From left to right: A red blood cell, a platelet, and a white blood cell.
Don had a rough week. Not only did the Interferon shot make his body ache, but the addition of the Nupogen shot to increase his white blood cell count, knocked him down even further. He really had to push himself to keep going.
What was becoming his usual schedule continued. Every Monday morning before work he headed over to the clinic to get his blood drawn and every Tuesday we either had an appointment or a telephone consultation about the results. This Tuesday we were going in for a face to face visit.
The ride over. The waiting room. The exam room..it was all starting to feel like da-ja-vu. First the nurse comes in and asked Don to step onto the scale.
She glanced at the dial, looked at his chart and then looked at the scale again."Have you been eating normally?" She inquired.
"Yes, not much has changed." he responded.
"Well, you have lost 10 pounds."
I just sat there and glared at him. In the same time frame, I had managed to gain 3 pounds. "I am gonna steel one of those shots and jab it into my thigh!" I said shaking my head.
The nurse laughed, "I would not recommend that!"
Again we were left alone in silence. Only a moment later the door knob turned downward and the doctor came in.
After exchanging short greetings and pleasantries, he got right down to business.
"Don, your platelet count has dropped way down. In fact it was so low, I made them retest it because I just could not believe it. The first time the count was 48,000 and the second count came back just a bit higher so it was not a mistake." he informed us.
We sat there completely silent. I knew that this could be the kiss of death for his treatment. According to our doctor there was not an injection to raise the platelet count and getting a transfusion was not an ongoing treatment option. If his count continued to go down he could be in serious danger of bleeding internally without cause of injury.
Just to give you a mental graphic....a normal platelet count for someone in perfect health is anywhere from 150,000 to 400,000. When we started treatment, Don's was already depressed to 113,000 which is a common side effect of Hepatitis C. In 5 short weeks of treatment his count went from 113,000 to 48,000. In essence his platelet count was dropping by 13,000 per week! That was frightening!!
His doctor continued, "I have had patients whose count dropped, but it usually happens months into the treatment. This is quite unusual. You will need to continue to have to have CVC's done weekly and as of now, you need to cut your Interferon injections by half. Hopefully by doing that, your platelet count will go back up."
"..and if not?" I asked.
"..then you will have to stop this treatment." he responded solemnly. Raising his voice level to sound more optimistic he continued, "I have had patients who were successful on the half dose treatment though, so don't give up! Do you have any questions?"
Each of us shook our heads. Honestly, I can't say that my brain was in a position to even think of a question at that moment. The doctor nodded his head, shook our hands and left the room. The air felt heavy. I had a lump in my throat and could feel that I was clenching my teeth. I didn't know what to say. I looked straight into Don's eyes and he looked stunned.
"I can't seem to catch a break."
We just held onto each other for the longest time...