When can Rachana come home? Well it depends, but ANC is a key number.
The blood is mostly made up of red blood cell (RBC), white blood cells (WBC) and platelets. RBC supply oxygen to the organs, WBC fight infection and Plaletes prevent bleeding by helping the clotting process. Leukemia is a disease where the body produces a lot of immature WBC (also called blast cells). This makes the blood carry useless cells around and therefore reducing the healthy functions. 50-70% of WBC is Neutrophil and these are the body’s army that fight infection. Usually neutrophils live less than a day and so the bone marrow has to keep producing these. RBC and Platelets can be transfused (pumped in intravenously), but Neutrophils cannot be transfused as they have a very small shelf life to begin with. RBC is given when hemoglobin is less than 7, Platelets are given when it’s less than 10k. Absolute Neutrophil Count (ANC) in a healthy person is greater than 1000. You are susceptible to infections if ANC is 500-1000. You should void crowded places below 500. Below 200 requires isolation and limited to no visitors. Rachana is now at 200 and the doctors say this can drop further before it picks up. ANC is the single biggest factor in deciding when Rachana can go home. When ANC rises, everything else will too. She might hit the nadir in the next few days and then fight back to healthy counts. The doctor said on an average most patients turn a corner around day 20.
This morning hemoglobin was at 6.1 and we felt it dropping cause of the low energy for the last 2 days. She received 2 units of red blood this evening. Nausea meds are working with zero nausea episodes today; she was basically sleeping all day but did eat well.
There are many friends in the local area who are obviously in touch but here is a quick thank-you to all other US, Canadian and Indian friends who have followed her progress closely, keep sending their best wishes and include her in their prayers. Rachana appreciates your best wishes and will soon be healthy enough to spend time on the phone with each one of you.