Anyone on just Taxotere and Cytoxan?
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The onco nurse seemed very unconcerned but I plan to raise the topic with the onc herself on Monday. This whole cycle was more intense for me and so I am apprehensive about Tx4 so want to be sure I talk to the doctor about it.
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catlover, your fever coincided with your Neulasta shot, right? I'm wondering if it could have been a reaction to the shot. Fever reflects inflammation (sometimes), so could you be developing a reaction to the ingredients of Neulasta? It does happen.
I think onco's are used to low-grade fevers with chemo (temps below 100 degrees). It wouldn't be surprising for the chemo drugs, especially Taxotere, to cause enough inflammation to give us a bit of a rise in temp.
I hope y'all start feeling better, soon.
otter
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Now on day 9 of tx#1, and yesterday and day have been pretty good days...a few aches and pains here and there but nothing some Ibuprofen couldn't handle. My brain finally seems to be clearing al little--I think that's been my worst complaint--foggy head to the point of almost feeling un-functional.
BTW--my onc asked if I'd tried an anti-histamine for the post-Neulasta bone pain, and I told him yes, Claritin, and that #1--it didn't help and #2--I hated the way it made me feel (I've never been able to take cold/allergy medicine) and he said next time try Zyrtec, he's seeing pretty good results with that. Just thought to pass it along to those who have found Claritin ineffective, too. He did give me a script for Vicodin for the next go round.
collector: I'm with you, I don't like to take anything for a temp under 100 or so, but I usually get so achy with a temp (usually my first sign of a temp) that I cave in for pain control.
Does the taste bud thing get worse with each treatment? Everything tastes kind of funny now, but I've noticed one really strange thing: I can no longer taste anything sour!! I drenched a salad in Italian dressing, and couldn't taste a thing. I tried to eat a dill pickle and couldn't taste a thing!! And as my DH remarked, "that's a crisis for you!" LOL
Thanks to all for much wisdom and encouragement!
Blessings to all,
Sherri
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No telling...there seem to be lots of reasons we could have these dang fevers, but who knows what mine is. I guess if I have the same problem next time, I can reasonably suspect the Neulasta. However, just to make things crazy, the last time I had a fever (on July 4th, whoopee), and this time, I had been out to eat just before. Am I picking up nastiness in restaurants?? I just get a little worried from reading about "febrile neutropenia deaths" and other horrific sounding things. I guess I'm following some others with #3 being a pain in the *ss. Surely this won't happen the next 3 times....
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Phillydee, Your post exactly duplicates my own feelings as I went into this. Up to the chemo, I didn't think of myself as a "cancer" patient at all, but it's pretty hard to keep that going when you begin looking like a cancer patient, and you are treated like a cancer patient. But it isn't really all that bad. Scan through the posts and you will see that most people have some SEs, but not all side effects, and with proper medication, you shouldn't have to experience nausea. But you do have to advocate on your own behalf. If this is a particular concern, you need to discuss it thoroughly with your Onco and be sure you understand the regimen of prescribed drugs and how to use them to best advantage. Good luck with it.
Terri, Just wanted to let you know that your timely post about your allergic reaction with Tx 2 was extremely helpful to me today. About 15 minutes into the Taxotere I started salivating like a mad dog, and felt this extreme sense of pending doom. I also was frightened because I was in a small room by myself and if I went into convulsions or something, no one would see me (unlike the large room with 9 chairs). I immediately buzzed and voiced my concerns, and they did all the right things: stopped the infusion, administered Benadryl, re-started the drip at a slower pace, and I got through it just fine. I owe you one, Woman!!!!
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Collector,
I have my last T/C on the 30th. Today my Onc told me to call my Rad Onc and set up an appointment. I will be starting rads near the end of August.
Enjoy the day, Karin
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Collector,
I'm starting rads mid-August also.
Michele
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I still haven't started the chemo yet - but have been reading your posts. Regarding the hair loss - has anyone ever tried the ice cap or putting ice on their head which supposedly freezes the hair follicles so the hair doesn't fall out? I read this on the internet and imagine it doesn't work or everyone would do it but was wondering if anyone else looked into it.
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Sandra - Sorry you had to experience this too, but glad you did the right thing and buzzed for a nurse right away. That is why I posted about it. You mentioned that you heard this could happen during second tx. That makes sense, but I'm surprised the nurses or doctor didn't tell me that. They actually seemed quite surprised by it. Did your nurses say anthing? I wonder if they are going to do anything for tx 3 to prevent this from happening again.
I went in for Neulasta shot today and my temp was 99, which I didn't think was a big deal except that when I get a fever it usually is in the afternoon. This nurse seemed more concerned and told me to watch it all day. Said to take Tylenol and if it doesn't stay below 100 to call. She did say the Neulasta could cause fever. But since I've been getting a low grade fever almost everyday, who's to know. I don't think anyone really knows what's going on. When we're taking so many drugs how do you know what is causing what!!!!
Phillydee-I too felt the same way. I felt great before all of this. The hard part now is that if I had just had the mastectomy, I'd be pretty much back to feeling myself again. But the two things I chose, chemo and reconstruction are still looming in my future. But the way I figure it will be worth it in the end for peace of mind and a new boob (and a lift on the other to match!!!!).
Good luck to you and all and have a great weekend!!!!
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Neluasta question: Do all of you have the shot 24 hrs. or more after the chemo? All 3 times I've been for the shot the next day within the 24 hr. period--the Neulasta info says it should be after 24 hrs.
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Karen and Michele, I have my last Tx on Monday (I hope) and would really like to get the radiation thing going by August 11. I know they have to see how I recover from the chemo and until this third round I would have felt sure that I would be in shape easily to start the radiation but now I wonder. I had one rad onc consultation and although I liked the facility, the doctor had just started there that week and couldn't find things, had no business cards and just didn't give me the confidence I was looking for. I will get a second opinion from another rad onc who will consult with my oncologist but this center will be farther away from my house and will require a 45 min. drive each way if traffic is good. The other radiation center was only 25 minutes away. Are you both already set up with radiation doctors and facilities? Maybe we should begin an August start radiation thread. I learned a lot reading the June/July one.
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Catlover,
Both of my tx's were on Friday's and the nurse comes in at 9:00 saturdays to give the Neulasta shot. So it doesn't matter what time you get chemo we all come in at the same time in the a.m. which is less than 24 hours after for some. I started infusion around 9:30 yesterday.
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Catlover,
Mine have always been on the next day and have also been before the 24 hours. Infusions have started around 2:00 all 3 times and shoots were given next morning.
Collector,
Yes I am set up with my Rad Onc. Saw him for first consultation on April Fool's day. Went to him first because I already knew and trusted him. He was my hubby's Rad Onc 10 years ago for prostate cancer. He is the one that recommended my regular Onc and I'm so glad I followed his lead. He also is the one that argued and fought with the insurance company on my behalf. They tried to charge me out of network saying he wasn't a participant and he was. Saved me a lot of aggravation.
Enjoy the day, Karin
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Karin, my husband is 3 years out from postrate cancer! It makes him understand some of what I'm going through but also makes him feel like he knows what's best for me which doesn't always work out so well! I wish I were further along in at least knowing who and where I'm going for the radiation. Hope the onco's referral works out but if it doesn't I'll seek out a third one to consult with.
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I am On Cytoxin and Taxotere. I have completed 2 rounds and had alot of side effects. Just got out of the hospital for low WBC (1000) and while there developed 2 blood clots in my left lung. I go for my 3rd chemo next Thursday and am really nervous about further side efftects. I am Stage 2; triple negative; tumor Grade 3; lumpectomy with clear margins and no lymph no involvement. My Oncologist is going to give me the Neutrogen injections for the next round and I am on Coumadin for the blood clots. I will be soooo glad to be thru with this. Have had alot of pain but no constipation since my Md had me take Colace with my pain meds. No nausea or vomiting but a lot of body aches and ulcers developed in my asphogus. Hope this gets better with time. Hope your chemo is less miserable than mine. Take care!!! Elaine
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Terri,
Again I thank you as I probably wouldn't have been so aggressive in asking for help with the probable allergic reaction if I hadn't just read your post. My Onco nurse also seemed surprised and claimed that these reactions occur on the first Tx, not the second, but I know from reading many, many posts on this thread and others that that just isn't true. It may take awhile for your body to build up (not antibodies, that isn't the right word, but some kind of histamine response). It's like people who are allergic to bees. They don't go into anaphylactic shock with the first sting, it's when they get stung the next time.
Yes, I think this will continue to be a problem for both of us and we shouldn't be afraid to express our concern before the treatment starts. I think they need to start with a much slower drip and watch it carefully. I will also request to be put in the big room with all the other people. It panicked me that I was in this little room by myself and no one was watching me. Enough said.
With regard to the Neulasta shots: this time my treatment got postponed till Friday and the offices aren't open on Saturday, so they just told me to come in on Monday morning like it was no big deal that that was 2 days later, so who knows? It has me a little worried because the last time I took the Neulasta, it quite awhile for it to kick in and I did end up with very low WBC, fever and a Rx for Levaquin on Day 6. I would really like to avoid the antibiotic this time around if possible. I think it's an over-reaction to prescribe it as (as I have said before): fever doesn't necessarily mean infection, it can just mean inflammation, and with all these chemicals on board, that would hardly be surprising!
Elaine, Good grief, blood clots in your lungs? Yikes! that's a serious complication. Do you have any other health conditions contributory to that? Now I will be worried to death that that might happen to me if my WBC drops way low again like it did the first time. That certainly was not a picnic. Hope you are feeling better now.
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Sandra, I don't think it matters if your Neulasta injection is delayed for a day or two (or three). Here's what the Neulasta website (www.neulasta.com) says about dosage and administration:
"The recommended dosage of Neulasta® is a single subcutaneous injection of 6 mg administered once per chemotherapy cycle. Neulasta® should not be administered in the period between 14 days before and 24 hours after administration of cytotoxic chemotherapy."
Some chemo centers, like the one I am using, administer it the same day as the infusion, despite the label precautions. According to posts on these boards, quite a few other centers are giving it the day after the infusion, but they're not worrying about it being a few hours before the 24-hr limit. If you're on the usual 3-wk TC cycle, you could get the injection (theoretically) up to day 7 of the cycle (14 days before the next infusion).
The reason why waiting a day or two (or three) after the "next day" recommendation still works is because the drug just sits in your body anyway until it's needed. That's literally how it works--it doesn't trigger neutrophil production by the bone marrow until the absolute neutrophil count (ANC) drops below a certain point due to the effects of the chemo drugs. That decrease in the ANC typically doesn't occur until day 5 or 6 of the chemo cycle, and for some chemo regimens, it's even later (day 9 or 10).
So, it does take awhile for the Neulasta to kick in, and it is possible to develop a fever and infection before that happens. But, waiting until Monday to get the injection probably won't make that situation any worse.
otter
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Elaine, can you tell me what the ulcers in your esophagus felt like and how they were diagnosed? I have had continued problems with a painful pressure in what I presume to be my esophagus. Have been on Protonix for a month but still take intermittent tagamet to ease the pressure. I'm going to mention this to my onc before my last treatment tomorrow but wonder if I'm feeling what you have. Sounds like lots of people have had problems with severe low blood counts. Pretty scary to end up in the hospital as a result of treatment on top of everything else.
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Otter, thanks for the information about how the Neulesta shot works . That explains a lot, and suggests there's not really any reason to take it so soon after the infusion. I won't worry about it any more. I just wish they wouldn't jump the gun so with ordering the antibiotics when/if the WBC drops down a little too low. That just seemed so unnecessary to me. Hate to think I am going to have to take 3 more rounds of increasingly stronger antibiotics just on a "precautionary" basis if this happens each time. It's that sort of reckless over-use of antibiotics that has gotten us into such a pickle with regard to the evolution of resistant strains of bacteria. Now I feel like I'm contributing to the the whole "super bug" problem for mankind--after a lifetime of avoiding antibiotics use as much as possible.
With regard to acid reflux and the potential for it to ulcerate one's esophagus: my Onco PA told me that acid reflux is a very common and potentially serious problem for people on chemo, and it's very important to try to prevent it. He also pointed out that the anti-nausea meds are not helpful in that regard at all as they have no effect on the production of stomach acid, their effect is confined to inner ear and other aspects of the nausea response. He emphasized it was very important to treat acid reflux with appropriate medications such as antacids, Pepcid, tagamet, or Proton Pump inhibitors. If you are having these problems, discuss it with your doctor as you may need more than OTC remedies. I had just some mild acid reflux and found that Pepcid worked great for that. I plan to start taking it precautionarily at the first sign of any discomfort (probably tomorrow, being Day 3)
Hope everyone has a pleasant Sunday!
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Catlover44, I'm glad you asked that question--I've only had one tx but my Neulasta shot was given well within the 24 hour period, and I had wondered about it but didn't ask when they were giving it.
Otter, given your wonderful explanation as to how Neulasta works, do you suppose that's why I had a 2 day lull in my bone pain? It was bad on days 3 & 4, practically nonexistent on days 5 & 6, then I woke up on day 7 feeling like I'd been hit by a truck and bones set on fire! My onc couldn't explain it, just said, "Hmmmm, usually once it's over it's over." Perhaps my first set of pain was the chemo and not the Neulasta?
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Sandra, That makes even more sense about the histamine. That explains why the benadryl helped so fast. Maybe they will give us the benadryl beforehand. I'm definitely going to bring it up before they start next time. Again, though, you would think they would have experienced this before and not be so surprised about it.
This is the first I'm hearing about serious acid reflux problems, good Lord does it ever end???My Onc nurse warned me about too much internet searches, but I think I'd rather have the heads up about some of this stuff then second guessing myself all the time.
Otter, you have been a wealth of info throughout all this. I can see you in medical school soon!!! You'd be great at it.
I have absolutley no taste buds this time and it figures my sister invited my dh and I over for a filet mignon dinner yesterday. The only way I knew it was good was that it melted in my mouth. What a friggin waste!!
Good Sunday to all and feel good !!!!
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TC Titans. TC Troopers. TC ... well, never mind. Just goofing off here.
Sandra, you are sure right about the acid reflux. Mine just about did me in during my 1st round of chemo. I was taking Pepcid (OTC) twice a day, and eating Tums in-between, but it wasn't keeping the indigestion/reflux under control. So my onco recommended a proton pump inhibitor--Nexium, or Protonix. I decided to try another OTC drug first, so I took Prilosec, which is also a proton pump inhibitor but had recently been released as a generic OTC (omeprazole). My onco said to take 2 x 20 mg per day, which is double the OTC label dose. I did that from Day 1 (infusion day) through Day 8 or 9 of each chemo cycle after that, and it worked. There were only a couple of days when I chewed some Tums in addition. 'Course, I was careful about diet, too--I just could not eat anything greasy or fatty during that time.
Sherri, you are on Taxotere/Cytoxan, aren't you? My onco said Taxotere can cause enough bone and muscle pain by itself (with the TC regimen) to make us miserable for a few days. I agree with you--it's probably the Taxotere that's causing the early pain. The Neulasta pain is thought to be "periosteal pain." It occurs when those newly generated neutrophils crowd at the periosteum of the bone, all trying to get out at the same time. (That's the current theory, anyway.) So, that wouldn't happen until after the Neulasta kicked in.
Terri, I know what you mean about wasting a good steak. My dh is in charge of buying and grilling steaks in our house, and he was careful not to buy anything expensive when I couldn't taste it. He's saving a nice bottle of Kendall-Jackson wine for when I'm back in tip-top condition, and I'm betting there will be some filet mignon to go with it.
Hugs to all...
otter
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DH took me out on his motorcycle today. Didn't wear the wig for obvious reasons. We stopped for gas and the women next to us complimented the motorcycle and then said I look great riding on the back! Me, with only 10% of my hair -- a hot biker chick! Who knew.
Hope everyone is doing good today.
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Kathy 926,
Sounds like you and I have very similar diagnoses. I had a lumpectomy June 6, and started chemo last Thursday. Happy to say no side effects, yet. About the ice cap you commented on, I looked into that too, but my doctors are against it. They say the freezing "may prevent the chemotherapy from reaching the skin on the skull where, theoretically, there could be cancer cells. Also, the ice cap is only partially effective, and can be quite uncomfortable".
Good luck with starting your chemo, stay in touch.
Barbara
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Well I have made it through the bad days of tx #5. I can say that this one wiped me out totally on day 3. I slept almost all day. I have had lots of trouble with acid reflux but I had that before chemo. Prolosec (or the generic) twice a day helps but it takes a few weeks for it to take effect. tx2 was the hardest. It felt like my entire throat and esophagus was burned. I has been better with tx3, 4, and 5.0
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Oh, no! I forgot to post the TC schedule for this week, and we had a bunch of women finishing up. Collector, SusanDL123, and katiesmommy had their last tx's today, according to my list:
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Mon. July 21: collector (#4-done!), SusanDL123 (#4-done!), katiesmommy (#4-done!), Stickerlady (#3)
Tues. July 22:
Wed. July 23: Boo307 (#4-done!), VBG (#3), phillydee (#1)
Thurs. July 24: rogam (#4-done!), Debbiem425 (#4-done!), judianna (#4 of 6), youlooklikeyouneedabeergirl (#4-done!), ggrose (#4-done!), BBLady (#3), Elaine62 (#3)
Fri. July 25:
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TC_Chickadee is also getting TC this week, I think, but I don't have her dates on my list.
otter
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Yes, Otter, I did my last one today after a long debate which was resolved with a chest xray that came back clear. I told the onc about my fever issues and continued coughing which she could hear as we talked so I now have a Zpak to start and an extra 2 days of steroid pills which are somehow supposed to help the coughing. My actual blood counts were somewhat below normal but still OK for chemo. Feels nice to leave that recliner behind although with ILC I cannot afford to think I'll never be back there. I did get set up for an appt with the radiation doc I consulted with previously. She recommended him when I asked for a second referral and since he is at a center closer to my house I decided to go ahead. So I hope to get moving on the radiation track after that appt on Aug 13. I won't see the onco again until I complete the radiation and then she wants to put me on Femara - a very negative thing in my mind but I know I have to TRY it. I'll be eager to hear your ongoing reactions to being on Arimedex. They are so similar.
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Hi, Otter,
My 4th/final TC treatment will be on 7/29. Thanks for keeping track of everyone!
Thanks,
Julie
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collector, so far, Arimidex has been a non-event for me. I've only been taking it for 4 wks, but from what I've read, that's long enough to get the blood levels stabilized and have a major effect on the estradiol concentration. About the only new thing I can blame on Arimidex is some very mild, subtle hot flashes. I went through the natural kind 5-1/2 yrs ago, and they were a tolerable nuisance (not as bad as for some women). I'm sure some of the Arimidex SE's will intensify with time, but so far, so good.
JulieC, you're on the TC list for next week (7/29). You're headed down the home stretch now!
otter
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Otter:
Thanks for remembering and keeping track. I did indeed have my last tx today and it feels good to have it done. Saw the Onc and he said I am good to go for rads in 3 weeks and then I should come back and see him in 10 weeks. I assume that is when I will be put on arimidex. This just goes on and on doesn't it. As long as it does the trick, that is all that matters. Thanks for all the support.
Susan
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