Chemo day 16 - "don't bleed this week"

Yesterday I went to the GW cancer center for lab work.  As expected, a number of key markers were low, showing the effect of 2 weeks of chemotherapy.  In particular, my platelet count was 56.7 (normal range is between 155 and 366).  After we got the results, I met with my oncologist.  She was pleased to hear that the constipation was under control, and encouraged me to use MiraLax on an as-needed basis, especially once I start the next round next week.  She noted my low counts, said that they were totally expected, and said that I should continue to be vigilant against infections.  She also advised me that, because my platelet count was so low, I should avoid bleeding this week.  Umm, thanks, doc.  Words to live by. 

I'm otherwise feeling ok.  This week I'm not as tired as I was while the poison was in my system.  It's a strange thing to try to describe how chemo makes me feel exhausted at the cellular level.  It's unlike any weariness from exercise or physical activity, or mental exhaustion, or any other kind of tiredness I've ever felt before.  As it's been explained to me, during chemotherapy every cell is using its energy to try to fight through the reproductive ban created by the cisplatin and gemcetibine.  As long as that stuff is in my system -- especially during the first 96 hours after each infusion -- the attention of my cells are focused less on what instructions are being sent from my brain, and more on just trying to survive at the elemental level.  That means that the cells allocate less energy to do anything else -- to blink, or lift a finger, or think, or whatever they are programmed to do.  It's like my tank is never full, and I run out of gas sooner.  And it's strange that it is every cell in my body, not just muscle cells or brain cells or whatever.  And unlike physical exhaustion, when I can sleep, or exercise less, or mental exhaustion, when I can stop thinking (usually aided by TV), when I have chemo-induced exhaustion, I have no control over limiting the effect.  I just need to let time pass and have the drugs do their thing.

But this week, so far so good.  The trip to and from Norfolk was fine.  I'm still on track for the NYC trip, and am looking forward to that.