04/05/2010
by Michael Wells Easter Sunday was a wonderful day. Other than a couple of vomiting episodes, Brady has no fever, his rash is gone and he is on the mend. I did however make one very big mistake regarding his absolute neutrophil count (ANC). The number I reported was 278 when in fact the true number was 378. This is just incredible news as once the ANC is above 200 Brady is on his way to the next steps to being released from the hospital. There are a number of “things” that must happen before he is released but an ANC of >200 is the first step. This will allow the doctors to start reducing the amount of prophylactic antibiotics, the amount of calories he’s receiving via IV and hopefully the amount of morphine. He needs to be “off” all 3 before he can be released but it all starts with an ANC above 200. I have been asked to give a little primer on ANC (Aunt Ellen this is for you): Neutrophils (aka polymorphonuclear cells, PMNs, granulocytes, segmented neutrophils, or segs) fight against infection and represent a subset of the white blood count. Neutropenia by definition is an ANC below 1800/mm3 (some sources use a lower value). The ANC refers to the total number of neutrophil granulocytes present in the blood. Normal value: ≥ 1500 cells/mm3.d neutropenia: ≥1000 – <1500/mm3. Moderate neutropenia: ≥500 – <1000/mm3. Severe neutropenia: < 500/mm3. Absolute neutrophil count (ANC) of 1000-1800: Most patients will be given chemotherapy in this range. Risk of infection is considered low. Mild neutropenia – Absolute neutrophil count (ANC) of 500-1000: Carries with it a moderate risk of infection. Absolute neutrophil count (ANC) of less than 500: Severe neutropenia – high risk of infection. Remember that a reduced WBC is known as leukopenia. So, all and all we had a truly wonderful Easter Sunday and while the road ahead is still very long we are confident we’re at least going in the right direction. Please continue to help us navigate our journey with your continued prayers, hugs and good thoughts.by Sherrie Wells Today Was Nothing Short Of Fantastic! Brady’s absolute neutrophil count (ANC) was up from 378 yesterday to 725 today. His white blood count continues to rise. He has not needed any blood or platelet transfusions in a few days. His rash is all but gone and just dry, flaky skin remains. If this trend continues he will be able to leave on Friday! Let me repeat that, we will be going HOME! I also spoke to Jimmy today and Dr. Bunin said that as long as he starts eating he will be going home on Friday as well. The RWJ boys are headed home! Brady’s morphine patient-controlled analgesia (PCA) was cut in half this morning. His total parenteral nutrition (TPN) the method of supplying all Brady’s nutritional needs by bypassing the digestive system and dripping nutrient solution directly into a vein; has been reduced from round the clock to 18 hours a day. His appetite is getting a little better and he had nine ounces of water today and did not vomit. He also had a CT scan of his sinuses, chest, lungs, and abdomen. He had this done with no anesthesia and stayed perfectly still! I am so proud of him. Brady had a wonderful visit from the Sesame Street characters Bert and Ernie. They waved and blew kisses back and forth through the glass door. I also had a visit from Brian, Jaclyn’s dad, who came bearing amazing gifts. Jacklyn was at CHOP with her mom Lori getting a check up and she is doing REALLY well. I also was told from Brittany (who ran the marathon in Brady’s honor) that the Leukemia and Lymphoma Society want to make Brady an honored team member. This means that they would run for Brady at EVERY event. I have cried many tears of joy today. All and All a very wonderful and busy day!!! I can hardly wait for Friday to get here. PS: My apologies for being tardy with my thank you notes… Thank you to Mrs. Kim Stroka for your donation to Caring Bridge and the beautiful card, it brought tears to my eyes. Thank you to Aunt Kellie for sending yummy cookies and brownies! Thank you to Rose, our RWJ RN, and Flo, Jimmy’s RWJ school teacher, who surprised us with a visit. It was so wonderful to see you both.
The Hugs for Brady Foundation will ALWAYS be in support of other foundations who allow people to donate blood, platelets, plasma, or register to become a bone marrow donor. However, we no longer ask supporters to donate financially to ‘The Leukemia and Lymphoma Society’ as their focus on childhood cancers does not coincide with our foundation’s mission.
“8 Years Later—Still No Cure for Pediatric Cancer” is a series of posts revisiting the journal kept by Sherrie and Michael Wells during the cancer diagnosis and treatment of their son, Brady Michael. Hopefully these entires will provide an understanding of the journey families face when dealing with these horrific diseases and of the important work the Hugs for Brady Foundation does.