Happy Birthday Mom/Grandma Mary!

The day after Ethan was diagnosed, my mom flew in from Western NY to support us…she hasn’t been home since. Need I say more? She’s given us such amazing stability at home, so that we can focus every ounce of our energy on Ethan. She’s given Emma and Eliot the consistent love, nurturing and comforts of home, that they know and need. She’s taught me to be strong, even when times are tough. She quite an extraordinary woman…Happy Birthday Mom…thank you for everything you are doing for us. One day, we’ll celebrate, the celebration you deserve, for all the selfless things you do for us, for all the love you give to us…for being such an amazing Mom and Grandma…

Birthday’s bring gifts…Today the gift is ANC! Except it’s for Ethan, not Grandma…

Skaket Beach – July 2002

Now for the Lesson of the Day: ANC

Ethan’s absolute neutrophil count (ANC) today is 160 (or .16)! ANC is the number of white blood cells (WBCs) that are neutrophils (bacteria infection fighting).

Neutrophils are key components in the system of defense against infection. An absence or scarcity of neutrophils (a condition called neutropenia) makes a person vulnerable to infection. After chemotherapy, radiation, or a blood or marrow transplant, the ANC is usually depressed and then slowly rises, reflecting the fact that the bone marrow is recovering and new blood cells are beginning to grow and mature.

The normal range for the ANC = 1.5 to 8.0 (1,500 to 8,000/mm3). In practical clinical terms, a normal ANC is 1.5 or higher; a “safe” ANC is 500-1500; a low ANC is less than 500. A safe ANC means that the patient’s activities do not need to be restricted (on the basis of the ANC).

Two days ago, Ethan’s ANC was 50, yesterday it dropped to 0, and today it’s 160. This is normal for it to fluctuate in the beginning. These “good counts”, are what we wait for at the end of each phase. This round, these infection fighting cells are even more beneficial, as Ethan has an infection that need FIGHTING! These WBC will go to the pneumonia site, and hopefully rid Ethan’s right lung of the pneumonia. The antibiotics only do so much on there own, they need these WBCs to do the job.

After Ethan’s ANC reaches about 500, he needs to be on antibiotics for about two weeks prior to going to transplant. We won’t forecast when that will be, as we have learned how quickly things change.

Today is the eighth day that Ethan has been receiving daily Granulocyte Colony Stimulate Factor (GCSF- growth factor) injections into his thigh. Now that his ANC is ready to come back, the GCSF will stimulate the bone marrow to push the neutrophils out into the blood faster, and we should see his ANC rise faster than normal.

His fevers continue, he receives Tylenol every 4 hours to suppress them. If we’re slightly late with the Tylenol, his fever spikes and he vomits. His IV pole has no room for anything else. It two single pumps, one triple pump, a pump for food, 5 hanging bags, and one PCA pump for his morphine.

The good news is his oxygen requirement (level of oxygen needed to sustain his breathing) has decreased from 5 liters to 1 liter. He’s breathing much easier now. In total ¾ of a liter of fluid has been drained from his right lung since last Thursday.

Grandma and Eliot should be coming in today to visit. I anticipate a good day for Ethan…we’ll see…