I'll have to tell you a little about blood first:
Chemotherapy affects three important blood cells: red blood cells that carry oxygen, white blood cells that fight infection, and platelets that help stop bleeding. There are usually visual signs of low red blood (paleness, fatigue) and low platelets (lots of bruises, petechiae or little red dots, and Ty gets severe chapped lips whenever his platelets are low) but there are no visual signs that I know of for low white counts. You can also do a transfusion for both low reds and platelets but not for whites. Ty's body has to make his own, and there really isn't anything I can give him to boost them. (I guess Neupogen shots are discouraged with his type of ALL)
So when his white blood counts are low, specifically his neutrophils or Absolute Neutrophil Count (ANC) then we have to be super careful about his exposure to germs and sick people. Even when they are high we have to be careful, but when they are low that means he can get germs that a normal person wouldn't even know they had and it can land him in the hospital for a few days or worse.
Thus the dilemmas: We can't reasonably spend over three years staying home and hiding from every germ, especially because sometimes they can get infection from bacteria already on or in their own body. But where do we draw the line? Activities that are outdoors are better because of the open air and less frequent contact with people and things they have touched. But still outdoor no no's include playing in rivers, ponds, sand, or dirt. When his ANC is high we can attend limited indoor activities, including Sacrament meeting at church with a mask on, but not primary. We are supposed to go to movies, stores, and other public places at times when they won't be busy or crowded. No fast food with low numbers, no soft serve ice cream, no 'licking' the beaters of batter, no cookie dough, no unpasteurized juice or milk products, no sharing spoons, drinks, or tasting someone elses candy or food, no using 'community' ketchup, mayo, chips, and other things lots of hands have touched...lots of no no's!
Probably the biggest dilemma involves people we love cause we LOVE spending time with them! We hate staying home from stuff, but also know that's our reality right now. We have been lucky so far in this area, neighbors have been good about keeping their sick kids away from Ty and family members have been good about letting me know about sick kiddos so we can stay home if we need to. My mom has been a lifesaver in this area, even sanitizing her own house when she knows we are coming. A fellow cancer mom actually had her in laws say she needed counseling for pointing out that they weren't washing hands properly after handling raw chicken and wiping little noses with hands and then wiping said nose goo on their pants. The truth is, people have this thing about others germs but seldom do they think about their own germs. It is certainly more awkward to ask an adult to wash their hands than it is a kid. I have no qualms following little kids around with hand sanitizer, but adults are a different story and when they aren't in the habit they don't even notice. (I certainly didn't before I became hyper aware)
It is also easy to forget when he otherwise seems pretty healthy, hair is growing, and he wants to run and play and be normal, sometimes I hate reminding him that he is sick by warning him about something germy and chasing him around with hand sanitizer.
Our three fever visits to the hospital so far have been a result of me relaxing the rules. The first time Ty's counts went up I was like woo hoo!! I let him play with lots of kids and sure enough he got a cough that persisted until it turned into pneumonia, all this while his counts were high! That resulted in a very crappy visit to the ER, a very long follow up visit the next day, and three very painful shots of a gelatinous goo antibiotic. (Rocephin I think it was called) The next two fever visits were from little tiny scrapes he got on his knee when he tripped and skinned them on some gravel at Camp Hobe. Oh if only I had taken him to the nurses station to get cleaned out properly instead of just slapping some neosporin and bandaids on them we might have escaped two five day hospital stays, lots of IV antibiotics, an ANC that refused to go up, and even more pokies. They were such little scrapes, they barely even bled but his ANC was 600 at the time and apparently that is too low to fight off unknown dastardly organisms. Who knows on that one though, they might have gotten him with proper washing anyway since they were persistent little buggers, they survived through many days of three different kinds of antibiotics. Ten days of a different one is what finally killed them off.
So the battle in my head rages on. It is impossible to follow all of the rules all of the time, but when you relax the rules, even for a little tiny second it might land you in the hospital for a few days. So do I go to something planned, making myself (and Ty) crazy the whole time, or stay home, that, my friends, is the ongoing question. Staying home all of the time is no fun...but spending a few days in the hospital is even less fun.
Have I mentioned yet how much fun cancer is? The most important thing I can say about that though is things could be worse, much much worse, when you see the things that some of these cancer cuties are going through you thank your lucky stars for having the 'good cancer', for doctors and nurses, and for CureSearch for doing so much to find a cure for these horrible diseases.
