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A small matter of white blood cells

Non-Hodgkin's lymphoma - what I have - is a cancer in white blood cells, particularly lymphocytes. A way to battle this cancer is to temporarily kill off the body's white blood cells using chemotherapy, thus stopping the cancer.

But there's one little issue that is part of the balancing act: Lymphocytes are an important part of the body's immune system. Without them, we have a difficult time fighting off something as common as a cold.

All of this was explained to me prior to starting chemotherapy in December. Michelle, my oncology nurse at the Tri-Cities Cancer Center, said I would reach the nadir - the low point of my white blood cell count - around 10 days after chemo. A quick blood test would show where my white blood cells were and determine how we would handle it.

So I stopped by the cancer center Dec. 23 to give blood, then headed out to finish off my Christmas shopping. About an hour later, Wendy, a nurse at the cancer center, called me and said, "Your white blood cell count is zero. Get back in here."

In other words, I had no white blood cells in my body. One sneeze from someone with a cold could land me in the hospital for Christmas because my body would have little way to defend itself. Wendy explained that the worst side effect of chemotherapy was the drop in white blood cells because that opens your body to something that could, frankly, kill you.

So I headed back to the cancer center, where Wendy gave me a shot of Neupogen, a drug that is supposed to stimulate white blood cell growth. She said one side effect was that my bones might feel a bit creaky, like I have arthritis. So I got a shot every day for the next four days (including Christmas). Additionally, I needed to wear a surgical mask so I wouldn't catch anybody else's germs.

By Dec. 26, my white blood cell count was back up to normal and I was able to discard the mask, which had caused no small level of consternation with my mother and brother, who came to our house for Christmas.

After my second chemotherapy treatment, Michelle said I would need to come in each day for 10 days to receive a shot of Neupogen, which would keep my white blood cell count at a safe level.

There was only one small issue: My insurance requires a $35 co-pay for every office visit. That's $350 in co-pays for every round of chemotherapy, multiplied by seven treatments. That's nearly $2,500 just in co-pays. So Wendy showed me how to give myself the shots (in my stomach), and now I get a box of Neupogen vials after each chemo treatment, along with syringes.

My wife, Melissa, has a healthy fear of needles and wants nothing to do with administering the Neupogen, though our 5-year-old daughter is quite fascinated with the process and offers every night to give me the shot. I let her swab the area where the shot goes in with an alcohol wipe and leave it at that. Meanwhile, every time I give myself a shot, I tell Melissa, "I just saved $35." The other night, she replied, "Yeah, well I just spent it."

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