Controlling Taxotere reactions

fritzinWA,

I had 4 rounds of Taxotere & Cytoxan, 3 weeks apart.  And, I had both the SE's you're describing in your post. 

About 8 days after my 2nd TC infusion, my nearly-bald scalp developed red, itchy bumps.  I tried to treat them myself by switching to a "medicated" shampoo (Head 'n Shoulders), but that made them more tender.  After 3 days or so, I noticed that some of the red bumps had developed "heads", like pimples (technically, "pustules").  I got worried and called my onco's office. 

My onco's nurse checked with my onco and reported back that I probably had "folliculitis".  I was told to stop using my regular shampoo ("Finesse"), and certainly avoid anything more harsh, like the "Head 'n Shoulders" I had tried.  The best thing was to use a very mild shampoo, like baby shampoo, and be very gentle with my scalp.  Don't scratch or rub the bumps, or they might get infected. I was told the bumps would dry up and disappear within a week or two.  If they didn't, I should call back.

Sure enough, the pustules became crusty and faded away before I went in for my 3rd infusion.  I did take some pics when they were at their ugliest, just in case they were gone by the time I saw my onco again.  When she looked at the pics, she confirmed that it was folliculitis.  She said she could have prescribed an antibiotic -- usually a tetracycline -- but they wouldn't have gone away any more quickly.  That was the only round of chemo in which I got scalp bumps.

I have really good veins, so I didn't have any problems with my infusions ... until the last one.  I don't know what was different that time; but after the chemo nurse put in the catheter and started the pre-med i.v., the monitor began beeping.  Apparently, the drip had stopped because the needle was pressed up against the wall of my vein.  The chemo nurse repositioned it and everything went fine -- no burning, no swelling, no problem.

Or, so I thought.  About 4 days after that last chemo treatment, I noticed that the skin directly over the vein that the nurse had used had become red and itchy.  I alternately put antibiotic ointment or steroid cream on the "burn" (which is what it looked like -- a linear burn), but neither seemed to help.  The red streak turned crusty, developed a scab (still in a line, right over the vein), and eventually fell off. 

I did call my onco and ask about it, and was told that if the streak got bigger or I saw any swelling or discharge, I should come in right away.  But, as long as the needle puncture mark was okay and the red line didn't spread, they were assuming it was phlebitis (inflammation of the vein), possibly because the vein was irritated by the chemo drug.

Nobody ever did explain why it happened that time and not at any other treatment; but I'll always think it had something to do with that i.v. catheter not being in quite the right place.  Did the catheter (or the needle) poke through the vein a little?  Was the inside of my vein irritated/traumatized by the catheter?  Who knows...  The only other thing that was different at that treatment was that my hands were kind of cold, so the chemo nurse gave me a "hot pack" (one of those bags that heats up when you activate it) to put on the back of my hand.  Maybe that hot pack dilated the tiny blood vessels in my skin and some of the chemo drug diffused out?

Anyway, even though neither of those problems was all that serious, I was glad I didn't need any more infusions.  Each treatment seemed to have its own set of weird SE's.  It's been almost 2-1/2 years since I finished chemo, and the memory is gradually fading.  I'm sure it seems like a very long nightmare for you, but it really will be finished soon.

Hugs, .... otter

I have only had 1 treatment, but I also got the vein thing. It is mostly gone now after 5 weeks. I haven't had my 2nd chemo yet because of other issues, but will talk to my onc about it if she decides to risk another treatment.

Karen