Blood 101

Here is my blood 101 crash course to help everyone who is not a doctor, nurse or a science major understand.  We get a lot of blood tests, in the past week Charlotte has had 3.

There are three counts that we are most interested in - and impact whether Charlotte needs a transfusion, and how tight we keep her bubble.

This is taken almost verbatim from my "children with cancer" handbook:

Hemoglobin (HGB) - If she does not have enough hemoglobin, she is anemic - tired, weak and pale.  The HGB gives energy to the body, provides color to the skin, and carries oxygen to all parts of the body.  If her levels are low, she gets a transfusion of red blood cells.  Chemotherapy is rarely postponed due to low HGB.  A normal range is 107-131.  Adequate is 70-80.

On Monday, her level was 75, warranting a transfusion (her chemo drugs lower her levels, so I don't think they wanted to send us home for 2 days at 75 and dropping).  When she was diagnosed, her level was 26.  If you or I had that level, we would be on the floor knocked out.  Goes to show how resilient kids are.  Transfusions have to be done over 3 hours so as not to tax the heart.  When she had the very first transfusion - they just did a small amount over that period of time as she likely had been low for a while.  The heart gets used to pumping the little amount, that to add all that blood at once would shock it.

Platelets - If the platelets are too low, blood will not clot well.  There is a risk that she will start bleeding and this will be hard to control.  If her levels are low, she gets a platelet transfusion.  A normal range is 180-440.  Adequate is 50.  They don't like to perform lumbar punctures or biopsies when it's below 50.

At diagnoses, Charlotte's platelets were 13!  We go back to the hospital on Thursday to check platelet levels before her lumbar puncture Friday.  She may need to get a platelet transfusion Thursday.

Absolute Neutrophil Count (ANC) - These are a type of white blood cell, and the most important for us.  These are the most powerful killers of bacteria.  A normal range is 3.9 to 10.2.  Adequate is 1.0.  Anything less then 1 and we are in the bubble and watching out for fever as she basically has little to no ability to fight infection!  They will delay chemotherapy at certain stages until it hits 0.75.

At diagnoses, Charlotte's ANC was 0.56.  It has gone as low as 0.03 during her treatment so far.  On Monday it was 0.78.

Charlotte's current drugs reduce all her counts, hence her transfusion Monday, and frequent blood tests.  We have a frequent flyer card for the local lab, and have to be aware of her most recent counts for any late night calls to the ER.  She will very likely need many transfusions over the course of her treatment.

So....on that note...I encourage everyone to hit a blood bank!  www.blood.ca

I'll leave you with a picture of Charlotte from Monday....riding a bike while getting her blood transfusion!