Starting Chemo May 2008

Adrienne ~ its the side effects mostly - especially the bone/muscle pain. Already have peripheral neuropathy in left arm and some days can barely handle that pain -and that is with the pain meds i am already on. That being said, after reading a few other posts about wbc dropping dangerously low after 1st tx, I decided to deal with whatever Neulasta brings me. I am highly susceptible to infection and get them on average 6x's a year - for everything imaginable - so, Neulasta it is. Thanks for your input...it's appreciated...

Hi all!  Just an update to my post on Sat night about my lumpectomy incision opening back up a little bit.  My surgeon was oot on sat, so I talked with another surgeon who said it was fine as long as the drainage did not have an odor, was clear and there was no redness, tenderness or fever.  So, since I don't know this guy, I called my surgeon this morning who confirmed.  If there is fluid that needs to get out, they would rather it happen than not.  So, I just have to keep an eye on it. 

Now, I called the onc and am waiting for a call back to see if this will postpone the 1st tx that is supposed to take place this Thursday.  I hope not, but if it does then I guess it was meant to be...

Tina

QUESTION:  When you go in for chemo and discover your WBCs, neutrophils, etc. are really low, do you have any inkling before you go that this might be the case?

My doctor had decided to put me on Neulasta before they even did the bloodwork.  But when I went in for chemo #1, they told me that my bloodwork was not great (e.g., my WBCs were already "low normal").  

I feel really good. But in the back of my mind I'm wondering if I'm going to go in there on Wednesday and find out that I'm actually not doing as well as I feel.  

Any thoughts?  

This helps so very, very much.  (Our pre-chemo results are quite similar.) Thank you.

Kristy,  Rats. I was hoping feeling well=good WBC!

I don't want to make you revisit a bad experience but . . . did they give you any sort of advice about the sort of measures you should be taking to strengthen your immune system/reduce risk of infection? I am trying to strike a balance between being careful without making myself a crazy lady (after all, I do have to take NYC public transit!). 

Good morning all.  I went for blood work 1 week after my first tx and my wbc was .08.  I felt terrific.  The nurse even commented that I looked way to good for counts as low as they were.  Nuelasta was given and I now receive it the day after each tx.  The first time I had a temp spike on Frid. after Wed. neulasta. and was achy. The dr. said I probably had an infection starting, but the antiboitics stopped it.  This time I was acky Sun. after Thur. neu. but feel fine today.

Rock, I agree with Adrienne.  There isn't much you can do to "help" those neutrophils at a time of need.  The only thing that will make them come screaming out of that bone marrow is a pulse of their favorite "hormone" (G-CSF; or a shot of our favorite genetically engineered version, either Neulasta or Neupogen).

Until that stimulus happens and they can respond, the best we can do is try not to place too many demands on the mature neutrophils we already have in the blood.  They don't live very long anyway (a matter of a week or so, it seems), and when the call comes for them to migrate into a site of infection to fight off the bad guys, their lifespan becomes mere hours.  So, if chemo has suppressed our bone marrow and we aren't producing new neutrophils to replace the ones being killed in battle, well, we're screwed.

Neulasta and Neupogen really are keeping a lot of us out of the hospital.  Most likely, unless we're running a fever or feel "sick", we won't even know when our neutrophil counts are down. Fortunately, the low point only lasts for a couple of days as long as we've been given bone marrow support via Neulasta or Neupogen.

RBC's are a whole different matter.  Neulasta does nothing to help them mature and be released from the bone marrow.  RBC's need to hear a signal from their own "hormone", erythropoietin (commercial versions are Epogen, Procrit, and Aranesp). You can feel weak and tired, and look pale, as a result of too few RBC's, but not necessarily.  Most people can tolerate a bit of a drop in RBC's and/or hemoglobin before they crash.  So, my onco proposed that even if my hemoglobin drops a bit more than it has, we just tough it out rather than use Procrit/Aranesp to boost it back up.  It gives me yet another excuse to be lazy.

otter 

I don't know if I was just being foolhardy, but I didn't restrict my activities at all during chemo.  I went to the movies once -- a kid movie, no less, so I'm sure the place was filled with runny noses -- and pretty much did what I always do on the days I felt up to it.  I don't take public transportation on a regular basis, but I did take the train and subway into Boston on the morning of chemo.  Of course I stayed away from any kids who had been diagnosed with strep or were actively puking, but besides that, I just washed my hands a lot and went on with life.  When I asked my onc about food restrictions, she said that this is more relevant for people who do a longer course of intensive chemo over many months, because their immune systems become really compromised (I was just doing 4 sessions of A/C).  She said I should follow the same guidelines that pregnant women do -- no sushi or undercooked meats, no soft cheeses -- but raw fruits and veggies were fine.  So I've been eating salad all along.  The Neulasta seriously boosted my WBC -- it was above normal the last two times -- so I guess it worked for me.

I'm not advising that everyone do what I did -- maybe my onco is particularly liberal, or maybe I just got lucky, or maybe 7 years as a parent of a kid who has been in daycare since he was 5 months old has given my immune system a natural boost?  But I wouldn't worry about a couple of public events if you really want to go.  You could be like my mom's crazy cousin, who is also in the middle of chemo and showed up to another cousin's engagement party with a spray bottle of Lysol.  No, just kidding, please don't do that!  If I were you, I would go -- and if the person sitting next to me started recounting her terrible bout with the stomach flu, I'd move to a different seat.

JMHO.

Hi. I start chemo on Thursday.  I am actually doing chemo first before surgery due to some research that my onc found. I am having TAC for 6 sessions - once every 3 weeks. My onc already assured me that hair loss would be imminent! I also have a prescription for anti-nausea meds the day before, day of, and day after chemo besides the shot planned for the day after. Anything I should be aware or or know about. She told me that I would definitely not be feeling better until the MOnday after. I am planning on working Friday, if I can, but I wanted to know if this was even realistic!?

Thanks for any advice.

Julie 

drcrisc

I also had a lumpectomy on March 21 and then a re-excision and SNB on May 2. It is now 17 days since 2nd surgery. My dented boob is still swallon, brusied and bigger then normal boob. Did you have any problems with second surgery? How long before swelling went away and you could tell it was the dented Boob? I am suppose to start TC next week 5/28 but think I want to heal better before they inject me with drugs that will slow down healing. See surgeon on Thursday for 2nd follow up, will ask him what he thinks. If he gives me the thumbs up, otter can add me to the list for 4 TC every 21 starting on the 28th.

Karin

Cristine -- Nothing to offer except to join you in an empathetic Grrrrrrrrrrr.  (Can you imagine what it would be like if every woman who was losing patience waiting for results/insurance reiumbursements/surgery/chemo showed up en masse somewhere and growled? If I'm ever reincarnated as a performance artist . . . )

Hi everyone,

Well it's Tuesday after my 1^st Friday treatment T/C.  I also had a neulasta shot yesterday.  I've had little or no s/e's so far.  I've been able to work and carry on with my normal crazy schedule.

The only thing I have noticed is restless sleep.  I doze off regularly, but it's fitful - the only way I can describe it.  Last night I had sort of creepy crawly feelings in my legs.  I got up and moved around a bit and that seemed to help.  I've never had that before, so I'm just assuming it's related to the chemo.  So, all in all, things have been relatively uneventful.   I keep waiting for the ball to drop and I'm sure it will, but for now I'll thankfully take this.

I'm wishing for minimal s/e's for all of us.  Sending prayers and good thoughts to each of you.

My first chemo went well except for being quite cold in the treatment room.  I had 2 blankets on the entire time and next time I will definitely take some long warm socks!  I slept well and have felt OK today.  Went in for the Neulasta shot and now want to relax a bit.  I hope to go to my needlepoint clinic tomorrow.  Not too many people will be there but it's a very enclosed, stuffy room so at the first sneeze, I'll leave.  For months I've been looking forward to a special needlepoint class that takes place for 4 days next week.  Those will be Days 11-14 for me and I sure hope I can make it.  Trying to avoid germy groups until then. 

Congrats, collector on Chemo #1.  Bravo!  clapclapclapclapclapclap.

Familyroks, Ready to grab hands and jump in the pool tomorrow and have drinks at the chemo cocktail bar?

Angelsaboveus:  Up until about 20 seconds ago, I thought you had a Greek login:, i.e., "Angel Sub oh vee uss."    

Otter:   Here, I hope, is a link for Summer Express: 101 Simple Meals Ready in 10 Minutes or Less

http://www.nytimes.com/2007/07/18/dining/18mini.html?_r=1&scp=10&sq=100+recipes&st=nyt&oref=slogin 

rockthebald - I'm ready to dive in.  I hope we do as well as we did for treatment #1!

Collector - glad to hear you are doing well.

Otter - I hope you were able to climb out from under your blanket long enough to have a tasty meal.