My lovely wife and I are trying to understand more about the danger of infection while getting Docetaxel infusions. I had my first one last week and will have five more to go.
We are cognizant of infection and take precautions in terms of avoiding crowded places for the first week and washing/disinfecting hands. How have others treated the risk of infection? My wife tends to be extra cautious for me in terms of seeing grandkids, going to parties, flying as so on.
I tried to stay away from sick people and used extra care in the kitchen when preparing food. Didn't take any chances eating anything that was questionable. Despite my best efforts, I ended up taking a trip to the ER with a fever that was borderline. Everything turned out OK, no problems.
One bit advice I would give is to get a professional grade thermometer. We had 3 thermometers with a 3 degree spread between them. It took quite a while to figure out whether I should go in.
Your medical team should be monitoring your blood counts, which should include CBC and Metabolic Panels. That wil give you an idea of what the nadir is for your WBCs, lymphocytes...they can give you a shot to boost your WBC counts, Neupogen neupogen.com/). That decreases your risk but of course does not elimiate it.
I can't say I went overboard on countering risks of infections. I followed normal life, washed hands, probably more frequently than when I wasn't doing six cycles of taxotere, clothes, ensured I used tissues when sneezing, blowing my nose, wiping a runny nose, ensured eating utensils and dishes were clean, not drinking or eating from other people's dishes, no sharing of food (can I try a bite of yours...!). Friends knew that if they were sick, stay away! I wore the dreaded mask on a flight from Kansas City to Las Vegas. I did keep small bottles of hand sanitizer around the house and in the car so I could wash my hands frequently.
I took special care for the first 10 days after each infusion (washing hands, avoiding crowds, regular mouthwash, etc), but relaxed thereafter and actually took 3 overseas trips during the course of my 6 docetaxel infusions. My oncologist was more concerned about the risk of blood clotting during flights (I injected myself with Clexane) than the risk of infection (common sense behaviour notwithstanding).
My white blood cell count dropped below normal numbers on my first infusion. I was given Neulasta after each infusion and I am at infusion number 5 of 12. Neulasta ensures that your white blood cell count comes up to above normal. The Neulasta has its own nasty set of side effects. As my doctor said you can go without the Neulasta and risk having to go the hospital and fight aninfection there. Or avoid the additional cost of that and do the Neulasta which has its own nasty high cost price wise and side effects. You might inquire about Neulasta with your doctor .
after 2nd or 3rd chemo wbc dropped to 2, which i could see online same day as blood work. Went on 2 day vacation anyway. Course nurse freaked out when I came in that Monday for xgeva shot. Got immediate shot of Zarzio (filgrastim). Similar to Neulasta. After each chemo from then on i had to come in 3 days in a row to get that shot although wbc was in 65 or so range. Made legs ache even when sitting. Worse than the chemo but they would not stop the shots and I sure told them IMHO they were not needed. I never missed a bbq or opportunity to take granddaughter shopping. Avoided obviously sick people. Continued to eat what i wanted, drink alcohol to excess, and smoked like a chimney (have quit since, but not because of pca). Don't let the terrorist win.
Best advice: Don't get caught kissing any woman other than your wife...If you do tell her it was merely an infection test. If she buys that then clone your wife and I'll marry the clone.
Had 6 cycles of Docetaxel/Carboplatin chemo from late September 2017 through January 9, 2018. Last step of each chemo was the application of an Onbody Injector of Neulasta (which boosts your white blood cells).
It was placed on my right upper arm and 27 hours after placement it injected the Neulasta. Never had a problem with infections, which my Med Onc said would be at highest risk Days 7-10 after each chemo infusion. My Onbody Injector of Neulasta was fully covered under Medicare and Medicare supplemental insurance,
which was great since it retailed for over $4500 each application.
Forgot to add that Med Onc advised to take Claritin beginning 1 day before each chemo and for 6 more days to reduce bone pain from Neulasta, and it worked--no pain!
Mark, Atlanta
Thanks for all of the input. Much appreciated! I am into day 9 after my first chemo. Still have my hair, no pain and long walks are becoming much easier. Sounds like Neulasta and/or common sense can both address the threat of infection.
Had 6 Docetaxel 3 weekly cycles from late May to early Sept 2018 in New Zealands public hospital system. Was advised days 7 -10 are when you are most at risk and it was during our winter. Pretty much isolated myself from visitors and friends knew to stay away if they were infectious. Ended up getting infections twice. 3rd cycle was possibly because we went to the movies on the way home and I ended up with a chest infection. Taking daily temperature readings let's you know if things are changing. Seek help quickly if a change is detected. I left mine over the weekend and spent 2 nights in hosp IC. WBC came back up by itself in time to carry on scheduled times. During the 4th cycle I scratched my leg on a small tree branch while gardening and it quickly turned infevtious. Reminded me of blood poisoning I had 30 yrs ago so we got it sorted with only 1 night in hosp. WBC count recovered again to carry on. Other issues were teary eyes and blood in nose and worst has been severe fluid build up from waist down. Progressively worse from 3rd cycle but especially after the last one and am still sorting it 8 weeks after last cycle. It's slowly getting better but still have bone, muscle and joint pain around ankles. Stretching exercises and walking are helping a lot. Took claratin to help plus GP prescribed a diuretic.
I used to be a fit and healthy 65 yr old. Zoladex since Feb 2018. Psa down from 50 to 0.5. Recently started IV Vit C, mild hyperbaric oxygen therapy and infared sauna plus on metformin, doxycycline, mebendozole, asparin and since Feb have been on a mostly vegan keto diet plus Budwig cottage cheese and flaxseed oil mixture and a wide range of other supplements. Hair growing back nicely! All the best
HanswoodRJ, thanks for sharing. I get my second infusion tomorrow in Seattle. This is a good reminder for me to be cautious. I'm still fairly active....ocean fishing, crabbing, long walks but so far not back to surfing!
My husband and I were always very cautious: avoiding crowded places, washing hands frequently, using disinfectants. This is really important. Your immune system will be compromised during the treatment and become more compromised the loger you have the treatment so it is really important to stay safe. Good luck. Mel.
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