Thursday, November 28, 2013

I am Sick - Or Maybe Not

For the first time in years, I have come down with something.

Or maybe not.

Here's the story.

Yesterday I got the relatively new conjugated more antigenic protein based pneumonia vaccine, PREVNAR 13.

My last pneumococcal vaccine, the weaker but broader spectrum Pneumovax, and the older PREVNAR 7 were administered more than seven years ago when I was first diagnosed in the hopes that early in the disease, my immune system had not crumbled too much and I could still mount a protective response.

The new improved PREVNAR 13 made my arm sore, which I took as a good sign, suggesting some immune response. In contrast, the flu jab a few weeks early was a non event.

That night I felt pretty awful- achy, lightheaded, nauseated, chilled, agitated. I slept little.

The next day, today, I went for my every 8 weeks IVIG. This by the way, may also dampen my immune response to the vaccine, but I wanted to get the immunization as far out as possible from the last boost to my passive immunity with the infusion of IVIG.

It was not that long ago that I was getting IVIG every 2 weeks! My veins are much happier.

I still felt terrible this morning.

Although the news was good with my hemoglobin and platelets (both within normal ranges), despite my stretching out the time between the protective dosing with other peoples' antibodies to prevent me from killing my own platelets as I have done so often in the past with my ITP, I got a surprise with the white blood cells.

My lymphocytes were zero, nada, missing in action, on the automated differential although I did have a normal 0.4 count of atypical lymphs.

My lymphs are my cancer cells. I am happy they aren't around.

But they are also my T cells and presumably some healthy non-clonal B cells. Where are they? I need you guys to fight infections and search and destroy any early secondary cancers. Come back!

Strange, but it gets stranger.

My absolute neutrophil count was a very high 16.7, most consistent with a bacterial infection. These are levels one sees in pneumonia or appendicitis or a kidney infection. Serious stuff.

Occasionally however, very early in the course of a viral infection, the neuts will rise. In the past when I was sick, my lymphs shot way up, not the neuts.

And although I had no fever, my blood pressure was as low as 81/45. It was still low, but better by the time I left the cancer center.

Despite the fact my wife was very sick all last week with multiple specific signs and symptoms, I have had no focal problems, just this general overwhelming malaise.

So is it the prodome of a coming illness? The oncologist who saw me at the infusion center wisely wrote a script for a broad spectrum antibiotic just in case, but said to hold it until it is clear I am actually sick with something infectious. Good counsel.

Or was it all just a weird rection to the PREVNAR?

I slept much of the day, and am starting to feel better, so I am betting on the latter. Us CLL patients have pretty weird immune systems.

More bad news.

On a sadder note, another CLL warrior died this week. Ellen Rhudy was a fighter, very actively battling her disease for years in her own unique way with mostly alternative, non allopathic medications. Over the years, we exchange many emails and a few phone calls as she tried to leverage her comprensive knowledge of different nontraditional therapies with the changing and less toxic CLL treatment landscape. We often disagreed, but we were friends because we shared a common enemy.

CLL plays for keeps. I hate it.

I will miss our exchanges, Ellen. Rest in peace.

Really sad.

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Anonymous Jan said...

I hope that by the time you read this, Brian, you are feeling reasonably well or better yet, up to par. I,m stunned to learn of Ellen's passing. I, too, had known her for years ... via e-mail and phone. Ill as she was, she seemed almost indistructible.I feel both sad and angry. RIP Ellen

November 28, 2013 at 6:34 AM  
Anonymous Anonymous said...

I had the prevnar13 a few weeks ago and felt almost nothing... Arm felt fine, no usual subtle symptoms of gunk coming on like I used to get with the flu shot. I suspect that prevnar will not help me that much. Will get a Pneumovax 23 in another 5 weeksish (minimum 8 weeks post prevnar13 shot). I hope you feel back to norm soon and hopefully the sickly feeling is a sign of a good vaccination response!

November 28, 2013 at 8:21 AM  
Anonymous Bcl2 antibody said...

Thanks for the article, very informative.

December 2, 2013 at 1:48 AM  

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