Saturday, July 19, 2008

AFFLICTION or BLESSING?

We've been taught throughout our lives that hidden among the many afflictions we are required to endure, come many of the most choice blessings from our Heavenly Father.  As a family, this past year has brought its fair share of trying times as well as many great blessings.

When I started my journey with chemotherapy a year ago, one of the side effects I was told I might expect was mouth sores.  Even though it hasn't been a constant thing, I have had experience with mouth sores.  Usually in the form of canker sores, I even had one bout with a couple of sores in the middle of my tongue that were determined to be a form of herpes. The medicine prescribed,  famcyclovir, is a commonly prescribed treatment for genital herpes!! 

I was confident that when the chemo was completed this past May that even though limited in occurences, I wouldn't be having anymore treatment related mouth sores. WRONG!!  Just a few weeks after treatment was completed, I had a couple of cankers that got pretty bad just inside my lower lip.  In about a week they ran their course and went away.

Then all h--- broke loose.  Just as the previous ones were finishing healing, what  started as a sore when I bit my lip while chewing, developed into something more.

Editor's note:
PARENTAL GUIDANCE RECOMMENDED
images may be to intense for
 small children or those with queasy stomachs

This sore started small while I was away on business and got larger as the week went by. When it didn't get any better, Barry (my brother the dentist) suggested that he might have an application that might help it. On Monday the 14th I went and saw him.  He immediately determined that he couldn't do anything to help it, but was concerned about the amount of inflammation in my gums which he said was due to large amounts of bacteria in my mouth.  He did some minor cleaning (too much pain) and gave me some toothpaste and mouthwash that would help keep the bacteria levels down until I could get in and do a full cleaning.

That afternoon at the INSISTENCE of my wife, I called Dr. Shehadeh's office to see what they could do.  They told me that they could call in a prescription (famcyclovir) or I could come right in and they would look at it.  I chose to make a visit to the doctor.

After the usual blood draw for a CBC, I saw Mike Cole, the physician's assistant.  While talking with Mike, Dr. Shehadeh came in to look at it.  Mary brought in the lab results, and as they looked at them together, I heard an simultaneous GASP! from each of them.

AT THIS POINT THE AFFLICTION BEGAN TO MANIFEST ITSELF AS A BLESSING 

The blood tests showed my white blood count to be 0.8 and my neutrophil level at 0.2.  Both of these levels are in the critically low range.  The "low of normal" level for the WBC is 3.6.  My temperature at the time was normal.  With such a low white blood count, they decided to give me an injection of Neulasta which is used to spur the growth of white blood cells in chemotherapy patients.  The catch with this injection is that the cost is approximately &6,000. After getting insurance approval, I got the shot.  All of a sudden the monster mouth sore, even though it hurt like h---, wasn't much of a concern.  I was sent home with a couple of prescriptions and instructions to call immediately if I had a temperature above 100 degrees. By the time I got the prescriptions filled and got home, my temperature was 101.4.  I immediately called the doctor who told me to go to LDS Hospital where I would be admitted that night.
  
It turns out that my condition had become neutropenic.  

Quoting from www.tirgan.com, "There are various types of cells in the blood.  The lowering of the white blood cells that fight infections is known as NEUTROPENIA.  It is the most important complication of chemotherapy.  It is almost always due to impairment of bone marrow to produce cells and normally occurs a few days to a few week after chemotherapy.
It is most severe in patients who receive aggressive treatments.

The signs and symptoms of Neutropenia depend on its severity.  However, patients with even mild forms can develop major problems.  Even in the most severe cases, it may have no signs at all, or it may cause fever and infection.  A fever in patients who have received chemotherapy must be taken seriously, requiring a complete evaluation.  Taking Tylenol or aspirin will only mask the infection and should be avoided.

One technical term of which cancer patients should be aware is "Febrile Neutropenia," which refers to having a fever while the white blood cell count is low.  Fever indicates the presence of an infection, which, in most cases originates from germs and bacteria that reside in the intestines or skin.

Febrile Neutropenia is a medical emergency and must be dealt with immediately.  Any temperature over 100.5 should be reported to the medical oncologist immediately.  Hours and minutes are critical."

The web site goes on to say:

IF LEFT UNTREATED, THIS COMPLICATION MAY
BECOME FATAL WITHIN A MATTER OF HOURS 

I spent the next three days and four nights at LDS hospital, hooked up to an IV, sometimes getting as many as four antibiotics.  One night, my temperature started spiking so the doctor ordered a full blood culture and chest x-rays.  Fortunately, all of the tests done came back negative.  They were very concerned about new infections and particularly the onset of pneumonia.  As the treatments progressed, my WBC went from 0.8 on Monday to 1.9 on Friday, with the neutrophils going from 0.2 on Monday to 1.3 on Friday.  Neither level great yet, but rising and good enough to get me off the IV and home. By the way, my mouth still hurts like h---, but has turned the corner and is getting better.

You wouldn't normally think that intense mouth sores, four night hospital stays, $6,000.00 shots, blood draws, 24 hr/day IV's, high temperatures and the such would be considered a blessing.

I have been blessed. Blessed by the above. Blessed to have a loving wife, mother, children and grandchildren.  Blessed by medical technology that indeed saves lives.  Blessed to have great doctors and medical staff who really care and aren't afraid to show that they care.

Thanks, everyone for blessing mine and Sharon's lives.  We love and appreciate all that you are and do.

In closing and on a less serious note, here is what I look forward to every morning when getting ready for the day.



5 comments:

Bryan said...

Hang in there dad. I'm glad Troy and I were there to help you on Monday before you were admitted. Our family is greatful for all you and mom do.

sware said...

blessings come in all sorts of packages, ah? I'm grateful!! I think of you guys often:) Good to hear about how things are.
Love you!
Sarah Ware:)

Dave & Jackie said...

The Lord works in mysterious ways. Even if they are a pain in the mouth. We are glad you are doing better, and are still with us. Love you, Jackie

Em said...

hang in there Uncle Randy the lord will bless you. we have been praying for you to get better

Sue Peebler said...

Wow that sore looks nasty. I am happy to hear you weren't too stubborn to get yourself to the Doctor. Better safe than sorry. Take care of yourself.