It has been a few months since I’ve had any blood work so I thought I would see how things were going. I usually like to at least check my CBC (Complete Blood Chemistry) quarterly, just to make sure nothing is brewing. With the cancer I had, Mantle Cell Lymphoma, a CBC is a very easy way to see if anything might be starting up again. I have been in remission for 7 years now and would like to continue to be for the rest of my life. If my WBC (White Blood Count) and specifically my Lymphocyte Count is elevated, and some of the other numbers become low – It could very well indicate the return of my cancer. I don’t have to go for stressful and complicated scanning – I can just have a quick blood draw. Then if the indicators point in the wrong direction – I know I need to do something further.
I also have the now present issue of a partial immune deficiency – the chemotherapy that previously killed off the billions of cancer cells in my body has destroyed the lack of certain blood cells to make antibodies (immunoglobulins). There are 5 classes of antibodies and only one, IgM, is present. It happens to be slightly higher than normal. The other four – IgA, IgD, IgE and IgG (makes up 75% of all antibodies) are negligible. This means that my body cannot identify pathogens like bacteria and viruses that are harmful, and basically lets them in to set up shop for a while before another part of my immune system figures out these things don’t belong. This also means that I will have a more severe case of whatever I might catch. My type of immunodeficiency also means that my body has no memory of previous illnesses, therefore I am not “immune” to anything. I can keep catching the same disease again and again. And it also means that any vaccine that I’ve ever had over my lifetime (polio, measles, mumps, smallpox, etc.) is gone – any antibodies that were made as a result of these vaccines have been wiped away. In fact – vaccines themselves won’t work well if at all in me because I don’t make the antibodies that they would try to create. Interesting living in these times of COVID. Basically my only defense is to not get it. Or not catch anything else for that matter.
Given the above issues I like to keep a periodic check on my blood work to see if my situation has improved… or degraded. I got my results 2 days ago.
My CBC was pristine. Beautiful. Like a piece of artwork. EVERY number was within the normal range and many of them were optimal. When I was diagnosed with Mantle Cell Lymphoma – my WBC was 240,000 – driven by a super high lymphocyte count. I was also severely anemic. And I had many different types of irregular and immature blood cells – showing there was a defect in my white blood cell-making process. I had way too many cells and they were defective. These are the hallmarks of cancer cells – they lose their ability to die (apoptosis) and their ability to function properly. Cancer cells like to spread, invade and destroy normal tissue. But in this current blood work – my WBC was 6.7 and this number was NOT driven by lymphocytes but neutrophils – another type of white blood cell that are first to race towards the site of an infection or inflammation as they do. They play a significant role in the front line defense against invading pathogens – which is seriously helpful for all of us but especially in my case – given I have little early warning system against invaders. I also had no immature white blood cells, also a good sign.
However, my Immunoglobulins are still low, except for IgM which is a little above the range. An immunological disaster. I still have a serious immunodeficiency. I am much more susceptible to pathogens, I am more likely to have a serious case of whatever I catch, I cannot be tested for any type of allergen since I have no antibodies to react to the test, and I am more susceptible to developing other cancers. I still cannot live in the world as a typical person. As COVID comes and goes and comes back again – I will be that person who will always need to wear a mask to protect myself. I will have to decline most gathering with friends. I will miss celebrations of all kinds, entertaining, concerts, gatherings with others. And I can’t be there for others in their time of need such as visiting people in the hospital, attending funerals or just visiting someone in their home. Zoom is the best option for me to join into something. These last few years have reminded me I’m much more of a social creature than I thought.
Ironically when you look at me – you think I’m the picture of health. And in many ways I am. Metabolically I’m more than a decade younger than my age. But when you look one level below – it’s not good. The options to fix this are awful – infusions of immunoglobulins for the rest of my life carry serious side effects. I’m not willing to go down this route yet. Keeping semi-isolated is the other option right now and then dealing with infections or illnesses as they crop up, but trying to prevent those from happening. Fortunately I haven’t caught anything from anyone else over the last 2 ½ years. I did have a basal cell cancer removed from my face, shingles and fracture my leg last year – but healed fine from everything. And in fact – I have anther basal cell cancer in a different part of my face that will be removed in a few days, hopefully uneventfully. “Fun Fact” – I am told I will have more of these than average due to my immunodeficiency coupled with my early years of sunburns.
When I was diagnosed with cancer 7 ½ years ago – I prayed to be able to live and have a future. When I went into remission quickly and there was no trace of cancer in me – it was a miracle. I started making exciting career plans, fun social plans, to become more involved in animal rescue – we even moved into a new home so we would have more room to have people over and have a larger backyard to get a dog. Many of those plans are not going to happen now and maybe never. While the rest of the world comes out of the pandemic, I will still be living it. It’s a strange, confusing and lonely place to be. I fought so hard to survive and thrive after my cancer diagnosis. Now I face a continued life of isolation.
I’m not going to give up though. I will continue to support my very healthy lifestyle and go even stronger than before. It has already helped me in many ways. I will be the healthiest immunocompromised person possible. I will keep testing and maybe one of these times I will be pleasantly surprised. And on my journey, I will continue to acquire knowledge that not only helps myself but helps others too. Perhaps that IS the plan for me……
On that note – Here are a few good resources that explain in more detail what a CBC is, how it breaks down, and what the numbers mean. These are good resources for any type of lab test, so take a look and learn more:
mayocliniclabs.com/test-catalog
Wishing you good health and a great life-
Sheryl
