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  • lassie11
    lassie11 Member Posts: 1,500
    edited April 2010

    I never had Neulasta or Neupogen through my six cycles of every three weeks chemo. My blood was checked every time before chemo and since it was OK, there was no need for more medications. Some people who had lower counts had one of those drugs. I think Alpal is right that it is sometimes used as a matter of course and on an as needed basis in other places.

  • Luah
    Luah Member Posts: 1,541
    edited April 2010
    Alpal: Seems odd they would test the week your triweekly treatment - I think days 8-14 are known to be the nadir, then WBCs begin to pick up to day 21.  Of course, if they were unusually and dangerously low, the neulasta makes sense.
  • Kathy044
    Kathy044 Member Posts: 433
    edited April 2010

    I had a fever during my first chemo nadir period requiring me to go to hospital emergency and according to the FEC-D treatment protocol that meant I had to either lower the drug dose for the remaining chemo by 25% or have the Neupogen shots. As I didn't have much time to think about it I took the lower dose for the second chemo but after doing some research (the shots don't prevent critically low neutrophils but do shorten the period you have them) decided for my safety to have the shots for the remaining chemo sessions.

    I also had a fever during my fourth session, the first with taxotere, this time requiring a  3 day hospital stay, so you can see what I mean about the Neupogen not preventing wbc problems. According to protocol with the second fever neutopenia I had to lower the dose of the toxotere by 25%. If I hadn't been taking the shots I would  have had to lower the dose of the drug by 50%.

    .

  • konakat
    konakat Member Posts: 6,085
    edited April 2010

    When I was getting chemo every week I got bloodwork done each week too.  It was also to make sure my liver and other bits could handle another chemo, not just checking for low WBC.  Also, when I was seen in the US, once I had a reading of low WBCs Neulasta (or Neupogin), was automatically given after each chemo to boost the cells and I assume also as a preventative. 

    Edit to add:  Comparing my care in Canada and in the US, I do think the US over-prescribe and over-test.  My onc here was appalled by the number and frequency of scans I had in the US and the radiation I was exposed to, especially following up each PET with MRIs galore.

  • rinna40
    rinna40 Member Posts: 357
    edited April 2010

    When it was established that my private insurance covered the Neulasta shot, I was given it after each treatment, by my home care nurse (my wounds from my lumpectomy didn't heal until after I finished chemo, so I had a nurse coming every other day throughout treatment). I had severe bone ache from it, and if I had to do it again, I think I'd see if my WBC count was low enough to warrant it.

  • Rico
    Rico Member Posts: 128
    edited April 2010

    Did anyone see this?

    http://www.msnbc.msn.com/id/36711197/ns/health-health_care/

    So, refresh my memory... why should we trust the insurance companies?

  • Rico
    Rico Member Posts: 128
    edited April 2010

    Hey E:

    Have you developed a taste for flesh?

    I'm looking forward to an update. 

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010

    Rico, if there's a better argument in favour of single-payer, I can't think what it might be.  Sounds like this might ignite a class action suit against Wellpoint.  After all, what's the difference between paying health insurance premiums and not receiving the promised healthcare, and laying out cash for a new vehicle and then having the car dealer forbid you to drive the car off the lot?

    Enjoyful, how are you doing?  Have you made your second trip to St. Louis?

  • Alpal
    Alpal Member Posts: 1,785
    edited April 2010

    Had my first Gemzar today - ok except for horrific head ache. Thought I'd mosey on over and see what my Canadian buddies were doing, not to post, just to lurk. I HAVE THE SAME INSURANCE AS THE WOMAN FROM LOUISVILLE. YES, I AM SCREAMING!!! I even got the damn robo calls about getting a mammogram (1 year after my Stage IV diagnoses). Maybe BC/BS knows my baby boy is an attorney? Hehe! Oh no, we don't need Health Care Reform! Whew! Hope you're all doing well. I miss you!

  • pip57
    pip57 Member Posts: 12,401
    edited April 2010

    Lindasa,  LOL at the return serve of the car analogy! 

  • Rico
    Rico Member Posts: 128
    edited April 2010

    Not to worry, Alpal. The Republicans are apparently suggesting we pay for our medical services with chickens.

    Hmmm. 

    I just cannot picture my onc knowing what to do with a live chicken. 

    LOL. 

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010
    Rico, your onc would have to go back to high school biology to figure out how to humanely slaughter it and then dissect it!  And then, figure out how to pay tax on it!   (let's see, grocery tax or income  tax......hmmmm)
  • Enjoyful
    Enjoyful Member Posts: 3,591
    edited April 2010

    Hi everyone!

    Rico - no craving for flesh yet, but those brains in the fridge are starting to look tasty.  :-%  (that's me smiling through a mouth full of brains)    And yes, I'm stocking up on chickens, turkeys, and other poultry so I can pay my doctor.  And hell, I may as well send some to the IRS to pay my tax bill.  Who's with me?

    Lindasa - I have my second visit on Monday, but it's just for blood work and a physical exam.  My next series of shots is on May 10, and Meg will accompany me to watch for signs of zombiehood.

    Alpal - CRAP!!  I AM SCREAMING WITH YOU!  Better lay low and wear camouflage.  My bet is they'll cease and desist now that their secret is out.  I wonder who their next target will be?

    So today, my radiation oncologist tells me that she thinks I have 3-5 years before I reach my expiration date.  Why, oh why, did I have to ask the question??

    *slapping self*

    E

  • Rico
    Rico Member Posts: 128
    edited April 2010

    Good to hear from you, E.

    Your rad onc is full of sh!t. 

  • Enjoyful
    Enjoyful Member Posts: 3,591
    edited April 2010

    LOL!!!  Thank you, Rico!  I needed to hear that.  :-)

  • Rico
    Rico Member Posts: 128
    edited April 2010

    Seriously. Does she have a crystal ball? On what basis can she possibly know? She's talking about averages. How can she possibly know where on the distribution curve you're going to fall?

    How can she know whether the chemo you've already received or the vaccine you're currently getting won't buy you a whole lot of years? 

    AARRGGHHH. 

  • pip57
    pip57 Member Posts: 12,401
    edited April 2010

    Both of my grandparents were doctors.  They were often paid with chickens and preserves.  We have a stuffed deer head in our log cabin that was payment from a patient.  They always said the worst payers were the people with money because they just couldn't understand how the "little money" that they owed would make such a big difference to a doctor. 

  • ananda8
    ananda8 Member Posts: 2,755
    edited April 2010

    If one looks at the data on a distribution curve, one will find that the line drawn is through the middle of data points.  Exactly where the line is drawn is up to the person interpreting the data.  There is a very old saying that my Statistics professor quoted in class.  "There are liars. There are damned liars. And, there are statistics."

    Statistics are valid for large groups of people but do not predict outcomes on an individual basis.

  • Enjoyful
    Enjoyful Member Posts: 3,591
    edited April 2010

    Rico,

    She did say that was her best guess, and she didn't know what effect the vaccine would have, and I could be an outlier and all that....  I was just hoping she'd say 5-10.  It was a shock hearing 3-5.  It doesn't seem possible since I'm in remission now. 

    PIP - Your grandparents sound awesome!  I can't imagine going to my doctor, though, and offering to pay for my chemo with chickens or house-painting or any other kind of service.  What could I possibly do that would equate to tens of thousands of dollars?  It might work for a few people who have a valuable and specialized skill or product, but it wouldn't work for the vast majority of us urban-dwellers.

  • Enjoyful
    Enjoyful Member Posts: 3,591
    edited April 2010

    Hey, notself!  How have you been?

    I have this stupid craving for numbers and statistics, even though I know that my experience may be very different.  I just can't help myself.  Must...have.....numbers..........

  • Kyta
    Kyta Member Posts: 713
    edited April 2010

    Stats/averages are just numbers E....and you're not a number. I agree with Rico...your rad onc is full of sh*t. Keep doing what your doing. I pray this vaccine trial is successful for you and many others.

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010

    Madalyn - ROTFLMAO!   What a picture -- and what a "clucking" good idea!

    Enjoyful -- I know it's only human nature to ask about one's own life expectancy.  Too bad that docs (who learn 'omnipotence' in God 101 in med school) continue to answer that question without much basis in fact. Please remember that any book on cancer is practically out of date by the time it reaches the store's bookshelf!

    Hugs to all,    Linda

  • ananda8
    ananda8 Member Posts: 2,755
    edited April 2010

    E,

    I am doing fine. 

    I crave statistics, numbers, quantities, probabilities, information of any kind all the time.  I want the reason, the meaning, the root cause all the time.  I want suggestions, solutions and outcomes all the time.

    I understand how you feel.  It's who you are.  It's who I am.

    We just need to remember that all of the above is subject to human thought, misunderstanding, interpretation and error.  None of it should stop us from enjoying this very moment.

  • Beesie
    Beesie Member Posts: 12,240
    edited April 2010

    "I have this stupid craving for numbers and statistics, even though I know that my experience may be very different.  I just can't help myself.  Must...have.....numbers.........."    "I crave statistics, numbers, quantities, probabilities, information of any kind all the time.  I want the reason, the meaning, the root cause all the time.  I want suggestions, solutions and outcomes all the time."

    Yup, me too.  If you're wired that way, you're wired that way.  Don't fight it.  But, for those of us who are wired this way, notself said the most important thing that we always need to remember -   "Statistics are valid for large groups of people but do not predict outcomes on an individual basis."  If there's a 1% chance that something might happen, it means that the odds are that it won't happen to you, but you just might end up being that lucky/unlucky 1 in 100. 

    So, "3-5 years before I reach my expiration date."??  Uh, no!  As Rico said, your rad onc is full of sh!t. Maybe it's 3-5 years for an "average" population group, but she has no idea with it is for you. You are not average.  You are unique and special and you can be the one who blows all those odds out of the water, and is still here to laugh with us well past 10 years from now.  Someone is going to be that person, so why not you?

  • pip57
    pip57 Member Posts: 12,401
    edited April 2010

    Tell me the stats for something and I will work my butt off to prove them wrong.  I have already done that!

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010

    "Why not you?"

    Funny how our perspective changes depending on the wished-for result.  If I buy a lottery ticket where the odds are one in 20 million that my numbers will be picked, I happily say to myself, "Well, why not me?"

    If, on the other hand, my doctor tells me (according to statistics) that my chances of expiring from this disease are one in 10, or even one in 20 -- oh boy,  I tend to not like those odds so much.

    Since we all want the odds to be 100% in our favour -- and we know that life just isn't like that -- there's no harm whatsoever in throwing all those stastistics, odds, whatever, out with the bathwater.  And any time a doc places a patient at a probable endpoint on her life's timetable, then that doc should be happy to be paid in clucking livestock.....so there!!!!!! 

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010

    Edited to say -- Oops, posted twice!

  • mke
    mke Member Posts: 584
    edited April 2010

    Steven Jay Gould wrote and essay titled "The median is not the message".  When he was diagnosed with some sort of nasty cancer.  As it happens Gould was misdiagnosed but the point of the essay remains valid.

  • crazy4carrots
    crazy4carrots Member Posts: 5,324
    edited April 2010

    Good news!  I just read in the Globe & Mail (aka Mop & PailWink) that the Ontario government has seen the light and is going to start funding the Oncotype DX test.  Altogether the gov't has committed $115M this year for various research projects, including stem cell research and genetics.

    The article by Lisa Priest went on to say that one of the reasons for funding the Oncotype DX was because it can potentially save many $$ in expensive chemo tx.  She actually used the figure of $10K.

  • Anonymous
    Anonymous Member Posts: 1,376
    edited April 2010

    Apropos Ontario gov't funding. I'm sure you've all heard about the ongoing battle between the pharmacies and the gov't over the generic drugs prices.

    I'm just thinking... Last year the company I work for was forced to cut some benefit coverage because of the rising costs (the plan is still great though). So I wonder about the benefit plans in this connection. Do you expect their costs to go down?

    Thanks,

    Yan

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