Fear of infection

Hi Hornsemail

I really understand your fears. During my whole chemo treatment I was also paranoid about catching some virus or whatever and ending up very sick. We took lots of precautions at home and out and about (hand disinfectant, hand washing, asking people not to visit if they had a sore throat or illness) but I ended up in hospital for 3 days with a high temp - all due to a simple head cold. However 2 days after that I was back for my next chemo treatment and it went fine. I think trust your Dr's judgement on this unless you just feel too unwell in yourself. And make sure you adhere to the rule - if yu do get a high temp whilst on chemo go straight to hospital or to your Dr. Mine went from mild temp to dangerously high in about half an hour!

Good luck and I hoep your treatment goes well.

Neece

My case was a little different from yours, but here is what my onc did.  Perhaps you should discuss this with yours as well.  I was always healthy prior to my diagnose.  Had my first AC and developed febrile neutropenia right after it.  My lumpectomy incision was very large and a small portion was still crusted.  Well, that was enough, with the low blood counts, for me to develop cellulitis of the breast.  Was hospitalized for 5 days on iv antibiotics.  Chemo was delayed for another week, then I resumed.  My counts went low but not neutropenic after the second round (yes, I had Neulasta after every round of chemo from the first one right through all 4 of the Taxoteres as well.  Right after second AC - I had my root canaled, capped molar fall out!  No pain or infection, but from that point on, my onc had me start 10 days of antibiotics on the second day after each of my chemos to ward off any further risk of infections.  It was a pain in the arse, however, no infections or neutropenia throughout the the any of the other rounds of chemo.  May be that you won't need them, but my onc did not want to take any chances and I was thankful for that.  Best of luck to you.  It stinks when you have a set back right out of the gate.  Will be thinking of you.

Linda 

I taught the whole time and was fine. I just washed my hands like crazy, kept my hands away from my face etc. the things we should always do (but usually forget) to stay well. Good luck!

I don't think you can prevent all MRSA.  People are in the community who carry MRSA.

Community-associated MRSA (CA-MRSA) refers to an MRSA infection with onset in the community in an individual lacking established MRSA risk factors, such as recent hospitalization, surgery, residence in a long-term care facility, receipt of dialysis, or presence of invasive medical devices5....While outbreaks have frequently been reported among members of defined groups, most patients do not have recognized CA-MRSA or HA-MRSA risk factors and are not linked to an outbreak38. http://www.cdc.gov/ncidod/dhqp/pdf/ar/CAMRSA_ExpMtgStrategies.pdf (emphasis mine)

  Of course, hand washing and surface washing is a VERY IMPORTANT step.  Antibacterial soaps, except in hospitals are usually NOT recommended. Soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1%-0.45% wt/vol) were no more effective than plain soap at preventing infectious illness symptoms and reducing bacterial levels on the hands. Several laboratory studies demonstrated evidence of triclosan-adapted cross-resistance to antibiotics among different species of bacteria. CONCLUSIONS: The lack of an additional health benefit associated with the use of triclosan-containing consumer soaps over regular soap, coupled with laboratory data demonstrating a potential risk of selecting for drug resistance, warrants further evaluation by governmental regulators regarding antibacterial product claims and advertising. Further studies of this issue are encouraged. http://www.ncbi.nlm.nih.gov/pubmed/17683018 (emphasis mine)

MRSA in serum survived 41 days on glass, 45 days on tile, and > or =60 days on countertop. Five of thirty-three stethoscopes (15%) tested were positive for MRSA. CONCLUSIONS: Previous studies showed fomite survival of MRSA for about two weeks using contact plate sampling and MRSA on 7.4% of stethoscopes. We showed longer MRSA survival times by wet swab sampling and a higher stethoscope contamination rate. As expected, higher organism loads survived longer.http://www.ncbi.nlm.nih.gov/pubmed/19354027

This study demonstrates that all epidemic nosocomial- and community-acquired MRSA do not survive when no organic protection is offered but survive well when soil (pus and blood) is present, thus offering protection from drying. This study indicates that contaminated coins may serve as potential vehicles for MRSA.http://www.ncbi.nlm.nih.gov/pubmed/17577483

Most gram-positive bacteria, such as Enterococcus spp. (including VRE), Staphylococcus aureus (including MRSA), or Streptococcus pyogenes, survive for months on dry surfaces. Many gram-negative species, such as Acinetobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens, or Shigella spp., can also survive for months. A few others, such as Bordetella pertussis, Haemophilus influenzae, Proteus vulgaris, or Vibrio cholerae, however, persist only for days. Mycobacteria, including Mycobacterium tuberculosis, and spore-forming bacteria, including Clostridium difficile, can also survive for months on surfaces. Candida albicans as the most important nosocomial fungal pathogen can survive up to 4 months on surfaces. Persistence of other yeasts, such as Torulopsis glabrata, was described to be similar (5 months) or shorter (Candida parapsilosis, 14 days). Most viruses from the respiratory tract, such as corona, coxsackie, influenza, SARS or rhino virus, can persist on surfaces for a few days. Viruses from the gastrointestinal tract, such as astrovirus, HAV, polio- or rota virus, persist for approximately 2 months. Blood-borne viruses, such as HBV or HIV, can persist for more than one week. Herpes viruses, such as CMV or HSV type 1 and 2, have been shown to persist from only a few hours up to 7 days. CONCLUSION: The most common nosocomial pathogens may well survive or persist on surfaces for months and can thereby be a continuous source of transmission if no regular preventive surface disinfection is performed.http://www.ncbi.nlm.nih.gov/pubmed/16914034

MRSA survived for 11 days on a plastic patient chart, more than 12 days on a laminated tabletop, and 9 days on a cloth curtain. Irregular surfaces may help harbor organisms in the environment. In addition to contact precautions, MRSA containment during an outbreak should include concurrent environmental decontamination.http://www.ncbi.nlm.nih.gov/pubmed/17080391

I got a cold right before my 5th chemo. It was really uncomfortable having a cold plus chemo side effects, but the cold wasn't any worse than a regular cold and they didn't delay my chemo for it. I traveled on business including plane flights during the third week of my chemo cycles, but the cold I got was one that my granddaughter had before I left. My husband and daughter-in-law got it too and had it about as bad so I can't blame it on lowered immunity.

My oncologist did give me Neupogen each cycle to help my white cells. We tried without it for the first chemo but my white cells went to almost zero and I got a fever even though there was no infection. That's when she started the Neupogen.

I was careful to wash my hands frequently (and had to use hand lotion because that dried my hands out). 

You don't want to go so crazy with infection worry that you wear out your support system. My son's MIL who lives with them is starting chemo and has been asking them to do all sorts of things. At one point she said she thought there shouldn't be any raw fruits or vegetables in the house because when she was in the hospital there was a sign saying visitors shouldn't bring them. When your immunity is very low, you should only eat fruits and vegetables that have either been cooked or peeled but saying that they can't be in the house in their raw state is excessive and hard on your house mates. 

She had a talk with her oncologist so now that's straightened out.