Wednesday, March 25, 2009

N=1: Leukopenia Limbo

I got "the call" the other day - don't you hate "the call"? The call goes something like this:

"Hello, Jenny, it's Dr. _______. Nothing to worry about, I just wanted to talk to you about the results of one of your tests. Give me a call at your earliest convenience."

This is the second time I've gotten "the call" this year - the first was for my diagnosis of Lymphocytic Colitis. What happens when you get the call? No matter how calm and reassuring your doctor sounds, you react: your heart rate elevates, you get a bit distracted, you can't find the phone, then you find the phone but can't find the number of the doc, you drop the phone while you search your purse for the number, etc etc. All the time telling yourself - "s/he says not to worry, so why are you being such a freak?"

So this time it really is probably nothing, but I do think it is yet another interesting piece of data in my "journey". (Boy, now I sound like I'm part of a reality dating show).

I went on Humira in October, and now my white blood cell count is low. I'm just under the low limit of normal. This is referred to as leukopenia. Your white blood cell count goes up and down every day, apparently, so this one test result is likely nothing to worry about. BUT, it does mean that we (my fab rheumatologist and I) have to keep a close eye on my blood for a while. More blood tests in 2 weeks.

What this also means is that andalimumab (Humira) is doing its job - perhaps too well, it seems. Humira suppresses part of my immune system, TNF-alpha, which is produced by my white blood cells. TNF-alpha is also what is believed to cause inflammation in those of us with Psoriatic Arthritis and Rheumatoid Arthritis.

The low WBC count also supports my hypothesis that Humira had something to do with my cold that lasted a month. White blood cells basically ARE your immune system, to speak broadly.

So I'll be in limbo for a few weeks, til the next blood tests come in. How low can I go? How low can I go?

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