T+7: Facts and Figures

For those of you who like to know the facts and figures of how Kay is doing I have put together the following data on her blood levels. Firstly, her red cell count:

The absolute minimum that her red cell count is allowed to reach before she needs a transfusion is 4, but the situation is reviewed from the moment that she reaches 4.8. You can see that just before she got the transplant on the 23rd, she had almost reached the stage that she needed a transfusion. However there were a lot of red cells in the transplant transfusion so her red cell count has been fine for the last week. The following graph shows her white cell count.

Her white cell count is pretty key since it provides a picture of the state of her immune system. Note that the scale is exponential. When she was admitted her count was a relatively normal 4.6. As the chemo and radiotherapy progressed it has dropped to an off-the-scale level of 0.1, meaning that it is too low to be accurately or meaningfully measured. In principle the leucocyte count has to be above 1 before Kay will allowed out of isolation. Neutrocytes are white cells responsible for protection against bacteria and are a component of the leucocyte count but are sometimes measured separately. Recent blood tests have measured the Neutrocyte count. To be released from isolation it has to be above 0.5. In the previous two blood tests it has been around 0.06, but today is was not measureable, meaning that Kay's immune system is still heading downhill.

Finally data for Kay's platelet count, which determines the clotting factor of her blood. Again this is presented on an exponential scale.

Kay's normal level runs around 300, which is what is was on admission. The minimum acceptable level is 20. As the chemo did its work you can see from the graph that the level has been hovering around 20. As a result Kay has been given a number of platelet transfusions in the last week. Unfortunately platelets don't last very long in the body, around 2 days. Although she had a transfusion on Tuesday, her count today was below 10, again indicating that her system is still on a downhill slope. She has been given another transfusion today and I expect that that will be a regular thing during the coming days.

Another indication that all the treatments that she has had are still affecting her system is that she has started to lose her hair again (shame!). At the moment it's a small amount but it is a clear reminder that we have not yet reached the lowest point in this process. We will continue to watch her levels closely during the coming days for the moment that they begin to pick up. That will be a huge moment as it will indicate that the transplanted stems cells have started to do their thing.

Otherwise Kay is doing well. She looks good, not least because her red cell count is good. She's still tired, but less so than at the beginning of the week. She is still not eating enough so the nurses are being more pushy with the NG feed, increasing the amount that she's getting from 500ml to 700ml per day.

Part of the reason that I'm writing this is to remind myself that, in spite of the fact that Kay seems so normal on the outside, she is still very much a patient with an extremely fragile system.