Day 13 – The Neutropenic Phase

The first week of intense chemotherapy involves 2 drugs in what is called the HIDAC-3 protocol . The aim of this two-pronged attack is to remove all the cancerous blood cells from your body. However, these chemo drugs cannot distinguish between the good blood cells and the bad and so both are eliminated by the chemotherapy.

In order to keep you alive until your bone marrow starts producing blood cells again, the doctors need to top up the red blood cells and the platelets . Otherwise, with limited red blood cells, you cannot transport oxygen around the body leading to hypoxic-type symptoms (think of the benefits Lance Armstrong gained from additional red blood cells). Platelets stop you from bleeding to death from things as simple as a blood-nose.

One of the major effects of the first week of chemotherapy is your neutrophil count drops to zero. Neutrophils are a subset of your total White Blood Cells and are your first line of immune defence.

After the week of Chemo you then enter what is called the neutropenic stage. This lasts until the bone marrow has produced enough neutrophils to get back in the normal range again. During the neutropenic phase you are highly susceptible to viruses, bacteria and other infectious agents. This is why isolation and hygiene during this period is so important.

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During the neutropenic phase I will be getting a new drug flown in from America ( more on this later).

The medical team also start injections of G-CSF – a compound which stimulates the bone marrow to start generating blood cells. This is injected just under the skin on my stomach once a day.

The aim of the G-CSF is to kick start the blood cell production system again, hopefully the good white blood cells will out-number the nasty cancerous blasts. There is some uncertainty as to how quickly the good white blood cells will reproduce and whether they will be able to compete effectively against the cancerous ones.

During the neutropenic phase, the so called ‘chemo brain’ cuts in. I also regularly experience high body temperatures with associated hallucinations during limited periods of sleep.

The doctors aim to support you as best as possible throughout this neutropenic phase, knowing that each day will be a rollercoaster of emotions and wellbeing – with a constant risk of infection. For me, it is one day at a time, making the most of the energy and positive vibe that I receive from all my great friends and family. Stay tuned for more.

(it’s important not to take yourself too seriously, no matter how bad you’re feeling)

8 thoughts on “Day 13 – The Neutropenic Phase

  1. Your commentary is serving to incredibly increase my understanding of what is going on and the reasons for it. None of my relatives and friends who succumbed to cancer, including my brother who ended up with bone cancer, were able or wanted to explain the ins and outs of what they went through. It is likely it was not adequately explained to them, or, they may not have asked.

    It’s like a fear of flying. Most of the fear is associated with the unknown. Once the unknown is explained and the underlying principles accepted, the fear goes. I’m sure this is helping you – and us too.

    We had great weather today – as close to a spring day as you could get. I took Peter and Gail Crozier with me in “Tyllie” to Orange for a meeting of aero clubs from around NSW. The meeting aim was to discuss how we all could work together to save money, increase activity and generally improve recreational aviation. Ben Morgan from AOPA attended and somewhat high-jacked the discussion. He has some good ideas but I’m not sure whether he will receive the level of support needed. It was a first step.

    Croz and Gail enjoyed the trip – a different day out.

    Cheers. Hope you have a restful night.


  2. Hi Geoff, you are always an inspiration, especially now. The blog is so generous. I feel more comfortable knowing how you are going. I hope you had a chance to see those magnificent swannies! I hope a few rest days and some new drugs will help. Loads of love Nicole and Mike


  3. Hi Geoff great to see the Daily updates on your blog mate , I have no doubt your going to beat this thing and probably end up with a medical degree in the process !!!!! Dr Hamilton !!!!! Has a certain ring to it hey ???


  4. Hello Geoffrey, A really tough call which has all the Grimshaw’s thinking of you, Jan and family. Like your story of the pilot instructor who cut your engine and threw you into a dive at 30 odd thousand feet over the French countryside, it appears you again will have to stay calm and listen carefully to the highly trained personal to get you back to cruising altitude. We have complete confidence Geoffrey in you and your medical team to tackle this. Your writing is fantastic as it is just so informative and honest about a really uncomfortable subject. Keep it up. Rach and Mill on donkeys in Morroco and this donkey who thought he was too busy to go is trying to keep his feet dry on the farm. Stay in touch.

    Mark and Rachel Grimshaw.

    +61 428310341



  5. Yep I have no doubt Geoff will beat this.100%
    I can hear his story now.

    So Geoff what lead you to become a Doctor at the tender age of 60?

    Well as luck would have it I was diagnosed with Leukemia in my early 50 s.

    Just like when I was in my 20s and couldn’t get my bloody kids into day care so I started my own chain of day care centers.

    Its just another chapter !!!! Go Dusty


  6. Hi Geoff. My name is Janet Vague and Liz & Peter Dowling are my family. My first cousins. Liz told me about you. We live in Montmorency near Eltham in Melbourne and if at anytime anyone needs accommodation. Don’t hesitate. We are here. Probs about 40 mins from you. Like Liz said. You are INCREDIBLE. Cheers Janet 😄🌈🌹


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