Anyone seen my white blood cells?

I'd never heard of a 'neutrophil' before I had cancer. Now my well-being, and diary planning, depends on the little bleeders.

For neutrophil-istines like myself, they are the most abundant type of white blood cells in our bodies. Neutrophils (pictured below) are tiny ninjas who rush to the site of any infection to fight off invading pathogens, protecting our immune systems. But their production can be diminished by the growth of cancer cells, and by chemotherapy.

Every fortnight I have an oncology phone call (or occasionally a face-to-face appointment) where they give their verdict on the blood samples I've provided the day before at the local 'ambulatory' clinic in Lichfield. If all my 'levels' are fine, chemotherapy is green-lighted for the following Monday. This is usually the case, though sometimes my neutrophils have been slightly low. They need to be at a minimum level of 1.0 for chemo to go ahead but have read 0.9 a few times. As these white blood cells continue to replenish in the days between the oncology call and treatment itself, usually this just means I have to submit fresh blood tests on the morning of chemo to check I'm back over 1.0.

However, this week's oncology phone call revealed that my neutrophils slid to 0.4. Because there is little chance of them perking up in time, this means next Monday's chemo is postponed for a week. I'll try again with fresh blood tests on Tuesday to see where they've got to.

So there you go, I've got neutrophenia, which sounds better (and more like a classic late-70s mods v rockers movie) than neutrophilia which is when the white blood cell count is too high.

I'm not entirely surprised by this as, after five fortnightly chemo sessions on the bounce, I've been pretty weary. Having a cold over Christmas probably didn't help. With my coughing and sneezing just about on the way out, I was still concerned that I'd be turned away from chemo on 27 December. But, as I was greeted by a chorus of coughs from other patients and staff on the ward, I needn't have worried!

Two weeks later, last Monday's chemo session was almost cancelled because, this time, my platelets (the cells which bind together to form clots in the blood) had dropped. Two blood tests and five hours later, the platelets had rallied enough for my chemo to carry on.

Surprisingly, the overriding feeling I had after being told about next week's cancellation was relief. After nine months of almost constant chemo (totting up 17 fortnightly cycles) I feel like I've been dragging my tired body up a hill recently to get me over the line. I experienced this relief yesterday as a physical relaxing in my body first, followed by my mind climbing on board in acceptance a while later.

The postponement isn't convenient as I've planned my diary, including syncing medical and social appointments, for the next two months based on the original chemo pattern. This 'life admin' takes more time and effort than I'd expected. The one-week postponement means things are now clashing - like my next 'staging' CT scan in February which is potentially due on the same day as chemo session number 19.

Learning to hold things lightly, not knowing what's going on next week or next month remains a tough life lesson. I eventually realised it was stressing me out when I snapped at Lisa over nothing on Thursday - my anxiety finally surfacing in normal, everyday conversation.

It's a good reminder of Franciscan author Richard Rohr's definition of suffering as 'not being in control'. But, as Rohr points out, this is also where life's rubber hits the road, helping us to grow in resilience as we "learn to live without resolution". In this place of tension, we also learn how to trust others who hold the keys to our diary (and wellbeing), and that there are less things we actually need to be in control of than we realise. While it would be nice to have this summer's holiday booked or work plans nailed down, there's also a freedom, and some character growth, in winging it at times. How, at the end of the day, we are surrounded by goodness, including kind people who walk alongside us, and that things generally do work out ok, whether we worry about them in advance or not.

I am also continually thankful for the relatively straight-forward chemo ride I've had to date. The Christmas cold was my first serious sniffle since my immune system-draining treatment began in May. During my last session, I overheard an older man talking about how he hadn't had chemo for months due to a skin infection. The cumulative effect of pumping litres of toxins around my body every fortnight is bound to take its toll. As with other medicine, I instinctively still expect this treatment to make me feel progressively better over time, but I know that's not how chemo necessarily works with cases like mine; it's more of a containment job. Managing and regularly re-setting my expectations remains an ongoing challenge!

Still, if I feel ok, I'll at least hopefully be able to get some running in next week after one three-mile effort in the frosty sun on Tuesday where I was alternatedly freezing and roasting. I've also been on some lovely walks in recent days. A picture from yesterday morning's is above.

Meanwhile, life moves on in the Bate household. Macy has bought her first car, Rosie's started a new teaching term with her lively Year 4s, Reuben scored a cracking goal for his Chasetown team the other day, and Dan has been back and forth to Worcester Uni this week as he continues his MSc in Applied Sports Performance Analysis, while working with Wolves Under-21s.

Thanks for all your feedback on Lisa's recent blog post. Talking of resilience, she's got more than any person I know. And she puts up with having me around every day too. We'll have been together for 35 years next month. Nuts!

I hope January is going ok for you all. We're officially almost half-way through winter now. Take care and don't be afraid to ask for help if things aren't going smoothly.

And if anyone spots any spare white blood cells...