Surpassing Expectations

We have discovered the drawback of receiving care at a teaching hospital: the team of doctors changes every two weeks.  We met our new team on Sunday morning and have had an additional new person each day.  Today we saw the team in its fullness and  it is 7 members strong.  We only got to keep Dr. Mitra who was the original Dr. who met us on our first day here.  He is the Fellow in his last year of rotations before he becomes an attending physician.  We are happy to keep him because he is the one we've been dealing most closely with.  Our new attending physician is a tired looking middle aged man.  He is average height and build with a thinning crop of hair and a permanent look on his face that says "I'm yawning inside because I am unimpressed with everything you say."  It is my new goal to an evoke any kind of facial movement from him. 
Yesterday he showed up looking exhausted and wearing jeans under his long, white doctor's coat.  I tried to imagine what had occurred in his morning to leave him looking so exhausted and thrown together in jeans.  It then occurred to me that maybe he was just celebrating the holiday by sporting casual wear.  Or maybe he had a BBQ to attend immediately after work.  Who knows?
Yesterday we had new female resident  MD join the team.  She is tall with a sporty build and long dark hair.  She cracked a joke about Will's weight lifting the second we met her which was quite the change from the stoic attending physician.  She wanted to know if the beard was a requirement of weight lifting in order to enhance the intimidation factor.  We all laughed. 
Today when the team came in she announced that they were there so Will could bench press them all.  We all laughed again.  Even our attending physician cracked the tiniest of smiles. I like her. 
Willie is having another good day.  He ate a good breakfast and is having a bit more energy.  The Dr.s continue to say that he is surpassing their expectations.  We were told from the beginning that Chemo will cause all of his blood counts to drop and we have been seeing them slowly trend down.  What we haven't been seeing is the physical response that is supposed to occur from that!  Chemo works by killing cancer cells AND the good cells as well.  As our Dr. explained it to us, you can imagine Chemo as an attack in which both the good guys and the bad guys are killed.  He can get infusions to replace most of the "good" guys being red blood cells and platelets, but white blood cells cannot be infused. 
This has been their concern from the beginning.  White blood cells are what the body needs to fight off infections.  Will's white blood cell count has been trending downward for the past two weeks which makes him highly susceptible to the tiniest of infections.  Before we even started chemo, Dr. Mitra explained that a drop in white blood cells was inevitable as is a fever and infection as a result of the body not having a line of defense.  This is why it is so important for Willie to stay isolated in his room and wear a filtering mask when he ventures out. 


Willie being used as a table.

To stay on top of his numbers, they now draw his blood two times a day at 5AM and 5PM.  It's funny how many syringes it takes to draw a few vials of blood from Will's picc line.  Most nurses place the items they will need on the bed or the table next to the bed, but yesterday that nurse ignored those locations and placed everything directly on top of Willie as if he were a table!  I thought it was so funny that I took a picture of it.  We then teased the nurse about it and all shared a good laugh.
Yesterday his white count was 0.8, today it's 0.4.  I asked the nurse how low the white count can go.
"It can go down to zero," she explained "it happens in all chemo patients so it's something we expect.  The counts will start rising again as his body begins to heal, so we'll just keep monitoring."
I think it's crazy that a white blood cell count can drop to zero.  How can a body function with zero cells available to fight infection?  This just confirms the amazing power of the body to withstand the hardest of conditions and heal itself in the process.  Will has been lucky that he has resisted infection this far since everyone has been expecting him to catch something by now.(knock on wood!)
Today Dr. Mitra reminded us that his white count was low, but this time he said
"Don't be surprised if you get a fever or infection, but now I won't be surprised if that doesn't happen either!"  This is coming from the guy who has been preparing us for the worst since the minute we stepped through the doors. The doctors are starting to realize just how strong Willie is and we are grateful that he has been the exception to the rule this far in his treatment.  We continue to hope and pray that he will keep up this trend through the coming weeks.  Thank you everyone for the prayers and positive energy!  As you can see, it's helping so please, keep it up!