shots for low blood count - Dr. visit required?

[mjb]

My husband has had to get shots for low white blood cell counts between chemos several times. It was borderline last chemo and doctor said come in and get shot Tuesday before chemo on Thursday. Any trip to the clinic is at least a 2 hour ordeal but shots have not been so bad - go in, go back and get it, leave.

Today they told him he has to come in, have blood drawn, see the doctor, then get the shot.

Said medicare requires it. Does anyone else have experience with this? Is it really a requirement or is this just another way to meet payroll. Don't mean to be cynical ... but I am:)

[RandyW]

I believe what they are doing is checking kidney function to make sure everything is ok in conjunction with the shots. Low white blood cell counts are dangerous as whites are infection fighters and reds are energy and oxygen. If HE is getting shots for white cells which I see he is then he is getting procrit shots. If its for red blood cells it would be aranesp. Reds can be boosted with leafy greens for Iron and also alternative is to get a 3 hour blood transfusion. Not sure about whites though. I am not sure if transfusion works for whites or not. Hope this helps..

[mjb]

Appreciate the input. It's not Procrit though, it's something that starts with an N. One week they had him come in and take shots three days in a row. Now he has to come in and meet with the doctor to get a shot. I wasn't there this time or I would have asked about it but she told him that now medicare required it (new health plan going into effect?). It's just that it turns a 30 minute stop into a 2 1/2 hour appointment and he's fed up with sitting around waiting rooms:)

[ronvrens]

Hello There

When my wife's blood went all wrong they also gave her the shots it's called Neopogen and when she was in hospital they gave her transfusions of red cells white cells and platelets.

The white cells fight infection and the platelets are for clotting.

Her bone marrow became depleted and could not produce anything hence all three types of transfusions.

Ronnie

[cat127]

I think what happens is that different insurers, including medicare, have different levels of decreased WBCs or RBCs at which they will cover the cost of the shots that will raise those cell counts back up. I remember at one point with Kelly's RBC count the nurse actually said - do you have (insert whatever insurer)? Then said, oh good, they will pay for the epogen if your levels are 12 or below, but medicare will only do if it is is 10 or below. Now we didn't have that same experience with neupogen for her WBCs, but I could see there being a similar requirement. You said that this last go around the levels were borderline, so I assume they are checking to be sure that the levels are still suppressed enough and therefore the shot is covered by medicare. And that is an expensive shot, so you don't want to risk it not being covered.

Not positive, but that is a possibility.

[laban]

It's just that it turns a 30 minute stop into a 2 1/2 hour appointment and he's fed up with sitting around waiting rooms:)

I understand. Bill hated sitting and waiting. Someone would tell him he'll be seen in a minute and taking that literally should have meant a minute. He couldn't understand why his time wasn't as important as the doctors and nurses that saw him. Very frustrating for the patient and the caregivers.

Sorry, that sentence just brought back some old, crappy memories.

[dianew]

I had to go in - on a separate day - after each chemo to get a "Neulasta" shot. It was my understanding it was for WBC - I hated it, made my bones hurt something awful and it got worse with each shot. They wanted me to have an Aranesp shot for red blood cells, but I had looked that up on line and refused that one. They didn't like it, but let it go.

All through treatment - as nice as most of the individual nurses, etc. were - the overall impression I got was that they really didn't consider the time and convenience of the patient. It was not at all unusual to have them schedule you for radiation at 10:00 on one side of town, and chemo at 10:15 on the other side of town - even though there was a chemo infusion center approx. 40 feet down the hall from radiation. It never made any sense. Now I volunteer to drive people for treatment - and they still do it - apparently no one has any common sense.

Diane

[mjb]

I really appreciate all for the input. Tomorrow is chemo day and I will have an opportunity to ask some things and now I have a better idea of what. Am relieved to hear that we are not the only ones who are constantly sitting around waiting like we have nothing else to do. In my next life I am going to manage some kind of medical facility - efficiently!