Note: I am not a doctor - what happens to neutrophils overnight is WAY above my pay grade - I am making this up! Sort of - here is an article discussing it. Good subject for study, because I'm sure that there are people who DO know.
Anyway the threshold for proceeding with the infusion was 1000 / uL, so here we go full speed ahead. I'm already in the chair, waiting for the prednisone to drain into me - the Darzalex can't be started for another hour after that.
These things happened between yesterday's blood draw and today's:
- Last night I took 20 mg of dexamethasone (DEX), and skipped one dose of Pomalyst. I think this may be the most important factor in improving the neutrophil count. This morning my fasting blood glucose was 143, normally about 90. That is a proven DEX effect, of course, and I wonder if that alone can affect neutrophils.
- This morning I got up well ahead of the blood draw and ate a good breakfast, including two cooked eggs with a scrap of last night's salmon, plus uncooked strawberries, blueberries, cherries, and blackberries, with low-fat plain yogurt, every item organic of course. In that mix we would find plenty of live bacteria, especially in the yogurt where it is intentional, and perhaps the food can cause the neutrophils to come out and play. I really AM making that up, but it is consistent with the realization that morning blood draws are almost always fasting, and afternoon draws always follow one meal at least, usually two meals.
- I did some short but intense adrenaline-pumping exercises this morning just before checking in for the blood draw: Six flights of stairs, running up as fast as I dared and walking back down carefully, and as many pushups as I could do.
- The blood draw itself was done at about 11:00 am, compared with 7:30 am yesterday. I have always believed (and observed) that neutrophils are at least double at 1:00 pm from what they are at 7:00 or 8:00 am. Now I am wondering if it might be more about the food than the time of day. In almost 13 years of treatment I never thought of that until today.
Next week's blood draw is 7:30 am on the same morning as the infusion. I will do everything the same as above, except the time of day. If the doctor agrees I will eat a similar breakfast, too, even if the doctor has ordered a blood glucose test, because the previous night's DEX will screw that up anyway. I may not skip the Pomalyst, either, because yesterday's low count was a false alarm.
We are still waiting for the results of yesterday's kit draw to show up on the Mayo Clinic patient portal. This is a real-time post.