Neutropenic fever

etherize - a neutropenic fever is just that - caused by low WBC, you can't cause it with anything you do.  If it is truly neutropenic you may need antibiotics for protection in the short term.  I ran a low grade fever after every chemo, it is pretty common - make sure you are keeping an eye on it.  I never exceeded 100.5 (that I know of) but I did flirt with it. If you do go to 100.5 definitely call your onc. Are you allowed Tylenol?  Are you receiving Neulasta?  For the slivers, etc. obviously it is an infection risk but keep it clean and use a topical antibiotic if you have one. 

Etherize, don't just treat a neutropenic fever with Tylenol!  It's not true it's just because the white blood count is low.  What your docs are worried about is overwhelming infection which can happen when you don't have the white blood cells to fight all the bugs that routinely get into us through the mouth, anus, minor skin nicks.  The risk is nowhere near as high for us as for people being treated for some other cancers, like acute myeloblastic leukemia, but it's there.   That's why they want you to call if the temp goes above a certain number.  

I actually was not supposed to take Tylenol at all so that my temperature would more acuratey reflect what my body was going through. I had one hospital admission for a neutropenic fever and the source was identified (which doesn't always happen), I had one kind of equivalent course of IV antibiotics done as an outpatient (they offered me admission and I turned it down) with no source identified, and one course of oral antibiotics when it seemed pretty clear that I had a virus going around my family.  

You are at more risk when your ANC is <500.   I think mine was 0.1 when I was admitted and more like 0.7 or so they let me stay out of the hospital.  But in considering your ANC, it's also important to know if it's starting to recover or not.  If it's 1.6 and it was 1.0 yesterday, that's great. If it's 1.6 and you don't know whether it was still going down or coming back up again, that's really different.  

Sorry to be the bearer of less cheery advice.  But please, please call your doc if it goes over the threshold they gave you. 

Etherize, 

What an unfair combination.  As if any of this were fair.  My admission and infection were my first cycle of chemo .  Afterward I was obsessively sanitizing doorknobs and faucets, wiping myself with baby wipes (softer), clipping my nails when my counts would be highest - all this stuff to reduce the chance it would happen again.  It was quite scary the first time.  My sweet old dog mis-judged where I was holding her bisquit and bit my hand - severe anxiety and threw her bisquits onto the floor after that.  Never did have to delay chemo 

I had neutropenia after my first chemo. Both the ONC and the hospital said that's usually when it happens most.  I'd been told to monitor my temp about 4 times a day and if my temp hits 100.5 to call them.  It did and I was told to take 2 Tyelenol and lay down and rest.  Recheck the temp at about 2 hrs and again at 4 hours mostly to make sure it didn't rise anymore.  If, after 4 hours it did not come down below 100, I was to get thee to the ER and I did. I had been told that the high temperature signified an infection and w/ a weakened immune system I may not be able to fight it.  The number one thing the ONC pounded into my head is that I could die much quicker from sepsis spreading rapidly throughout my body than cancer could ever take me. 

Here's the thing tho - I didn't feel bad, never was warm and actually there was no real way of knowing that it was happening in my case other than the temperature.  Was put in the hospital for 2 days b/c that's how long it took to get temp back to normal range.  I was given continual IV solution and every so often the IV had an antibiotic added.  They released me once my temp returned and stayed in the normal range for something like 12 hours. 

Don't beat yourself up - I did something stupid that I am sure landed me in the hospital and the ONC and hospital staff said that we cannot live in a bubble during this time and so these things may happen - oh and this never affected chemo schedule - next one was still on.