It has happened a lot over the nearly four years since I was diagnosed, and it has happened a lot lately.
It happened in mid-August, when I went to my local doctors’ surgery to have my post-chemotherapy blood tests.
Then again last Friday when I went for my MRI.
And it happened yesterday when the nurse was taking blood ahead of the start of chemo cycle two.
Essentially, whenever someone with a sharp needle comes close to me they observe in impressed tones, “oooh, you’ve got good veins”.
Now, I quite understand this might be the small talk that nurses and others use to get through their day, and maybe they use it to put patients at ease.
But such is the consistency and quantity of the compliments I have received regarding my arterial system, that I prefer a second explanation. That I really do have good veins.
They protrude. They’re thick. They show up against the muscles in my arms, like deep purple rivers winding and connecting on a barren but bumpy map. Nurses barely have to tourniquet my bicep to get access to a wonderfully swelling pool in my inner elbow from which they can easily draw off a few tens of millilitres. Take more, there’s plenty to go around.
I’m proud of my veins in the same way as I’m kind of proud of my legs. They’re cyclists legs: stringy and sinewy, bulging in all the right places. All cyclists tense their leg muscles in front of long mirrors, don’t they?
This isn’t vanity, I’m merely drawing attention from my upper body – particularly above the neck – which was nothing much to look at in the first place, but is now topped by the most ridiculous radiotherapy-damaged haircut that any diversionary tactic from that barnet is surely legitimate.
After receiving the compliment about my veins once from a London radiologist – about to offer me a ‘quick scratch’ so he could squeeze dye into my blood – I asked why they did seem to be so prominent.
“Its because you probably have a higher than normal red blood cell count,” he said. “I can tell you’re an athlete. What do you do?”
I told him I was a cyclist, and we fell into cycling chat, and then we both probably realised we were flirting a bit, and hadn’t we better get on with the MRI. Good job, as I’d have probably started showing him my tensed legs and who knows where that would have gone.
But what bigger compliment for a cyclist than to be told you are so fit (no, athletic!) that it shows up in the streams of blood running up and down your arms?
Whether his diagnosis of my athleticism based on the state of my veins was correct or not, is probably just as sound as the assumption I have now made about my own white blood count.
I am, and always have been, susceptible to illness. I had two kidney operations as a kid, as well as an appendectomy. I got a hospital infection. I pick up colds more often than I pick up the phone.
A sting, or a scratch, or the slightest stink of a cat has my whole body itching in response, as my good veins get flooded with histamines.
I am fit and I am healthy. But I am not robust. I have good veins but a poor constitution.
All of which is a roundabout way of saying my second round of chemotherapy didn’t go to plan yesterday. No matter how purple and inviting my veins were for the intravenous dose of chemo, I was unable to go ahead. Treatment has been postponed for a week.
Chemo attacks rapidly dividing cells, including red blood cells (responsible for carrying oxygen around the body) and white blood cells (responsible for fighting infection).
Yesterday’s blood test showed my white blood cells were below the required quantity for me to receive chemo. So I had to be sent home for my white blood cells to further recover.
It’s frustrating, but it’s also revealing. As fit as I’ve generally felt throughout treatment so far, its a reiteration that what shows on the outside doesn’t necessarily match with what’s going on internally.
I have been very tired lately – brutally, crushingly fatigued at times – and have had a constant salty taste in my mouth, as well as aural hallucinations and a little dizziness. But these are known side-effects of radiation and chemotherapy, so none are a surprise and I have to live with them for the time being.
Low white blood cell levels don’t tend to show as a symptom at all.
So, the question is: what can I do to raise my white blood cell levels? I want to get chemo done as quickly as possible, but if yesterday becomes the pattern (seven weeks or more between the beginning of each cycle, instead of six) then that will add months to the regimen in total.
A quick search on Google confirms what I expected. If there was something I could do to raise my white blood cell count myself, my doctor and nurses would have told me.
Here I know I will depart with some of my readers, but using diet to raise my white blood cell counts sits firmly in the zone of nutri-nonsense. Unfortunately, there’s far too much of this food-cures/treats-cancer stuff around (for more of which, do please feel free to check out my book on the subject).
For all the cancer cookbooks and healthy eating manuals in the world, there’s not one food that has been shown to increase white blood cells in cancer patients. Food can’t ‘fight’ cancer in that way. Only time and mild exercise will allow my bone marrow to do its thing. Or else my oncologist can prescribe me yet more drugs.
So, I have to sit it out. Doing bike rides when I have the energy. Sitting at home tensing my calves and admiring my good veins when I don’t.
It could be worse, and it might get worse. During my first round of chemotherapy, I was placed next to an older lady with whom the nurses were struggling to find a vein at all.
It was a sad sight, and reminds me now that even though the latest developments may be frustrating, and the fatigue has been particularly crushing, I’m still lucky to be where I am.