01/20/2010
by Michael Wells Wednesday night and I have the “watch.” I think there must be a few nurses and/or staff members reading Brady’s journal as everyone has made an extra effort to point out the fact (to me) they were washing their hands. All I can say is; “thank you.” Tonight Brady had his broviac catheter dressing changed, the bandage is about half the size of Brady’s entire chest and has very aggressive adhesive that requires detachol adhesive remover to get it off him. This bandage is changed weekly and it’s a rather painful process. For the very first time Brady not only cried but had big crocodile tears streaming down his face. It was very sad and when Nurse Katie was finished Brady turns to her and said as clear as an adult; “thank you.” I think it was at that point we were both holding back tears. The other news of the day to report is: Brady’s blood count continues its downward spiral with his white blood count falling to 900 which brings his absolute neutrophils count (ANC) down to zero. Brady’s sleeping so if you’re up to it here’s a little primer on ANC: Absolute neutrophil count:The real number of white blood cells (WBCs) that are neutrophils. The absolute neutrophil count is commonly called the ANC. The ANC is not measured directly. It is derived by multiplying the WBC count times the percent of neutrophils in the differential WBC count. The percent of neutrophils consists of the segmented (fully mature) neutrophils) + the bands (almost mature neutrophils). The normal range for the ANC = 1.5 to 8.0 (1,500 to 8,000/mm3). Sample calculation of the ANC: WBC count: 6,000 cells/mm3 of blood Segs: 30% of the WBCs Bands: 3% of the WBCs Neutrophils (segs + bands): 33% of the WBCs ANC: 33% X 6,000 = 2,000/mm 3 ANC of 2,000/mm3, by convention = 2.0Normal range: 1.5 to 8.0 (1,500 to 8,000/mm3) Interpretation: Normal 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. 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). – copied without permission from MedicineNet.com So, the bottom line is Brady’s blood count is in the basement, he is neutropenic and he is “highly” susceptible to infections of every type. Hence, my paranoia with everyone and everything he comes into contact with. While Brady’s current ANC is to be expected and actually means the chemo is “working” it’s none the less very scary. Sherrie is home for the night and I must say she has earned her short break; she will be back early tomorrow morning. Brady is developing a bad case of cabin fever and I truly believe he wants to get out of this place more than anyone. He is a very active child who wants to be on the go and not confined to the indoors of a hospital. We will hopefully be leaving this place in the next 2 or so weeks and it cannot come fast enough. It’s all a matter of how soon his ANC returns to somewhat of a “normal” level. With that in mind, let’s continue the prayers, hugs and good thoughts for Brady’s ANC to rise back to normal levels with NO blasts!!! Until tomorrow; goodnight and thank you…“8 Years Later—Still No Cure for Pediatric Cancer” is a series of posts revisiting the journal kept by Sherrie and Michael Wells during the cancer diagnosis and treatment of their son, Brady Michael. Hopefully these entires will provide an understanding of the journey families face when dealing with these horrific diseases and of the important work the Hugs for Brady Foundation does.