Bald 'n Sassy

Life is for the living. Live simply. Expect less.

Archive for the tag “blood tests”

Missing in action – NOT!

I have just taken out my ruler and slapped myself on the wrist!  Ouch! I deserve that.  I just looked at my blog dashboard and it has been almost 3 months since I posted with what has happened. Of course there are excuses but I am sure you don’t want to hear about them.   

Well, I am still here.  It’s time to share on health progress.  Overall, physically I am feeling very good.  Since I have switched my diet to a gluten-free and dairy menu, my body is good shape.  I am still going back to my oncologist every 6 weeks for check up.  I have had 3 blood test since the start of the 2012.  My CEA and CA.A 19.9 markers are on the upward trend.  From double digits, it is growing to 3 digits.  Here is a snapshot:

Feb 2012: CEA – 63;  CA.A 19.9 – 61.2

March 2012: CEA – 121.2; CA.A 19.9 – 135.6

April 2012: CEA – 192.9; CA.A 19.9 – 384.8

No cancer patient wants to see such numbers.  I always remember that my oncologist telling me in the past that it is the trend of the markers versus the absolute numbers.  It is an indication on the “active” cancer cells in my body.  Despite the exponential growth, I am feeling well.  There was a slight scare for me when I started losing weight in between check up.  I lost 2 kg.  Ordinarily I would be happy to lose that weight but given my situation, losing weight is another element taken into consideration in my progress.  I haven’t not made any further changes to my diet and I exercised less.  I was perplexed.  I asked my oncologist  and she wasn’t too concerned about it.  Her feedback is because I exercised less and losing my muscles.  Good consolation.  I am still monitoring my weight and now I have resumed my swimming, it will interesting to see if my weight continues to fluctuate.

So what does it mean with all the numbers going up?  Theoretically, I should be resuming chemo.  My oncologist did hint if I want to do chemo.  I jokingly replied “who would be anxious to do chemo?”.  She didn’t force on me that I should do it.  The wait and see approach still stands.  With all my other vitals looking good and no major symptoms, I choose to defer treatment. The oral chemo option is still on table.  I am still looking into alternative treatments which I will share in another post.

The fight continues!

The question is to Oral Chemo or not Oral Chemo

I know, I know.  It has been a long, long while since I updated my blog.  I am not going to give any excuses either. Since my last chemo in October 2011, I have kept myself busy looking for work.  Plus I took another short break to visit my homeland of Australia.

Anyway, coming back on to chemo or not chemo.  I have gone for a regular check up – 6 weeks to be exact.  In the last blood test just before Christmas, my liver was good.  I always look out for the red numbers in the report.  They show if I am below or above the normal range for various elements.  The December blood test was a little more colorful this time.  There were at least half-dozen indicators glowing in red.  But my oncologist reviewed that the key elements are my liver, my haemoglobin, white and red blood count cells.  Not forgetting the cancer (CEA) markers.  Liver was good but the haemoglobin, white and red blood count cells are still below the normal range.  The doctor mentioned that my white blood cells may not recover to the normal range for the pure simple reason of past radiation treatment coupled with chemo.  Basically my body has taken a good beating.

My CEA marker for Dec crept up to 30.  I was a little alarmed but I stayed calm. The doctor did ask if I was feeling under the weather in the week leading up to the appointment.  I didn’t have any major symptoms like cramps or flu. I did have diarrhoea but nothing serious.  Believe it or not having the tummy runs does spike up the CEA markers.  l learnt something new. Even though my markers increased again, it was still too soon for any next steps in terms of treatment.

Last Friday, 3 February it was my second follow-up post chemo. This follow-up was a little unconventional.  The nurse from the pathology lab took an extra vial of blood.  My oncologist rushed into the treatment room explaining that the extra vial will be tested on a separate machine.  The lab introduced a new machine and the readings for CEA Markers plus Cancer Antigens 19.9 is vastly different.  This is a major concern for my oncologist because she is not able to decide if her patients need further or not.  The “discrepancy” was discovered through another patient. I am so happy that she found out about this soon enough.  I hate to think that patient’s having to continue chemo unnecessarily.

The blood tests took longer this time round. I zoomed in on how my cancer markers were performing.  I got a real shock when the CEA doubled from 6 weeks ago.  The doctor asked the same question if I had any symptoms.  She reminded me again not to focus on the number.  If the trend is going up, then it  just indicates that the embryonic cancer cells are active once again.  Since that I pose no symptoms, she would not recommend any treatment.  I did ask about oral chemo.  I recall from earlier consultation that there was an oral chemotherapy yet to be introduced in Singapore.  She shared the oral chemo drug is now available. From the trial, the drug has 40% to 50% success of keeping the cancer cells from producing.  That is not too bad of success rate.  Of course with oral chemo, you would need to take several tablets per day everyday for up to 4 weeks.  Then a 2 week break and then you resume.  The beauty of the oral chemo is side effects are much less severe in comparison to traditional intravenous chemo.  diarrhoea and low white cell blood counts are the reported side effects.

So the question now is to whether switch to oral chemo. I am trying alternative treatment via diet and exercise to bring down the markers.  At this stage it is good to know that I have the oral chemo available.  Furthermore, at least I don’t have to spend hours at the clinic and not be sick for 1 week.  I am going to do my own research on this oral chemo.

Time to wrap up this post.  Till next post.

Ding ding, round 8 of chemotherapy

Oh boy, it has been a while since my last post.  Oct was a very busy month for me. It was mostly spending time with my family.  For the first time in over 10 years, all my siblings and their kids plus my mum were in the same city.  I must say it was great to have everyone together once again albeit for a few weeks.  As you can imagine, my sister’s apartment was rather crowded.  Anyway, I am digressing from the main subject about my last chemo.

Round 8 of my chemo was on 21 October.  I decided this round to be the last chemo I would want to do.  I am looking to alternative medicine as my choice of treatment.  My reason for stopping chemo is to give my body a chance to be back to normal.  The chemo drugs literally “kills” all the good cells in the body.  While I am under treatment, my white cells are low and producing minimal red blood cells.  The former is expected but having low white blood cells can be dangerous.  It means that I am more susceptible to catching any sickness and have a harder time to recover from the ailment.  I am learning that now with the ongoing cough that has prolonged for almost 2 weeks. With low red blood cells, my haemoglobin levels are low and classified as anaemic.

On the Friday morning of treatment, the usual routine of drawing blood but it was done by my favourite nurse.  I was rather anxious about the results this time. After seeing a decrease in the previous round, I was hoping the downward trend will continue.  When the results were back, there were 2 other patients ahead of me.  When it was my turn, I sat down and my oncologist smiled.  She showed me the results and the cancer markers dropped by 50%.  I was so deliriously happy. I shared with my oncologist that I wanted to stop treatment after this round and try alternative treatment.  She had no violent objections to that idea.  I need not do any more chemo on the premise that my cancer markers are around the same levels.  My oncologist and I are crossing our fingers and toes that it stays the same.  With the usual physical check up over, it was time to start the chemo session.

The nurse placed the hot pack on my right hand to help my veins come alive so the hunt and inserting the needle is much easier.  I took a good look at my hand and the needle marks from previous sessions are still there.  You could literally join the dots and form some sort of shape.  My poor veins has used and abused. I soldiered on for the next 4.5 hours.

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Time to hide under the covers.  Wish me luck for the next blood test! I will post another blog about the results.

Lucky number 7

Well not sure it is lucky or not but it was round 7 of chemo a fortnight ago.  Oh boy, the side effects post chemo was tough at times.  The worst side effects was the body aches and the bad headaches. The body aches I felt was right through the bones.  It made it difficult for me to fall asleep and sit up right for too long.  I laid in bed for most of the day trying to get some rest.  Even falling asleep at night was a challenge.  The aches prolonged that falling asleep was hard.  Once I do, I would be tossing and turning throughout the night and wake up feeling more tired in the morning.  Cat naps was indeed in my recovery plan.  Having headaches didn’t help either.  I felt that I was supporting a bowling ball with my neck coupled with the slight nausea was not a great mix. Taking strong Panadol didn’t make it go away.

Coming back to my treatment day.  When I walked into the clinic, my favourite nurse from the pathology lab was sitting in the waiting area.  Whether it was coincidence that she was there or she just finished taking blood from another patient.  I like to think she was there for me.  Like previous experience, it was a painless experience when she poked the needle for the blood test.  A good start to that day.

Time for the review the blood test.  It was a rather a busy Friday at the clinic.  I had to wait for my turn to see the oncologist.  The doctor had a smile on her face when she opened her door greeting me to enter her office.  As soon as I sat down, the first news she shared was the cancer markers has decreased to 56.5 from 66.3 – FINALLY!  What a relief!  I could say it is definitely lucky number 7. The other components in the blood test indicated that I am still slightly anemic and white blood cells to be low.  Even though it is low, it was acceptable to go ahead with the next round of chemo.

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It has been a while since I had the company of other patients in the treatment rooms. Sharon, a young nurse working at the clinic shared that one woman was rejected treatment by another oncologist for the simple reason that her cancer has advanced cancer that chemo would be futile.  However, she didn’t give up hope and sought a second opinion my oncologist.  Our oncologist took her case and prescribed a treatment schedule buying her more time.  There are two school of thoughts here.  One doctors’ are taught to save lives and convince patient’s to consider all possible medical solutions.  This would mean more financial impact for the patient. On the side of the spectrum some doctor’s may tell you the prognosis and enjoy whatever time that you have left.  Of course some person would not accept the news and look towards alternative medicines to prolong their life. What would you do if you are placed in this situation?

Slight change of plans for round 5

Number 5 must be my lucky number.  It is exactly 5 days ago that I had another round of chemo treatment.  However there is a slight change of plans. The morning of the treatment started like any chemo session – a blood test.  I was hoping to have my favourite nurse to draw my precious blood but wasn’t my day.  I am not sure if she was rushed for time.  It was rather painful when she poked me with the needle. I could feel the blood flowing into the tube.  My arm was sore and weak for several hours – this is the first time I have felt any discomfort post a blood test.

So what is the change of plan you might ask.  The cancer marker level in my blood test showed a northward trend – about 10% increase from 56 to 62. This is not what I wanted to see.  My oncologist did not hesitate to advise me that we need to change the chemo drugs.  The plan is to go back using the set of chemo drugs administered last year.  The combo drugs are Carboplatin and Taxotere.  Before we proceeded with the treatment, she gave me an option of changing Taxotere to another drug called Taxol. From what she explained to me, Taxol is within the same class of Taxotere and used to various cancers such as breast and ovarian.  Taxol can be administered either on a weekly basis or every 3 weeks. I just can imagine not having a rest in between each session.  Plus my veins would not be able to recover in time.  I could have opted to insert a catheter but I can’t bring myself to go under the knife once again even if it is for very short duration.  I would be silly enough not to take up the 3 week plan. Mind you it takes around 4 to 4.5 hours to fully administer.   At least I have a longer period to recuperate in between each session.

Now that treatment plan took a detour, the next question I had to ask the doctor is how many rounds would I need to complete.  The answer I received is “Until the cancer markers has stabilized”.

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I am happy to say that the side effects for the new drugs are much easier to manage than the Japanese Campto drug.  No nausea, a slight headache and body aches for a day or two.  Mind you I am still very cautious about my immunity in the first post chemo.  My white blood cells has crept up a little higher but I am not completely out of the woods.

I am looking forward to walking out of the house for some natural Vitamin D tomorrow.  The other happy news is that I can fit in more swimming days in between treatments.

What will the results show today?

It’s Friday and today is round 5 of my chemo treatment. My body is starting to ache from the 2 consecutive days of swimming.  I am proud to that I can swim 40 laps each time. This is my personal best thus far and my minimum number of laps each time I swim.

Ok, swimming aside.  I am little anxious what my blood test results will be later this morning. The results will decide what course of action I will take.  Should there be minimal decrease in the cancer markers, then I may have to revert to using the Carboplatin and Taxotere combination used in my first chemo treatment last year.  If my memory serves me right, my oncologist mentioned that she will change to Taxol instead of Taxotere.  The white blood cells count will be the other indicator closely monitored. Although I feel physically fine, I am susceptible to catching any cold or virus’ very easily plus my body would have a tougher time to fight should I fall ill.  It doesn’t help that my sister and her daughter have not been well over the past week.  I just keep a good distance away when possible.  My brother in law has a sore ankle to add to the woes. So I have been helping out with the cooking and housework. Not a fun household to be in right now.

I am crossing my fingers and toes for a better blood test results.  It is a short post today.  I’ll be leaving shortly to head to the doctor’s.

Round number 4 – checked

Is it me or is timing flying past much faster.  It is exactly one week ago that I successfully completed my 4th chemo treatment.  Phew!  Overall the treatment well but there is a possibility a change in plans.

So here is the story.  As you may have learnt from my earlier posts, there is a blood test that is carried out prior to start of each session to decide how I am responding to the treatment plus the results will raise any concerns in my blood.  For me the key indicators are the cancer markers and white blood cells that I am most worried about.  I like to see a downward trend for the cancer markers and for the white blood cells level increased to a higher level.  As soon as my oncologist sat down with me to review the results for round 4, I was taken aback to see cancer markers increased by 10% from 49.9 to 56.3.  She was just as surprised as I am.  There are two possibilities that could see the markers spike up.

  • Fighting a viral infection.
  • The cancer cells has learnt to adapt to resist drug and mutate to generate new cancer cells.

I have been physically fine and not fallen ill in between treatments. As for the second point, cancer cells are incredibly intelligent to regenerate new cells in a matter of days.  In round 3, I postponed the treatment by 5 days simply because my white blood cells were too low and anemic.  In that short space of time, it is an opportunistic time for the cancer cells to adapt and learn to be resistant. I haven’t researched into this myself nor can I prove it.   Moreover the chemo drugs has  “expiry” date in terms of effectiveness.  In my case, the drug, Campto last for about 17 days or so. Delaying any further could pose further risk and lower the effectiveness.

So what does the above mean for me.  My doctor explained the options available.  First option is to change the chemo drug to the Carboplatin/Taxotere combo used in my first volume of chemo last year.  This means back to one round every 3 weeks and I would need to completed at most 4 rounds.  My white blood cells levels with this drug didn’t drop below the normal range.  Second choice is to use a complete new drug that is prescribed on a weekly dosage.  I am not too keen on this option because my veins would not be able to cope with the weekly poking.  As it is now my veins are under so much stress each time I have chemo plus I only have less than 2 weeks to rest before it all happens again.  In the event I choose to have his intense program, she strongly recommended for me to insert a catheter near my collarbone for much smoother and painless administration.  Oh boy!  Decisions decisions.

If I had to compare the choices, I would opt for number 1. And from past treatments, my white blood cells did not take a huge beating from the drugs.  There is a fine balancing act right now of making sure the drugs are working and still be somewhat strong enough to fight off a cold.

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I am just wondering with the modern medicine today, how come pharmaceutical companies haven’t thought of a wonder pill for white blood cells.

TGIF.  Have a good weekend everyone!

Round 3 – this time it’s for real

Gosh where has the time gone.  One week has zoomed at a blink of an eye. After the wait and see approach and taking iron tablets to address my anemia, it was time to get another blood test done to decide if I am  medically fit to go ahead with round 3.  Aside from the haemoglobin the other key indicator the oncologist is hoping to see some improvements is my white blood cell count.  I kept my fingers crossed while I waited patiently for the results.  In the meantime, I fed my tummy with a nutella and banana sandwich for breakfast.

An hour and half later, the results are back.  There was good and bad news.  First, the good news is that in 5 days, my haemoglobin level increased and fall within the “normal” category.  I was no longer anemic.  The bad news is that my white blood cell count specifically the polymorph level has not changed from last week – this is also known as leukopenia. With low white blood cell count it means that my body is not as strong to fight off any infections. So what does this mean?  My doctor said that I have 2 options.

Option 1:  go ahead with the chemo session with the same dosage but I would have to inject myself with Neupogen, is a man-made form of a protein that stimulates the growth of white blood cells in your body.

Option 2: Wait for another week with the hope that the white blood cells improve.  I did ask if I could eat or do something to help.  Unfortunately, there is very little I can do in this case.  Should I wait a little longer to do chemo, there is a possibility that I may encounter some cramps in my stomach because the cancer cells are working their way into my guts.  Not a pretty picture and nor do I want to wait and see if the pain comes back.

With no other obvious symptoms such as pain or discomfort, there wasn’t anything to prevent me from continuing with the treatment.  Since I am not keen to have any stomach cramps, I chose the first option.  I would rather have the injections.

By now my body is attuned to receive the chemo and most of the common side effects are manageable.  One of my least side effects is the nauseous feeling.  Despite the anti-nauseous medications I am given prior to each chemo session, it still lingers around for 4 to 5 days.  I hate it!  It is having the hangover feelings without the alcohol.  Somehow, I fought the feeling and survived it.

I have officially completed a quarter of my treatment.  Hooray!

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Not quite ready for Round 3

Today is my scheduled day for the 3rd round of chemo but it just didn’t happen.  The reason lies within my blood.  Yes, my blood test result is the determining factor if I my body can cope with chemo.  In my case the 2 key criteria that was the show stopper are my haemoglobin and total white cell count.

My oncologist asked if I am including red meats or other good sources of iron.  Since my last hospital visit and based on dietitian’s advice, I have kept to a low fibre diet.  Mind you I have consumed more fish and white meats like chicken and pork.  I only eat red meats maybe once in a fortnight.  I do take iron supplements on a daily basis but it seems that it is not enough.  My doctor says that I should be consuming at least 200mg of iron per day.  I just checked the over the counter iron supplement and the real dosage of iron is 18mg plus 10mg of iron in my multi vitamins .  In total I am only consuming 14% of the recommended daily intake – yikes.  Here I am thinking that other iron in the natural foods that I take should be enough.  I guess not.  This is not the first time I have been told that I am iron deficient. Hence, I self prescribed to take store-bought iron tablets.  As of today, my doctor has prescribed higher dosage of iron tablets to take over the next few days to boost my levels.  Of course the alternative is to eat more red meats like beef and liver.  Isn’t that a great reason to go out and eat a thick slice of delicious prime roast.. Ha!

As for the total white cell count, it was one particular cell called polymorphs that was particularly low.  Based on my understanding it is this polymorphs in your body that fights any infections or bacteria.  The blood test indicated that it is below the normal range.  If my doctor proceeded with the chemo, she has to administer a lower dosage of the drug which means less effective to kill the cancer cells.  It also means that I maybe more susceptible to catching infection post chemo.  The doctor strongly suggested that to postpone the treatment a few days after taking the prescribed iron tablets.

This is the first time in my chemo treatment plan where I had to wait for a few days till my body is ready.  I rather be safe and have the drug work effectively. Wednesday, 13 July is the D Day.  My body will be ready then.

Round 1 is done and dusted

Ok, I am guilty for not sharing my post any earlier on this.  My energy level was so low that I had to muster myself out of bed, take a shower and eat when I am hungry. So here is the low down on what happened on the day.  Having a pretty good idea from the first batch of chemo, I knew the drill as soon as I stepped into the clinic.

First task is to get a blood test done.  Blood drawn and sent to the lab to test for cancer markers so fast that I didn’t have time to leave my butt imprint on the seat.  Normally I would have to wait at least 2 hours for results to come back but it wasn’t necessary this time.  I went in to see my oncologist so she can do her normal checks before I start my chemo.  She shared the expected side effects once again and answered my questions I had.  The drug will take 2 hours to administer.  I was ready to start but not before I had a quick bite of breakfast.

For those who remember from my earlier posts, I have very small veins and I knew it might take the nurse to hunt for one again. Tap! Tap! Tap!   I love the way the nurses keep telling me that I have such nice skin but pity that my veins is not the same. Ha! Even with the tourniquet in place, it took a good few minutes to find a possibility. Note to self –  I must resume my “squeezing the ball” exercise to bring out my veins.  She found one vein and a quietly confident to poke me with the needle. I felt the first prick and that was ok.  She pushed in a little further and it hurt a little but tolerable.  As she pushed a little further into the vein she stopped concerned that there was no blood coming through.  A little further nudge of the needle and a sign of blood trickled through.  Phew! With tape to secure the needle and place, the drug started to drip into my system.  For comfort, lights were dimmed in the room and I kept myself occupied by watching some TV series, “The Mentalist” on my iPad.

Over the side effects, I was ready to deal with the side effects.  Fatigue and waking with a headache the following morning was the first signs to crop up.  Then the nauseous feeling started to creep later in the day. Imagine waking with a hangover feeling that last for days.  Took a couple of Panadol hoping to relieve the symptoms.  I guess the drug in my body is not reacting as well to such medications.  I endured it. There was a glimmer of hope 2 days after chemo when headache subsided a little and some energy picked up in the evening. But it didn’t last for very long. By the 3rd and 4th day, my energy level was all time low and the headache returned.  I slept for most of the day. The best Rx for I could give myself is pure rest.

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6 days on and my energy is back to normal.  Looking forward to step outside of the house to get some fresh air and some natural vitamin D.

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