My liver is complaining…. And I haven’t even had a drink!

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It’s probably time I gave you a little catch up on my health. I also thought it might be useful to list the side effects I have had from chemo, so the people who are about to undergo it who read my blog can get some idea of what to expect. (People do all react differently to it). I was going to do that today, but needed to catch you up on some issues I have been having (when do I have a plain sailing cycle ;)). So this can wait till next blog.

First though, an update. I had my fifth round nearly three weeks ago. I felt pretty poor for the first week, more so than on previous times (mostly my issues start week three). Still I got through it whilst still doing most things I am now able to do since I stopped needing the blood transfusions.

I had a temperature one night so drove myself to a and e at 3am as recommended. I was seen and then released at 9am and drove home for a nap. They felt my temperature spike was due to the warm weather and that I could monitor myself at home. (By the time I was seen everything was back to normal).

The next day I went for blood tests. The good news is that all the normal ones are fine. Limited infection markers. Great hemoglobin and platelets. Basically a good selection. Unfortunately my liver enzymes were both up pretty high. (ALT and ALP)

(ALT, which stands for alanine transaminase, is an enzyme found mostly in the liver. When liver cells are damaged, they release ALT into the bloodstream. An ALT test measures the amount of ALT in the blood)

(Alkaline phosphatase (ALP) is an enzyme that is present in many parts of the body, but it is primarily found in the liver, bones, intestine, and kidneys. Alkaline phosphatase testing measures the amount of this enzyme in the blood.)

My Alt was at 260 (should be max 55) and the other was at 400. (Should be max 147). This concerned them a fair bit and they took me off two of the drugs I had been taking, aqavone and fluconazole. One targets pneumonia caused by bendamustine and the other is an antifungal, but both can affect the liver.

I have then had to go in twice a week for blood tests, to see if they have reduced. It’s been nine days and my counts have dropped slightly to 190 and 250, but they are concerned they haven’t dropped faster. Also if they aren’t both below 200 they won’t give me my next round of chemo, and given it’s my last I really don’t want to delay it.

Luckily I don’t have any other side effects of the liver issues (problems with wee, yellow eyes and skin, pin pricks of blood) but I do get occasional pain on the torso.

So all in all I hope my next blood test on Monday shows a bigger drop, but they have also booked me in for an ultrasound, to see if there has been any damage to my liver.

Still with only one cycle left I’m hoping this is nothing serious and the counts drop. Being so close to the end I really want to have a final clear run and then get back to work and for my body to start healing up and resolving my immunosuppression, which can take up to a year, but sooner started quicker finished. Once that’s done I can take a few more risks with normal colds and the like, as well as being slightly less worried about covid and being able to have vaccines that work.

(I have had both covid vaccines but my antibodies have been smashed by chemo). As it stands it’s pretty bad news for blood cancer patients to get covid. As shown by this American study.

Wood reported on 656 patients with hematologic malignancies: a little more than half had leukemia and a quarter had lymphoma. The mortality rate was 20% overall and 33% for those who required hospitalization. COVID-19 severity and death were linked to cancer status: 50% of patients in remission developed moderate or severe infection and 13% died, compared with 69% and 21%, respectively, of those receiving initial treatment. Those with relapsed or refractory cancer fared the worst, with 79% developing moderate or severe COVID-19 and 36% dying.

So those odds aren’t great. It turns out rituximab is an awful drug to have and then get covid. It basically wipes out the immune system. I have been having this with every dose of chemo.

Hopefully then, I can get through this round and then recover to the point I can actually go out in public and see people a bit more without such a high risk. That’s what I am aiming for anyway.

I hope you are all well and getting on with getting on. If any of you ever want to chat about cancer or anything my blog touches on, do reach out on my comments with your email. I’m always happy to help if I can. 🙂