I realize that for folks who read my previous post about my low white blood cell count, there is still perhaps some mystery about what's going on (especially if you're not friends on facebook or twitter or whatever.) Or if the whole subject is just still confusing for you and you're too polite to ask me directly, here's what's going on!
I have a specific deficiency of one particular variety of white blood cells called neutrophils. My bone marrow biopsy did turn out to be negative, which of course was a huge relief. However, that simply ruled out any problems in the bone marrow, that is, it is clear that the deficiency was not a problem with producing new neutrophils as much as it was a problem with neutrophils dying or being destroyed. The first possibility is almost certainly ruled out by normal neutrophil counts before, the latter is the diagnosis that we've rested on.
What would destroy these poor, innocent neutrophils? Well, without going into the fascinating world of immunology too deeply, I will briefly say that sometimes other parts of the human immune system get confused and think that your own cells are invaders. This is called "autoimmune disease" and it's the phenomenon responsible for lupus, multiple sclerosis, rheumatoid arthritis, immune thrombocytopenic purpura (what I had last year), and, apparently, what's going on now. My Absolute Neutrophil Count (which they figure out by counting how many neutrophils they can see on a sample of my blood) has been in the "severely low" range for a while. Any particular reason for why this happened is pretty much unknown; sometimes this can happen after a viral infection when a pumped-up immune system confuses something in your body with the virus.
My counts have been up and down the last few weeks, and because technically that means I'm more at risk for infection, I haven't been allowed to see patients. We've tried a few things to treat it; nothing has really worked. Fortunately, though, things are coming back a little, so I'm allowed to see patients again!
Thanks to all who have been praying for me through this or have sent me notes of encouragement. I'm really thankful for y'all and I am so glad that I didn't actually get sick while I was at this "severely low" neutrophil count. Hopefully that updates you appropriately?