effects, of either the leukemia or the medication. This week, I am relatively certain that it is this dag-gone cold sore.

This thing has lingered for three weeks now, and last night was the very first night, in three weeks, that I actually slept. I did wake up once, to slather on Neosporan, but other than that, I slept the entire night. My first thoughts upon awakening was; “That was certainly a great night”! I am such a dork, but I realized that the past three weeks, my sleep was filled with tumultuous thoughts, and constantly being aware of that darn cold sore. It was either stuck to my top lip, the pillow, or just throbbing and bleeding all over.

The day time hours were spent whining to Joe and hobbling around the house feeling miserable. I really am not sure that the fatigue and over-all crappy feeling was 100% the cold sore, or if something else was brewing. My ear hurt, my head ached, my eyes were sensitive and sore, and I had pain down my neck. The over-all fatigue didn’t help to brighten my day, and as bad as the nights were, I just kept wishing for the next day to be here.

Well, I am here to say that Mr. Cold Sore is finally on his way out. Sleeping was such a pleasure and my tumultuous thoughts were pleasant ones again. I suppose that is what intrigued me the most about this episode; my night-time, subconscious thoughts and the way they changed, as soon as the pain subsided.
What it has also taught me is to be WAY more sympathetic to those in pain, whether it looks like a “small” injury or not. I also realized that when around others in pain, I need to speak more slowly and softly, and to not over-power or overwhelm, their brain. I know that for the past three weeks, everything seemed louder and everything seemed a bit more difficult to process.

I am thrilled that this episode is mostly behind me and from now on, I will be a more empathetic person! 

Bricks for the Brave!!