Sunday, July 17, 2011

Day 8: Blood Tests During BEP Chemotherapy

On Day 8, the pill schedule changes again:

Morning: 1 Pepcid
Night: 1 Pepcid
As Needed: Zofran (up to 2), Reglan (up to 3)

I finally felt as if my body was settling down. Unfortunately, it chose to settle halfway between the swamp picture and forest picture, but I'll take it! The thing about blogging about day 8 is that chemo recovery is nothing but a waiting game; you live your life to the fullest extent possible, and wait for the side effects to slowly subside.

On day 8, I didn't do much; went to the library to pick up some books to read (Ender's Game and Ender's Shadow by Orson Scott Card, my two all time favorites) and went to get my weekly blood test, which since we haven't covered yet, we shall now.

Blood Tests & BEP Chemo
If you're reading this blog, then you've almost definitely had a blood test in the past. I won't delve into the basics of what a blood test looks like. Long story short, the tech finds a vein on your arm, sticks you with a needle, fills up some 5cc or 4cc vials, and then slips the needle out and gives you a cotton ball & med tape dressing.

A few personal reflections on things to keep in mind as a chemo patient having blood tests:

1. You're getting stuck with needles all the time for your chemo treatments. this means your veins will be thinner, more fragile, and overall harder to stick.

2. Because of this, as a chemo patient, I don't want to have a student draw blood on you. When I was assigned to a student, I'd ask for a professional and note that you're an oncology patient. They understand, getting stuck over and over isn't fun.

3. Drink 50 oz of water between 4 and 2 hours before getting blood drawn. Hydrated veins mean happy, easy to stick veins. Easy to stick veins means less getting jabbed!

Bloodwork that was ordered for me during a chemo Cycle:

Day 0- CBC+Metabolic Profile, AFP, LDH, HCG, Creatinine, AST
Day 8- CBC+Metabolic Profile, Creatinine, AST
Day 15- CBC+Metabolic Profile, Creatinine, AST
Day 21*- CBC+Metabolic Profile, AFP, LDH, HCG, Creatinine, AST

*Day 0 of the next cycle

*DISCLAIMER: The below characterizations of these tests are not intended to serve as medical advice nor should they be interpreted as such. Just a lay-patient trying to paraphrase things that have been said to me by the medical professionals who care for me. Talk to your doctor, ask questions, be an active participant in your treatment, etc.*

What are these tests?

CBC= a Complete Blood Count. This test finds out everything concerning the make-up of your blood, from your red blood cell count to your white blood cell count to your platelet count. On top of that, a WBC differential will also figure out what the concentrations of different types of white blood cells are in your blood.

Metabolic Profile= This test finds the sodium, magnesium, potassium, and calcium levels in blood. Cisplatin causes fatigue by messing with these levels, so it's good to monitor them.

AFP= AFP is a normal fetal serum produced by the liver. It is very evident in fetal plasma but then quickly dissipates after birth. Because you're not supposed to have much of it in healthy adults, it is a very good tumor marker, or cancer indicator.

HCG= HCG is a hormone found in pregnant women. It is the same hormone that is detected for in pregnancy tests, and also the one that causes nausea, morning sickness, pregnancy cravings etc. Since men don't have babies, they shouldn't have this hormone, and so it is another good tumor marker for testicular cancer as it will be elevated should TC be present.

LDH= Lactate Dehydrogenase is a third tumor marker but not as much for the specific type of tumor, rather for the sizes of the tumors (tumor mass).

Creatinine= Creatinine is left over after the muscles break down creatine phosphate. It is mainly filtered out by the kidneys. Because Cisplatin is nephrotoxic, monitoring kidney function is critical to prevent kidney failure should it get overworked and watching the creatinine counts is a good way to do so.

AST= This enzyme is generally found in low levels throughout the blood. When an organ such as the liver is damaged however, AST is released into the bloodstream to help repair the problem. Chemotherapy isn't exactly the best thing for your body, so monitoring AST levels can be an indicator of possible organ damage.

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