Published on July 29, 2019
Today is blood test day.
If you ever suffered test anxiety in school, then you’ll understand. I'm on the line. Someone will measure me. It's personal. And there could be consequences.
Before I was diagnosed with chronic lymphocytic leukemia (CLL), I would sometimes look at people with cancer and wonder how much time they spent fixated on the “other” within them. I imagined that in the same circumstance, I would feel a claustrophobic sense of revulsion, as though I were being squeezed into a corner of my own body.
In fact, I live remarkably unburdened by my cancer—most of the time. When I feel good, it’s difficult to pay the condition much attention. If there were a problem, surely, I'd know about it. As the due date approaches for blood work, however, anxiety edges into my thinking. Sometimes it will grab me by the lapels and shake me for a few minutes or a few hours, but mostly it hovers like a socially awkward friend, and I just want it to go away.
I have been able to remain physically active—to increase my physical activity, in fact—primarily because my red blood counts have so far remained normal. In leukemia, as the white blood count (WBC) rises, the surplus cells can displace healthy cells and inhibit the manufacture, in the marrow, of essential blood components. This has not yet occurred in me, but it’s always a worry. A long-time colleague and friend who died of SLL once told me he lost about 50 percent of his muscle mass in the space of a few weeks.
I try to sneak up on the test. My wife often asks, “When's your next blood test?” Usually, I tell her, “A week or two.” I don't plan on a specific date. I try not to think about the test at all. Then, one morning, I wake up and head for the lab. It’s better if this happens on a busy day, because that keeps the pending results on the periphery of my thinking.
I always go for the test first thing in the morning. The results show up online by early evening, at the latest. I start checking in the middle of the afternoon. By suppertime, I am sometimes so anxious for news that I’ll reload the Life Labs page every 10 minutes.
I sometimes wonder if I’ve ever gone a full day without thinking about cancer. I’ve come to believe we fight the disease on two fronts—in the physical realm by exerting control over diet and exercise, and in the mental realm by doing what we can to focus on health and life rather than disease and death. Both require a determined effort.
For me, there is no magic blood test number—no point at which I will automatically be treated. It's “B” symptoms that indicate treatment—hot nodes, night sweats, extreme fatigue, enlarged spleen, and so on, but I have a couple of bad markers, and an informed member of the CLL community once cautioned me that I should expect “the bear to jump up and bite” at some point. On blood test day, I'm always aware that this could be the day I see him rise, claws glistening in the sunlight.
Today, fortunately, was not that day. My numbers are up, but there’s nothing to be alarmed about.
Three months until the next test.
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I consider myself a pretty well educated CLL patient but there was much presented today that was new to me, and much more that expanded upon what I already knew or filled in missing bits of information.