Have Yourself a Neutropenic Christmas

Neutropenia is the fancy name for when your neutrophils, which are the bacteria-fighting cells in your blood, get obliterated by illness or treatment. 

Many types of chemotherapy cause neutropenia, which is why cancer patients are often immunosuppressed. We remember those immunosuppressed folk from Covid - the ones that gave us a sigh of relief when the death numbers were published because they had Underlying Conditions, and were therefore Sitting Ducks, and didn't count. 

Having little or no ability to fight infections is a pretty serious situation to be in. We all know what it is like to feel a cough or a cold coming on, and to feel sorry for ourselves for the impending few days of snottiness and general urgh. But if you get an infection and you have no internal ways of killing it off, you will need some other kind souls to intervene. Usually, this will end up being the kindest souls of your local intensive care unit, who have skills of life-saving that David Hasselhoff could only ever dream about. 

The advice for people who are taking chemotherapy is to check their temperature every day (with a thermometer that works) and if it goes above 38º, then they must go straight to the hospital. The recommendation is to be seen and treated with one hour, as this is the magic window before sepsis overwhelms your entire system and you basically shrivel up into a dying purple heap on the floor. I am aware of many fellow cancerheads who have had a number of what they call "blue light" experiences, where they have hollered for an ambulance at the first sign of a fever and hightailed with all the bells and whistles (literally) into the nearest emergency department. I don't actually know anyone from Cork who has done this, as I think we have an additional protective factor when it comes to invoking the emergency services. The weight of Morto* can often far exceed the weight of I Am About to Die in our critical thinking strategies. Better to have your cold purple heap scooped into the back of a hearse than to disgrace yourself by calling a false alarm.

But that one-hour golden window is an interesting one to contemplate around Christmas time. Will I check my temperature before I put the turkey on the oven and if it's high, risk an even more cremated bird than usual as I nip off for a quick resuscitation? Will I bother with the thermometer at all on Christmas Eve, in case I miss out on Santa? Will I ignore every possible symptom of ill-health and decide that only a coma is a good enough excuse to ruin Christmas for everyone? 

Also, people with low neutrophil levels are supposed to: 

• avoid crowds
• avoid close contact, such as hugging or kissing
• avoid soft cheeses, undercooked meat and poultry and the skin of raw veg
• avoid fast food or takeaway food

Have you ever seen a list that more encompasses the spirit of the festive season? Kissing people in a huge crowd while eating deliciously manky burgers? That's the Christmas party out the window so. Hugging snotty children while munching on a brie and cranberry sandwich? Nope. Rooting around in the 5-day-old turkey trimmings for a final tasty little morsel? Out of the question. 

I tried to navigate the chicanes of immunosuppression this Christmas, but it was very hard. Yes I would love to see you, but no I can't hug you or sit near you if you sniffle. Yes I will go to see the Frank and Walters, as always, but I will stand with my coat on at the side of the room, trying to pretend that the scarf wrapped around my face is a stylish fashion choice. Of course I will go and enjoy the festive spirit in the Marina Market, but only by standing in a freezing draught and keeping my Ninja-ears peeled for the vaguest hint of a cougher. 

It didn't help that influenza was rampant, and as usual people were very blasé about it - until they got it, of course. Then they wail and gnash their teeth and say "never again!" - but forget about the vaccine again next year. 

I survived a trip to London, on planes and trains and buses (not the Tube though, I am not insane) and it all went well until I suddenly panicked about the flight taking more than an hour, which meant that if I started going septic as we were taxiing, well then I would surely be dead by the time we landed in Cork. But as long as no one noticed until we were in Irish airspace, at least I wouldn't end up in an NHS hospital...no E111 card will save you there. 

If I have a choice, I will choose not to to be neutropenic at Christmas again. It's a real humbugger.