Taxotere, Carboplatin and Herceptin
Comments
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I had no issues with the 30 minute infusion but others did. When they switched to 90 minutes they seemed to be resolved. I would let your MO know before your visit you want to try the 90 minutes due to SE.
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Blownaway - I insisted on a 90 minute infusion time and also got an extra liter of fluid each time since I can never drink enough fluid to push the drugs through. SEs were minimal - achy lower back, calves & joints sore, maybe headache, drippy nose.
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blownaway - hopefully the longer infusion time will help. I personally would not take any extra steroids if possible - I ended up prediabetic after chemo due to all of the steroids wacking my system (I'm still prediabetic - and no, not overweight - very active - doc concurs it likely was due to the high steroids 2 years ago).
Perhaps there is something else they could give you to help manage the symptoms better.
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princessm - the infusion lasted 30 minutes. I forgot to add that the same night as the infusion, my body ached all over like I had gone through a major workout with a deranged personal trainer, then I woke up nauseated the next morning and feeling very bad in general.
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blownaway, they gave me my first herceptin a few weeks ago and I've had muscle aches ever since. Nothing awful, really, just annoying. And the drippy nose is a herceptin se? Crap. My nose drips constantly, and I figured it was because I lost all my nose hairs during chemo lol!
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blownaway - ask them to slow your infusion down, then see what happens.
wyo - I never had joint aches and bone pain during chemo but I sure did with a fast H only infusion. Slowed it down to 90 minutes and had no further issues. The drippy nose is a Herceptin SE but it exacerbated by the lack of nose hair - once it grows back it won't be as bad.
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specialk - Do you tell the oncologist to notify the infusion department or do you just tell the nurse administering the herceptin to slow it down and give more saline.
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I just asked the nurse to slow it down - I had received it over 90 minutes when it was given with chemo, and it is within prescribing instructions to give it anywhere from 30-90 minutes. They usually speed it up when doing H only because they get you out faster and it is (theoretically) easier for you too. I tended to go later in the day for H only when they had more empty chairs so that infusing over 90 minutes would not cause the nursing staff any issues.
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specialk - It looks like thats what I have to do because the onco nurse just came back and said to take Zofran if I feel sick and that slowing the infusion should not make a difference. Meanwhile, I will try to find something in writing to back this up in case the nurse gives me any trouble about it.
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Blownaway don't let the nurses fight you on this. Many tend to do what's expedient for them. You are paying for this!
True story:
I was going for a liver scan (again) and the tech said to me "I noticed last time you got the IV in your foot." This time we are going to do it in your arm." I looked at him and said nicely "No you're not. If you don't do it in my foot I'm leaving… and I'm not kidding." Ended up he didn't have any experience doing it in the foot. He got another tech to do it. 6 months later when I had to do it again he did it in my foot. It was his first time so it hurt a bit more but he got it on the first try. Didn't ruin my vein. BTW I have LE in one arm and the other is at risk so I don't let them do IV in my arms.0 -
+1: what Lago said.
Do you know how much $ chemo brings into a facility? If you threaten to go elsewhere I bet they'd give it slower, lol.
My nurse didn't like doing it slower either b/c he was so busy. You probably will have to tell the MD this is what you want to try.
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I am on this combo. I had my first infusion on Sept 15th. I had lab work today.. OH LORD.. I am a Nurse, so you know I was shaking my head at my levels.
Anyone had platelet count in the 22,700-ish range?!
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Your platelets will take a hit but being a nurse you know that platelets are the shortest-lived blood cell - your platelet count varies from day to day and you are at the ends of the nadir, so it is entirely possible that they will come back up shortly. Generally you will see a stair-step process with your counts, Are you getting weekly CBC?
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Blownaway - what they said is right. It's YOUR decision to try it slower. If you think the nurses will give your trouble, make sure the MO has turned in order to back you up. I have to have orders from the MO for the extra fluid every time.
I'm in Houston too. MD Anderson can be wonderful but it can also be like a production line in factory. That 's why I stayed with Baylor & Methodist. Make sure you insist on individual care!!
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I also had to have orders from my MO to slow down my Herceptin. Thanks to SpecialK, it did make a difference.
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SpecialK~
Thank you! It clicked when you said that, "DUH Cari, remember..." It guess it was easy for me to forget the fine details while I was in "holy moly" mode.
My first treatment was 9/15, my first blood test was 9/29. I will have another 10/6 before my next chemo. I believe they will do weekly CBC's after. I recall them saying weekly when they were discussing labs.I am only slightly amenic, and my WBC is actually pretty good considering.
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violetkali - Lol! I like the "holy moly mode" reference - I might have to steal that! Being a health professional and a patient at the same time is hard! Don't stress too much about the platelets - they are pretty mercurial - just look for trends. Are you getting Neulasta, or is your MO waiting to see if you need it? You will most likely see the downward pattern emerge in your CBC of a drop, then a recovery, but as time goes on your recovery will be slightly less. Try to up your protein intake if you can to keep your Hgb high enough. I have seen people with low platelets have a tx delayed, but not very often. It is much more common to see the Hgb take a hit.
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lol Lago !! As soon as the surgeon told me about my BMX plan, I was looking into the veins on my feet.
Blownaway I hope next Herceptin will be better with the slower rate.
Violetkali and specialK, holy moly mode !!! All the knowledge will be thrown out the window when it comes to our loved ones or ourselves. I just learned to close my eyes and relax during the treatment. I observed my 1st and second treatment to make sure they accessed my port with sterile technique. Lol. We are the patients now.
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Yeah, my Hgb took a hit. It is 10.5, but it could be worse! MCH, MCHC and RDW are all within normal limits. Hct is 31%.
I do not feel weak though, thankfully.
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I hope/wish my HGB is 10.5!!!! When I was in the hospital it went below a 7 (had to get a blood transfusion)! When I was released it was 8.4....then last friday it was 9.8.....so was getting there.....then had treatment on Fri. I can feel it dropping!!!! Hope it gets back to the 10+ range!!!
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Everything is done online at MD Anderson. I can't just call them and ask for schedule changes or infusion time increases. Everything I ask for takes several back and forth messages on their website. Right now I'm driving them crazy just trying to get back to back appointments (1-2 hours between each) instead of 4 hours or more between labs and onco appt. Also trying to get Fridays instead of Thursdays in case I get sick again, I won't miss the next day at work. To top that off, I'm working on getting them to change my rads to early morning instead of 10:45 everyday - I'M A WORKING GAL FOR PETE'S SAKE! Once I get my appts where I need them to be, I intend to message the onco nurse that I won't take no for an answer on the time increase. I tried once and was told it would make no difference and to just take my zofran if I get sick. That stuff has its own s/e's!
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Blownaway - if you have trouble getting what you want, you may want to look and see if they have a patient advocate system (they probably do b/c they are so big). Often that helps to put a fire under someone's butt and get them to listen. I used it once when I realized in post-op (from my MX and SNB) that the tech was trying to do BP on my SNB arm! They launched a full investigation with follow-up actions and letters sent to me about it for several weeks post.
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dancetrance - I had a message on my phone from the onco nurse scheduler. They have put in the orders to increase the infusion time to 90 minutes, plus extra saline. Also, I learned from her that the reason that each of my appts on any one day are so wide spread is because my particular onco insists on 2 hour intervals between echo, labs, his appt and infusion. It takes all day long and is exhausting. By just seeing a PA instead of him, my down time between appts is drastically cut and I get home much earlier. He's just such a diva!
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blownaway - glad you got the 90 min infusion arranged. Hope it helps.
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ha ha blownaway - diva oncologists!
Well, glad you got your infusion time lengthened! 0 -
Diva oncologists? I imagine that's the amount of time it takes to be certain that they'll get lab results in time for the appointment even if the lab is busy, and likewise to make sure the infusion drugs are ready after they're ordered. I have do my labs and oncology appointments the day before infusion to make sure the labs have time to come back and get looked at and the drugs will be ready and waiting.
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There are lots of Diva Doctors… many of them men!
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Actually the lab timing for a CBC is about 10 minutes. I was weighed and had port accessed, CBC done, doctor appt., drugs mixed, T over an hour, C over an hour, H over 90 minutes - all in one day.
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Writing from the hospital. My eye infection was diagnosed on Monday, but by Tuesday I was running a 100.5 degree fever. It turns out I have developed cellulitis and neutropenia and will probably be here until the weekend. Last night was pretty rough, but I got a transfusion and IV antibiotics, so I'm grateful to be here. I'll spare you the photo, but I look a lot like this.
My advice for any ER visits or other emergencies is to prepare a chemo bag -- especially food and fluids. I got to The ER by 3:00, but food, pain meds, and even water had to be approved by a doctor, who would "be there shortly." I got dinner at 9:00, and fortunately I was on IV fluids, because the only thing I had to drink was the water I had brought with me. It was not approved by doctor, but I'm getting pretty cavalier about restrictions that are counter to what I know I need. Once I was admitted, I got round the clock care -- which I certainly needed by that point. And the food is quite good!
Will post again when I'm home -- typing with one finger and one eye is not easy. Will there be a round 4? I don't know...
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SpecialK, I imagine it depends on where you are. I'm at a very busy hospital and the laboratory services every department, not just Onco. If they STAT you they can do it faster, but instead they do it the day before to be sure all departments have time to process everything. Last time I was in the ER with a fever I had to wait several hours before they came bac with my CBC results to decide whether or not to admit me.
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