Taxotere, Carboplatin and Herceptin
Comments
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Rockermom - it seems that every onc has his/her own approach to the neulasta/neupogen injections. Mine didn't offer for the first or second TCH, but when my counts started to drop, wanted to schedule it for the third. I said no, that I would take my chances that my counts would pass. I worked from home and didn't go out much, so wasn't exposed to a lot of germs. The worst that would happen (they told me) was that if my counts were too low, chemo would be delayed by a week to let the counts come up to a passable level. I was willing to gamble with that.
I was on a whole list of supplements and (trying to) eat healthy, rest a lot etc. And I always passed and never got the shot. So you DO have the choice, from what I found. I took the risk and got away without having to get the shot. But others get the shot as a matter of course. Maybe there are other factors that determine whether they offer it or not - but it seemed to me to be the doctor's protocol.
Good luck. You will make the right decisions.
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I agree with Amy, It may be the dr's protocol regarding the neulasta shot, and I too did not need it.
I wasn't on these boards while going through chemo so I am glad my dr said I didn't need it! I have since been sooo educated by all the ladies here that it is good to know going in that YOU have options.
Ask your dr if your counts warrants having it, otherwise it is just an added drug with more side effects to add to your equation.
It is always a bonus when you can be a part in your treatment plan and know what to expect, It also gives you a little control in your journey.
Hope this week is a good one for everyone in treatment!!0 -
My MO just automatically included the Neupogen shots in the regular routine of things. My counts didn't dip too badly but she said I had to keep taking it anyways. I think I'm glad she does the Neupogen instead of the Neulasta from what I read though because the Neupogen was 7 days of self-administered shots instead of one big one. I did have some soreness but Tylenol was enough to make it tolerable.
I never iced my nails and I didn't have any nail problems at all. I did try sucking on ice (provided at the hospital) throughout my chemo infusions but I still ended up with bad taste issues. You just never quite know what you're gonna end up with when you do chemo. Everyone is so different.
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Dear cinrae: I met a women in London who was on this weekly treatment. She was very happy with it and said her she didn't have and bad side effects, other than slow hair growth on her head. She had been doing this treatment for two years. Good luck. Snowyday
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Nail issue are one of the less common SE. Of course I was one of those who got it, and got it pretty badly. They never did recover fully but my fingernails are too bad.
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I iced from the get-go, but still had to have my wedding ring nail completely removed - it had been injured with a high tear on the side just prior to chemo. It took six months to grow back. The remaining nails did not discolor or get ridges and looked great throughout chemo and Herceptin. I also lost the pinky toenail on my right foot but the replacement grew in very quickly. I don't know if the cold didn't reach far enough over onto that side of my foot. Other toenails all looked great. Even though I lost those two nails while icing I still advocate icing - I think I would have had serious problems if I had not done it.
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Just home from 2nd chemo yesterday & neulasta today. I still haven't read all 523 pages so I hope you all won't mind a dumb question or two.
Did I read somewhere that the SE's were worse if the infusions were fast? They switched my Herceptin from 90 minutes the 1st time to 60 minutes this time. Should I make them keep it 90?
Another White Blood Cell count quesion. Before any treatment my WBC was 15.5. Just before 2nd treatment - after having had Neulasta the 1st time - I was still only back up to 6. My chart says 4 is the low end. Everything else looked OK. What kind of supplements can I do for WBC?
Thanks in advance.
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minus - Most of us who have talked about SE from faster infusion were referring to receiving Herceptin alone once chemo was done. For some of us a faster infusion at that time brought on some new aching and some other SE, but this is not universal. When combined with chemo I think there has been more variation of infusion time but it seems to vary by center in terms of patient tolerance and reaction. If you are curious about it, and did not have any adverse reaction, just ask them why they infused faster. I would imagine that if you are more comfortable with slowing it down they will do that if you ask. I was one who had aching with a faster Herceptin only infusion, asked to have it slowed to 90 minutes, and no more aching. My center was happy to do that for me. On your WBC - if you had a count of 15.5 prior to any treatment, that is actually high. A normal value is 4-10, so 6 is actually fine. There are no supplements you can take to improve WBC, that is why docs give Neulasta/Neupogen. WBC are not like red cells, they are unaffected by diet, etc. You will see a cycle with Neulasta - if you are receiving chemo every 21 days, and getting Neulasta 24 hours after chemo, your nadir (low point) for WBC will be about 7-9 days after treatment, with fluctuation throughout that 21 day period. As long as you have an acceptable WBC for the next treatment that is the goal.
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Thanks Special K. The MO has ordered blood work 10 days out this time so we'll see.
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minus - mine did weekly CBCs so I got to watch the rollercoaster that was my WBC, lol! I also wanted to add that it is normal to see your RBC and hemoglobin stairstep in a downward trend as you go through the process - they may drop, then recover, then drop lower and not come back as high. You can influence them to a certain degree with protein and iron-rich foods, and I do recommend doing that. Platelets are also pretty mercurial - they have a very short life so they can be very different on any given day - they will always look at your platelets on the day of, or day before, chemo though - and they will delay you if they are too low. Chemo causes soft-tissue injury and platelets help your blood clot - low platelets combined with chemo are a recipe for badness - not to be messed with! It took about 6 months or so for my labs to normalize once chemo was done - this is pretty common, so don't let it throw you.
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your nadir (low point) for WBC will be about 7-9 days after treatment,
Interesting.. this was exactly when I had a runny nose and my sinuses felt they would escape my head with every heartbeat, I couldn't move at all for 3 days, bloody nose that will not go away and my mastectomy incisions opened up after almost being healed! Can a virus that would have been just "the sniffles" really feel like a flu that would kill you during these days? Apparently.
I am so afraid to go into public without wearing a mask now. I do NOT want to have to go through that again.
I think I was just unlucky, it's sad.0 -
rockermom, after every tx I had what seemed to be a head cold. Sinus congestion, runny nose, etc. The first time I thought it was a cold, the second I wondered, by the third I realized that was just one of my particular SE's from tx. Unfortunatley after the third tx I developed an ear infection too and had my ear drum rupture. So maybe the sniffles will be normal for you too, but hopefully you won't have to go thru those horrible flu like symptoms with every tx!
I avoided going into public places until the last week of the cycle, right before the next tx. I did go to work part time, but I made sure I wiped down the copier buttons, etc with disinfectant wipes. I also carried them in my car along with a bottle of antibacterial gel. I was a little OCD about germs for the 4 months of chemo.
Minus, my WBC started at 7.3 and went as low as 3.4, and I never got the shot.
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minus 60 minutes for Herceptin is still slow. I got mine in 30 minutes. I don't remember how fast I got it at my first infusion but because I wasn't having any SE they kept speeding it up. I think you'll be fine with the 60 minutes.
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Bren58, thanks for the insight. I can handle a runny and/or stuffy nose. My nose is still stuffy, I guess that is something I'll have to deal with. Hopefully I won't have that flu-feeling again! Sorry to hear about a ruptured eardrum, that must have been painful.
I ordered some cool looking micro-fiber facemasks from Amazon, they are coming in the mail today. I'm not risking it!
I work from home and I'm not generally around large amounts of people so I should be ok.0 -
rockermom you can also draw on the paper masks. They take marker nicely.The first group you can purchase. Just click on the image to go to the page.
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These are so cute lago, thanks for the tip!
I got 3 masks, leopard print, blue flowers and Space Invaders.. I have some School of Rock shows coming up so I will save the Space Invaders for those, the kids will dig it.
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Did anyone regrow hair while doing TC? I lost my hair on day 21 (the day of chemo#2) and in the past 10 days have regrown a head full of peach fuzz. Not just a little hair, but a lot. How is that possible? I'm hoping that other women also had hair grow!
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monkeymom this is possible. It all depends on the cycles of your hair. Do note that if you get SE or don't get SE it has no meaning as far as chemo working. I do believe my hair might have started growing before chemo ended. I just didn't check my hair till 5 weeks PFC because I don't like watching paint dry. On the back/sides of my head I swear I had more than 2 weeks of hair growth.
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monkeymom - I did not lose all hair on my head - I was never completely bald, and I think regrowth is more common than thought. Mine also fell out late - at day 24. I also had to shave my legs throughout chemo, but I did get the "free" Brazilian!
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Monkeymom--when I did TC in 2009, I never really was completely bald even after shaving my hair off. I'd have little hair regrowths between treatments. Sometimes I looked a bit like Charlie Brown.
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I never lost all my hair either. Probably about 90% of the hair on my head. I am now 9 weeks PFC and most of the rest of my hair is finally coming in. Very fine and very slowly. But my legs remain smooth and hair free! If only that would last~
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Have the peach fuzz on my head and it is growing very slowly.
Just caught up on reading and I see I am not alone with having the big D. After four chemos my onc is now concerned about the diarreah and is testing me for Cdiff.
I feel a light pain on my sides where my kidneys are but not bad. I gain and lose about 8 pounds every chemo and that is probably very stressful to the body.
Two chemos left before heceptin only. So ready to be done!0 -
adavisart - I had the Big D for about 10 days following each tx for the first 5, then magically on the 6th and last - no Big D! I was pretty excited! I just ate bland food and tried to stay hydrated during the first week and a half following each tx. I ate as much red meat and protein-rich food in the 10 days preceding the next tx. I did have some minor Big D issues on Herceptin alone. At one of my H infusions one of the onc nurses suggested adding a probiotic - that made a world of difference and I have continued with it. I had IBS-like symptoms for many years following reflux surgery and wish I had started a probiotic much earlier. I am hoping that your c-diff test is negative and that this is just a SE of chemo. I also gained and lost the weight with each tx until I swelled after #4, then the weight did not come off - but it is not real weight - it is fluid and swelling. Most people do this and then they return to normal pre-chemo weight by a couple of months PFC.
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Special K thank you! Have noticed my stomach feels a bit swollen maybe it is what you are describing. I am at the start of my week before chemo 5 and today I am eating like a piggy! Everything is starting to taste good again!
I have been taking Immodium and a probiotic sometimes even twice a day, Florastor. it did help a little but mainly just postponed times between bathroom visits. I had a solid week with out diarreah before chemo four and was thrilled!
Does anyone get their blood draws from their port or from the arm? The lab tech went through my vein last week and I have a huge three inch black bruise on my arm now. I don't want to go through that again. Wish they would just use the port but they said it is an infection risk.0 -
Adavisart I had the big C and also would gain 4-8lbs on chemo but lose it as soon as they put me on the steroids. Not only my legs but tummy bloat which was also in part from the big C but most of it was from water retention. It comes off.
I got my blood work done through my port. I had nodes removed on both sides with LE on the left. I would go to the chemo room to get it done.
Last blood draw I got was in October for the surgery to remove my port. Not sure what I'm going to do but it looks like I'm going to have to risk it in the at risk arm.
I would do it in my foot but no one will do that because the infection risk is higher.
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Lago i am sorry you have to go through that. My "good" arm for blood draws is the one on the side I had my lymph nodes removed. i was curious what the level of risk was for using that arm since they only took three nodes.
There is another lab tech that I am willing to let take my blood but the last one will have to stay far away from me!!
Do they do labs every round when you start doing herceptin only?0 -
adavisart - my center will draw routine labs from my port, it is up to me. I have done a combo of port and non-LE arm (which had 2 nodes removed) but they use a butterfly, and they are really, really good. I have big needle blood draws for my vaccine trial, but that nurse is also very good - and she is drawing a boatload of tubes each time. I did not get a CBC done every time once I started Herceptin only, but was seeing the onc every three months at that point and got CBC, CMP, Vit D, tumor markers done then.
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I had 4 nodes in my "good" arm. 10 nodes in the LE arm but no rads. You are at risk but it's much lower. I think the real risk is use of the tourniquet. I'm going to try to get them not to use it. I have really good veins. I'll just be sure to drink lots of water to plump them up before the next blood draw.
I'm a bit more concerned because I already have LE in the left arm. So we know that I have a predisposition to it. Mom has it in her legs.
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Thanks SpecialK and Lago that info really helps. Am usually dehydtrated the day of my blood draw even though I try really to drink as much as possible. i just can't keep ahead of the diarreah.
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Adavisart, I only get blood draws from my port!! I have blood work done every 3 weeks, and I time it with my herceptin infusions. Those rare occasions when I need blood work on non-chemo/herceptin days, I still have them use my port. After getting a bruise similar to the one you describe, I won't allow them to take blood from my arms!! The excuse they gave you about "infection risk" is nonsense!!! I recenly had a colonoscopy, and I deliberately had it done at my hospital, instead of at the dr's office, so that I could have them use my port. At first, the nurse refused, and gave me a list of bogus reasons, including infection risk. I insisted, and told her to call over to the infusion center if she had any questions. She did and then came back and used my port!!
Some nurses are lazy or simply more comfortable taking blood from your veins, but if you insist, they will use your port, or find another nurse who can.
Good luck!
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