Counts Can Be Scary
Last updated: May 2023
On Halloween, I enjoyed a treat: Wynton Marsalis and a big band playing arrangements of Sesame Street songs while The Muppets sang along. Since it was Halloween, I thought it was fun to see The Count in particular. The occasion was PBS’s Jazz at Lincoln Center’s A Swingin’ Sesame Street Celebration: 50 Years and Counting, and if you bear with me for a minute, you’ll see how this ties into blood cancer.
The Count, whose full name is Count von Count, is a friendly vampire-like character. According to the Muppet Fandom web page, “The Count has a compulsive love of counting (arithmomania, an affliction of legendary vampires); he will count anything and everything, regardless of size, amount, or how much annoyance he causes others around him. When he finishes counting, The Count laughs and announces his total (which sometimes appears on screen).”1
Fixating on counts
In the blood cancer world, you can also get fixated on counts. Not, of course, on Count Dracula or Count von Count, but it is worth noting that vampires suck your blood, and the counts that I obsessed over have to do with blood. (Another show that just celebrated its 50th anniversary, the soap opera “Dark Shadows,” had the world’s sexiest vampire, Barnabas Collins. After school, my friends and I would rush home to see it and chase each other around, saying, “I vant to suck your blood.”)
After my leukemia diagnosis and treatment, and at subsequent checkups, the words I longed to hear were, “Your counts are good.”
When going into the exam room at checkups, I held my breath for a minute when I saw the doctor or nurse practitioner holding the printout that contained my counts. When they went electronic, I waited with bated breath for them to read the magic numbers off of the screen.
Blood counts can fluctuate
During chemotherapy, at times my counts were so low that I gasped when I heard them. I remember the time that they said I had two or three platelets. I asked if I could bleed to death. The answer was no, just don’t bump into anything, which didn’t make me feel that confident. Those numbers, by the way, are not really JUST two or three. They are short for 2,000 or 3,000. But since normal is 150,000 to 400,000 platelets per microliter (mcL), it is still pretty low.
In between rounds when my counts percolated back to normal, the platelets usually lagged behind. For a while, they were stuck at 50. My doctor said you can get along with 50. That was reassuring. Later I learned that even for “normal” people, blood counts can fluctuate, and so I tried to not get fixated on small variations each time had blood draws.
Dwelling less than I used to
Especially if you have relapsed like I have, it’s hard to keep from being jittery about these things. But 11 years after my fourth stem cell transplant, I don’t get as nervous about counts as I used to.
Last week at my checkup, after my doctor told me that my counts were normal, he asked if I wanted a printout of my counts to take home. I said sure. At home, I went to recycle a pile of papers and saw that the one with my counts was in them. I hadn’t even read through it all. I went and did it. I thought about the difference between the scary early days when I dwelled on the counts so much and the better days now when I almost forgot to read them. My platelets, by the way, were 156. That’s good enough for me.
What blood cancer were you diagnosed with?