Beware The Blood Count


I’m different. I have a different constitution, I have a different brain, I have a different heart. I got tiger blood, man. Dying’s for fools, dying’s for amateurs. Charlie Sheen.

If only I was more like Charlie.

How much do you know about blood?

Unless you happen to be in the medical racket, probably not much. As long as it stays conveniently on the inside, where it belongs, we rather take this amazing stuff for granted. I’ve lost count of how many blood tests – or “bloods” as we say in the trade – I’ve had over the last few months but it must be two or three dozen by now. I have a vexing habit of asking questions, and demanding to know how things work so I’m starting to become something of an expert. At least by layman’s standards.

Let’s start with something easy. Why is blood red?

Well, it turns out blood is complex stuff, made up of a whole bunch of useful parts. The medium in which all these different bits and pieces are carried, the runny stuff, is Plasma. It’s a slightly viscous, pale yellow liquid, which as well as carrying the actual blood cells also transports antibodies for fighting infections, Fibrinogen, which causes the blood to clot when required, proteins, carbohydrates, salts, minerals and all sorts of other good stuff.

The red blood cells, or corpuscles, account for about half of our blood volume. About 35 trillion of the little tinkers at any one time. They are manufactured in our bone marrow, and comprise mostly of Haemoglobin, which is rich in iron, hence the red colour, and protein. Ever noticed how dried blood looks like rust? Haemoglobin has the handy property of attracting oxygen from our lungs, which sticks to the cells and is carried around the body through our arteries, veins and capillaries to be distributed to all our other cells. After dropping of the fresh oxygen, they hoover up unwanted Carbon Dioxide and returns it to the lungs to be breathed out. This is the really mind blowing bit. The whole process, from a blood cell collecting oxygen from our lungs, doing a complete circuit of our bodies, including all our extremities, nooks and crannies, and back to the lungs with the garbage, takes about thirty seconds.

This is all well and good, but what happens when something interferes with this invisible but miraculous process? Well. Funny you should ask. I happen to have some first hand experience in this very field. In the few weeks leading up the The Brittomart Incident, I wasn’t feeling the full-shilling. Tired. Listless. I couldn’t get out of bed in the mornings. Excretion of any kind made me breathless, and standing up too quickly made me dizzy. If I ran for the train, it would take me ten minutes to get my breath back and my heart-rate back to normal. Then of course there was the small matter of the black poo. I knew there was something wrong. But then,when your a rampaging hypochondriac there’s always something wrong. Always has been. Always will be. Sick is the default position.

With the benefit of hindsight, and my new found and encyclopaedic knowledge of physiology and haematology it’s all blindingly obvious. Internal bleeding. Steady blood loss over several weeks. My red blood cells were being depleted, and so less oxygen and nutrients were being supplied to my hungry cells, and less waste materials were being properly disposed of. That’s why I was so tired. Why my limbs felt heavy and ached. Why my head spun whenever I got up from my computer.

And incidentally, why vampire victims are all so pale and interesting. When I got to the hospital they figured all this out in a matter of seconds of course. A bleeding ulcer. Not a big deal these days. Common even. A couple of blood transfusions to top up the red cell count and I was on the road to recovery.

And then they found the cancer.

Which leads me neatly onto another way you can really screw your blood up. Chemotherapy. Chemo is a complicated business. An umbrella term for a whole raft of different drug regimes and therapies. I might go into my own particular personal brand in more detain another time, but for know, here’s what you need to know.

At the very simplest level, cancer is just cells growing out of control. They multiply in an unorganised fashion, and much faster than normal ‘healthy’ cells. Which is why they tend to spread and take over. One of the main functions of chemotherapy drugs, Cysplatin for example, is to damage the DNA in the cells nucleus and thus preventing it from dividing and multiplying normally. This is a great idea. The drug hits all your cells indiscriminately, but because the cancer cells reproductive cycle is that much faster than normal bodily cells, they get hit the hardest. All being well, the growth of the tumour can be slowed or even reversed. Brilliant!

Only on teeny-tiny little snag.

There’s another kind of cell in our bodies that reproduces very quickly too. Yes, you’ve guessed it. Those busy little workhorses, the blood cells. So at the same time as hammering those cancer cells, the chemo is also playing havoc with your bone marrow’s ability to manufacture new blood cells.

I know this is going on a bit, but I’ve only given you half the story so far. As well as the sexy in-your-face red blood cells we all know and love, we also have the less visible but equally essential white cells, and something called platelets. Platelets line the inside of the blood vessels to prevent leakage, and are also responsible for bloods useful ability to clot in the event of injury. Needless to say low platelet count can lead to all manner of messy unpleasantness.

That just leaves the white cells. A subject close to my heart in more ways than one, for reasons I will now explain. White blood cells – they come in several varieties – are our bodies defence mechanism against infection. How they do this is complicated and best left for another time. Suffice to say that without them we wouldn’t last for five minutes.

This is why the boys and girls up at the oncology unit are so interested in my blood. The regular test allow them to monitor the precise levels of cells, platelets and other goodies. If they drop below certain levels, problems can quickly ensue. My particular problem has been very low levels of a particular kind of white cell called neutrofills. This condition Neutrofillia, means a very weakened or non existent immune system. The chances of picking up a minor infection is high, and without the normal defences in place they can quickly spiral out of control. A nicked gum from an over-zelous brushing can be enough to trigger an unpleasant infection and fever. last week my count was low enough that my second cycle of chemo was postponed for a week. I was quarantined at home, avoided people like er.. the plague, and washed my hands about a million times a day. I did get to read a lot of books though. Low iron is another problem I have right now, so there has been a good bit of manly carnivorous activity recently, a welcome chance from the fruit, nuts and rabbit-food.

Anyway, I made it through the week without incident, skilfully avoiding any close encounters with microbial nastiness and my last bloods on Tuesday were much improved, which just shows how quickly our bodies, even this well used and abused one, can fix itself up given half a chance. My counts were up in all departments, iron was good, and my second cycle was scheduled for Wednesday. Much as it was nice to have a break from the tyranny of the medication schedule which rather dominates day to day chemo life, it actually feels good to be back on the wagon again.


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  1. Jo 2 says:

    That is really good news that your bloods were back up and you are on track again! Lots of love till next time you are on safer ground and can risk meeting up with double-hernia man and me!

  2. Tricia Hollingum says:

    Oooh Linds you could get one of those giant plastic bubbles to sleep in when your count is low. Have you seen the movie with John Travolta called Boy in a bubble??? Don’t, it’s bloody dreadful but he does get to hang out in a plastic room and young girls comes to visit him. Not that I am suggesting that either (honestly Jo!!). Thanks for the informative post on blood and stuff, it all makes so much sense when you write it!! xxxxxx

  3. Maestro,

    All well and good.
    (I hope)
    I was reminded by some comment or other you made of TV show I used to like. Actually, I still do, though it is no longer shown. Six Feet Under.
    Aside from hugely influential title graphics (the likes of which you might have designed your uber-talented self) I rather like the line for the ad campaign to drive viewing and advertising support.
    “Every day above ground is a good one.”
    You. Me. And Us.

    Enjoy everything.
    Fear nothing.


    • Linds says:

      Yes “Six Feet Under” was a great series. How completely tactless of you to bring it up…

      I’ve used the “Every day above ground is a good day” quote many times, and not just recently. It became a bit of a mantra when I was battling depression. I always attributed it to Lou Reed, but I’m very happy to stand corrected, I could have just made that up.


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