David's blood tests during and after chemo therapy

Purpose: My purpose in making these pages is to help people. My hope is that seeing how brain surgery can go in the year 2009 will ease minds and give some hope and comfort.

This is the personal experience of David Luckenbach, diagnosed with brain and lung cancer in May 2009. A sailing instructor who smoked and drank, and almost died, saved by friends and angels and given another chance. Odd fellow I am, always ready to help other people, and neglected myself.

Here is a spreadsheet of part of my "weekly" blood tests, we update it when I get another test. They do a new one the day before chemo to see if the chemo will be safe. We're still learning what everything means, found out that RDW stands for red blood cell width variation, as you can see the width is getting more varied which is not real good. If a number is in bold that means it is out of the "normal" range.

Platelet count
For example, my first test showed a platelet count of 487, out of the normal 150-400 range which meant I don't bleed well but can clot well. A high count is nice if injured as I don't bleed much, but more chance of a blood clot causing a stroke or something. The platelet count has been dropping steadily so far, and I don't want to go below 200, at which point I start to buise easily, too easily. The platelet count is what I'm controlling now, and have been raising and lowering it by changing the amount of raw spinach I eat. There are many things that have an effect on platelet count, and it has taken a while to find that spinach apparently has a large effect. I cut down on spinach the last two weeks, 9/1 to 9/8 the most, and my platelet count dropped below 200 again even though I'm off chemo. I started bruising again and bleeding more easily, so I'm back to one spinach salad a day and after two days I can see a reduction in the bruising already. Everyone is different, so having regular frequent blood tests is essential so see what is happening in your body.

Blood test results during chemo, bold is out of normal range

Blood test results after chemo, bold is out of normal range

Blood test results in 2010, bold is out of normal range

RDW
A measure of the random width of blood cells. As you can see, my RDW marched steadily upward and well out of the normal range of 10-15. This can be caused by many things, one of which is the platelet count. If I produce more platelets, there are more the same younger age and the RDW should go down.

The white blood cells and newtrophils went up 7/20, and the platelet count went up a bit. This is when I got a fever and even went on antibiotics for a week. Glucose is up, but I did have a big sweet breakfast that day. The doctors and nurses seem very happy with my blood tests, so far. Happier than I am.

Glucose This is highly variable depending on what I eat and WHEN I eat it. A more accurate test is obtained by fasting the correct time before blood is drawn, normal for a glucose test but I haven't been doing that. Since my glucose was so high on 7/20 I asked about it. They seemed not worried and said I probably had a sweet breakfast that caused it. So on 7/27 I had Grapenuts without the Danactive or banana, then the blood test, and the glucose was back below 100. I'm going out of range on some things, like RDW, Neutrophils and white blood cells, but they say this can be normal when on chemo. I'm starting to not like chemo.

8/10/09 My platelet count dipped below 200 to 194, still within normal range but I can tell I bleed a little longer when the IV is removed. Also easier to bruise. I started eating more "good for platelets" food, like berries (especially blueberries) and spinach, and continued avoiding "bad for platelets" food like margerine, soft drinks, and fast food.

8/18/09 Last chemo treatment. I've been taking too many prescriptions, at least for me, but doctors orders to counteract the chemo effects. With the fever, I didn't feel very good, so they gave me a IV of saline. RDW didn't climb as much. There's a bit of variance in the accuracy of the blood tests it seems, but I'm getting the impression that I do have some control with what I eat and how much exercise I get. My sodium level dropped below the normal range, so I ate a bit more salt. I suspect avoiding preservatives which often have sodium could have something to do with this. Glucose is up again, too much ice cream to go with the berries?

8/24/09 Interesting, my platelet count went up to 498, above normal range. But it normally goes down while on chemo. How odd. RDW went down too, for the first time, back toward the normal range, but this is related to the platelet count. I feel good today, first day for a long time. I'll continue the blood tests to see what's happening, even off the chemo. Amazing what they can tell you, those blood tests. So much to learn.

8/31/09 Uh oh, I slowed down on the spinach, and my platelet count dropped to 281 from 498. Wonder if it's the spinach or a coincidence. I'll cut back some more for a week and see if the platelet count goes down more.

9/8/09 Sure did, platelet count dropped to 182, lowest it's ever been, so perhaps my bone marrow has really been damaged, and I'm only getting it up with the spinach? I'm bruising easy again, too easy. I'll go back to a spinach salad a day and see if my platelet count comes back up. After two days I noticed the bruising fading, so hopefully I can keep my platelet count up while the bone marrow heals.

9/22 Yes, the platelet count is up to 302 the last two weeks, much better. I'm not eating a lot of spinach, just trying to get the platelet count near 400 which is the top of the "normal range".

What's next? I noticed my Creatinine level has dropped out of range, what does that mean? Alison said creatinine is a waste product from muscles, and if it's low it could mean I'm not getting enough protein, and I haven't been eating much. I'll eat a bit more and see if it comes up into the normal range. Since the Creatinine is a waste product the kidney get's rid of, if it too high that could be a sign of kidney damage, so I'm glad I'm not high. One sign my kidneys are working, I hope. Creatinine is coming up, went from 66 to 70 on 9/21 and up to 88 on 9/28, back in normal range.
I'd like to see RDW, random red blood cell width, come back near the normal range of 11-15. It's been rising steadily during chemo, around 22 to 24, and has lowered from 24 to 20.8 on 9/21/09 and 19.4 on 9/28, heading for 15! Has something to do with the age of the cells, so I'll watch this RDW. A one time blood test can tell you a lot, but getting one every week and trying to change things puts it in a whole new light. Fascinating.

10/3 Now to change the glucose levels. Since tumors use sugar for fuel, and glucose is blood sugar level, it would be better if my glucose was 60-90. I avoid sugar most of the time, but I guess I'll cut out the ice cream too, one of my weaknesses, and see what my glucose level is in October.

10/12 Today my doctor stopped my blood tests, even when I protested! So for now I can't see what's happening with my blood and feel a bit annoyed. I find this very strange, as if he doesn't want me to know what's happening. His reason for this I fail to understand, although he did say I could have blood tests IF I got more chemo treatments.

10/19 Today the blood test are on again, at least to keep track of the indicators for liver function, AST and ALT.

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