Need Advice about full strength Chemo

[Faith&Hope]

Hello,

My husband has an appointment tomorrow morning with his Onco and he is scheduled to receive first full strength chemo next Monday the 22nd and one more 3 weeks after.  3 days after the last weekly chemo, he developed fever of 100.4 and ended up at the hospital for 5 days.  Very low WBC (think they said it  was 0,5??)  So my question for y'all who have been at this point are:

1.  What kind of questions should we ask tomorrow concerning the full chemo and the scary side effects?  We are going to ask about low WBC and platelets and how she is going to handle?  Can you get a shot to boost the WBC before or after chemo?  Even now, 2 weeks after the last radiation and weekly chemo, my husband's temperature goes up in the evenings sometimes.  This happened 3 times so far.  (Weird it only happens in the evenings.) 

2. IF (hope none of you had the problem!) you did develop low cell counts, what did your Onco did for you?  A shot?  Send you prescription for Neulasta or something?

3.  She said to go ahead and get a flu shot a day before chemo, since "he will be feeling yucky with chemo anyway" and might as well get it over with.  Did any of your Onco tell you the same?  If his WBC is low already, the thought of flu shot is scary to me.

Thanks in advance for any insight and/or help you can give us.  God bless.

 

[Tom Galli]

Faith&Hope,

During my time in chemo, 2 days after infusion I reported to the clinic for a blood test. If my white count was low (often) I got an injection of Neulasta. If my red count was low (rarely) I was injected with Procrit. Both worked. 

There days there are methods for continuous injection of either medication. I’d mention his WBC history to his oncologist and I’m sure a solution will be found. 

Ensure he stays away from children during his chemo. The last thing he wants is a chest cold. 

Stay the course. 

Tom

[Robert Macaulay]

I asked the nurse while getting chemo what reason would they cancel my infusion, Her reply was your blood work that the doctor reviewed earlier in the day.I do get copy now of my blood work that was done today and I do review the results every two weeks after the tests prior to my infusion next week. 

I put my trust in the doctors decisions with all my treatments.

Bob

[BridgetO]

During my chemo for a non-lung cancer (Taxoterre and Carboplatin), I developed low neutrophils. I went to the ER for a fever and it was found my neutrophil count ws zero. I was given two kinds of antibiotics and sent home. My onc told me later that the ER docs had talked to her and they together decided not to admit  me to the hospital  because I didn't seem ill. For future rounds of chemo, I had neupogen injections for several (7 or 8, can't remember) days after each round.I gave these shots to myself. Neulasta is the same drug but in a long acting form so there's only one shot. On the neupogen I didn't have further problems with white blood cells. 

If the full strength chemo is the same chemo that caused his white blood cells to go low and land him in the hospital, I suggest asking whether they can go ahead and order the neulasta or neupogen before he has another occurrence. It's my understanding that those meds are given only after the infusion, not before. Somebody correct me if this is wrong.

[Faith&Hope]

Quote

 

Thank you, Tom, for your valuable advice.  Sorry you had to do it the hard way. but you made it!!   We bought a box of face masks and lots of hand sanitizer and now, thank you for the reminder about children!  There are quite a few in our neighborhood.

Robert, our chemo nurses usually tell us why they are waiting for doctor's approval, etc., so we know.  One time the doctor did cancel the chemo and gave him a unit of blood, then chemo next day.

Thank you both for your reply.

[Faith&Hope]

Thank you, BridgetO,

Yes it will be the same chemo combo, so that's why I've been concerned.  We will ask her about Neupogen and Neulasta and see what she says.  She may have planned everything already, but me being a worrywart, I want to be prepared and ask away.  I will also ask her about the timing of the medicine.  Thank you again for your help.

[BridgetO]

It's important to plan what you want to ask about. It's not being a worrywart. It's being prepared. Your husband is lucky to have you advocating for him.

[Robert Macaulay]

Yes you made a good point ,She may have planned everything already.

[LexieCat]

In answer to your question about the flu shot, take a look at this article: https://www.verywellhealth.com/immunizations-during-cancer-treatment-2248837

It sounds like the injection, which uses killed virus, not live, is safe for cancer patients with compromised immune systems.  They also make the very good point that avoiding the flu is especially important when your immune system is weakened.  

I'd say if the docs are recommending it, he should probably have it.

[Robert Macaulay]

As long as you do not get it on the same day as your chemo and if they were a reaction, The would know which one. My nurse asks me every time did you have a flu shot today prior to my infusion.

[Faith&Hope]

10 hours ago, LexieCat said:

In answer to your question about the flu shot, take a look at this article: https://www.verywellhealth.com/immunizations-during-cancer-treatment-2248837

It sounds like the injection, which uses killed virus, not live, is safe for cancer patients with compromised immune systems.  They also make the very good point that avoiding the flu is especially important when your immune system is weakened.  

I'd say if the docs are recommending it, he should probably have it.

Thank you, LexieCat.  I just read the whole thing twice and understand a lot of it, but not all.  We didn't get to ask her about it today because something else came up, but I will call tomorrow before doing anything. Sounds like it is a necessity.

My husband developed shortness of breath the last few days, so when he told the doctor about it, she immediately ordered blood test, chest x-ray and a CT with contrast.  

She wanted to rule out blood clots and pneumonia and I sense that she was concerned, so I became very worried to live up to my name, worrywart.  Thank God, no blood clots, no pneumonia and blood works must have been okay, because we came home instead of having to stay at the hospital. 

So we still do not know what's causing the shortness of breath.  Will call the doctor tomorrow. Again I have a list of questions.  We will be so grateful when this stage of treatment is over.  Wonder if anyone else had shortness of breath at this stage?  2 weeks after finishing weekly chemo and radiation treatments (for 2 months)?