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Cold Therapy to Prevent Neuropathy? Tips, Anyone?

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mountainmia
mountainmia Member Posts: 857

Chemos commonly used for breast cancers include taxanes, such as taxol and taxotere. Common side effects of taxanes include peripheral neuropathy, numbness and tingling caused by damage to peripheral nerves. This can cause difficulty with both fine motor skills and larger ones, and can affect balance and mobility if it persists. You can read more about peripheral neuropathy here:

http://www.chemocare.com/chemotherapy/side-effects/numbness-tingling.aspx

Research shows that cold therapy (cryotherapy) may minimize the side effect of neuropathy.

https://www.breastcancer.org/research-news/cryotherapy-may-prevent-taxol-neuropathy

What tips do you have for cold therapy to prevent neuropathy? Did you buy special socks or mitts? Did you use ice packs or frozen peas? How did you rig a system for managing this side effect?

Please share ideas, tips, reviews, and links in comments. I can compile ideas here in the leader for the topic.

TIPS

  • begin icing at least 15 minutes prior to infusion, and continue at least 15 minutes after infusion is complete. If you have a combined chemo session, such as taxotere and cytoxan, the T part is the important segment for icing.
  • keep a thin layer of cotton (thin sock or glove) between your skin and the ice to prevent skin damage.
  • whether using purchased mitts or sox or in your own system, you will probably need to switch ice packs during the process to maintain the cold.
  • you'll probably need to take your own cooler to the infusion center, as you probably won't be able to use their freezer. You can keep your cooler cold by including solid ice packs or frozen water bottles, rather than loose ice.
  • you can make your own ice gel packs using heavy-duty freezer resealable bags, water, and rubbing alcohol. Check this link for more.
  • try wrapping the ice packs on with an elastic bandage, followed by a thin cotton towel to conform it to your hand or foot.
There are a few more specific product ideas in the comments below. I don't have any experience with any of them so am not personally recommending, but they're definitely worth checking out.


If you have questions, share those, too, and perhaps someone with experience can help the rest of us understand better.


Comments

  • mountainmia
    mountainmia Member Posts: 857
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    The Weekly Taxol group covers all kinds of ground on using taxol. Lots of pages here, lots of information, not just on neuropathy prevention, but you might find it useful.

    https://community.breastcancer.org/forum/69/topics/788735?page=1

  • mountainmia
    mountainmia Member Posts: 857
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    From a comment at the link:

    "My wife was DX in AUG17 for the second time. Just finished A/CX4 and Taxol wklyX12. We (she) used cold gel socks and mittens with each Taxol and had absolutely no neuropathy, none, ziltch,nada... 15 min before, during, and 15 min after. Never adjusted dosage. Infusion center nurses were skeptical at first but I think they are rethinking their opinion. Each one of the nurses said that in their experiences "everyone develops some level of neuropathy. Socks and mittens are available online. "

    https://community.breastcancer.org/forum/69/topics/859551?page=1#post_5157243

  • mountainmia
    mountainmia Member Posts: 857
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    From a comment at the link (and I'm going to post these as I find them):

    "I held on to frozen water bottles or ziplock bags of ice during my treatments. I used cold therapy socks on my feet. I would also drink ice water or frozen cokes or smoothies ( ok, mostly because I judtlike frozen cokes). I did not have neuropathy. Maybe I just got lucky but either way it was pretty easy to do."

    https://community.breastcancer.org/forum/69/topics/861596?page=1#post_5126868

  • mountainmia
    mountainmia Member Posts: 857
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    I've seen the idea of using frozen peas as a cold pack. If you have a longer infusion period, that might not work well, but it's worth considering.

  • mountainmia
    mountainmia Member Posts: 857
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    From a comment at the link:

    "Little advice: my onc did a "affect of cryotherapy on neuropathy" while i was on taxol so i was included. The other participants and I had 0, yes ZERO, incidence of neuropathy! The icing does in fact work, and is worth every penny. Here is what they did for me during the study - the researcher actually felt that the first 15 mins before taxol and the 15 mins after were the most important to be iced.

    15 mins before taxol - start icing

    30 minutes after taxol started, at the 45 min mark - get a fresh pair of gloves (yes this sucks)

    leave gloves on for 15 mins AFTER taxol is done running in.

    I literally had NO NUMBNESS in my hands and feet. I had only the tiniest bit of temperature oversensitive (hot felt too hot and cold felt too cold) and I strongly recommend you do it!"

    https://community.breastcancer.org/forum/69/topics/840700?page=2#post_4631691

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "my DRs office has the hand gloves and footies - as seen here:

    http://www.amazon.com/Elasto-Gel-Therapy-Mitten-10...=sr_1_1?ie=UTF8&qid=1443616249&sr=8-1&keywords=cold+therapy+gloves

    They put a paper glove/footie on my then the cold glove - this is what the researcher thought most important - the gloves go on 15 MINS BEFORE taxol is started. my taxol was 60 mins - so at 30 mins into the taxol infusion, switch out the gloves to a second fresh cold pair and leave them on for 15 mins after the taxol (so 90 mins) - as I get premeds and the post work of unhooking you, it didn't make the total time take any longer.

    The researchers were surprised by the results - no numbness/tingling/pain neuropathy in any patients. I had temperature sensitivity only, which is completely tolerable.

    Now, those cold gloves are COLD. Uncomfortably cold for a few minutes but they do warm up- the little bit of discomfort is well worth it if it helps you avoid neuropathy - do check with your MO tho, I have heard that some do not allow it."

    https://community.breastcancer.org/forum/69/topics/788735?page=172#post_4525400

  • SparkleGirl2018
    SparkleGirl2018 Member Posts: 39
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    Thanks for starting this post. It does make it easier to find. I had my first of 12 rounds of taxol last Thursday and used the gel socks on my feet and held a gel pack in my hands. I didn’t start 15 mins prior but will do that next time. I mentioned it to my oncologist and she didn’t act like she thought it would work but didn’t discourage it. I amwilling to try anything that won’t interfere with treatment and might help!

  • mountainmia
    mountainmia Member Posts: 857
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    Thanks for chiming in, SparkleGirl. Do you have a brand name or product link you can give us for what you used?

    REALLY wishing you great luck in dodging this! Honestly, permanent neuropathy is the SE I fear most.

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "it really makes a difference to ice your hands & feet. Start 30 min before & keep it up 30 min after. I used frozen peas in zip lock bags for my hands and put my feet in coolers with ice bags. The nurses brought my extra bag of peas to switch out 1/2 way through. Yes - it was FREEZING. I wear turtlenecks at 75 degrees and often have gloves on in my house at 70. But I shudder to think how bad my neuropathy would have been w/o icing."

    https://community.breastcancer.org/forum/69/topics/763459?page=69#post_5330866

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "I put my feet and fingers in ice during the Taxotere (final one was Taxol) infusions. NOT scientifically proven to help guard against neuropathy, but there's some anecdotal discussion, and I wanted to take no chances. Fingers in a tupperware container with ice + some water and a small towel on top, bare feet in 9x11 rectangular cake pan with ice, some water and a towel on top--infusion RN kindly brought me the ice, I brought my containers + towels. I did this freezy-plan just during the T infusion, and it was not fun. Sometimes brought them out to thaw, used my fingers to eat and use iPad and then chilled them again, etc. I'm a pianist and a hiker. Didn't want to take a chance on more neuropathy than necessary. There are freezable mitts and socks available online. Didn't seem worth the expense and trouble, since they don't last through a whole infusion, so you must swap and refreeze--not convenient to do during infusion day. Ice worked fine. And, who knows, this might be completely useless, but I did it any way, just in case."

    https://community.breastcancer.org/forum/69/topics/864629?page=22#post_5272468

  • mountainmia
    mountainmia Member Posts: 857
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    From Tiffany's Twenty Terrific Tips for TC:

    "2. Ice your hands and feet during Taxotere. I used these http://www.amazon.com/Elasto-Gel-Chemotherapy-Hypo... and these http://www.amazon.com/Elasto-Hypothermia-slippers-... and never had any neuropathy or nail changes. It does make playing on your iPad or reading difficult with the mitts on, so I just listened to a podcast during that infusion."

    https://community.breastcancer.org/forum/69/topics/839070?page=1

  • mountainmia
    mountainmia Member Posts: 857
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    From a comment at the link:

    "I was less concerned about my nails, and more concerned about permanent neuropathy. I bought reusable flexible ice packs and placed them on the tops and bottoms of my feet, inside big wool socks. I took extra packs in a cooler and changed them every hour or so. Not gonna lie, it was uncomfortable for several minutes while my toes and feet hit "frostbite" status. I started icing a few minutes before treatment started, and continued for several minutes after it ended. I did this for both Taxol and Taxotere. My infusion center had freeze-mitts for my hands - again, uncomfortable for a few minutes but the you're frozen and it doesn't hurt. I have minimal neuropathy in a couple fingers, and my toes/feet are in good shape. It's worth the discomfort and inconvenience (and no one looks at you twice, don't worry!) to not be dealing with painful, debilitating neuropathy."

    https://community.breastcancer.org/forum/69/topics/864046?page=1#post_5189528

  • mountainmia
    mountainmia Member Posts: 857
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    How to make your own flexible ice packs using water and rubbing alcohol:

    https://wellnessmama.com/91823/reusable-ice-pack/

    NOTE use heavy-duty freezer resealable (ziplock) bags to prevent leakage. ALSO from the link "This ice pack is very cold so remember to place a cloth barrier between it and your skin"

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "I used insulated lunch bags with one of those frozen plastic ice block things in the bottom and 2-3 bags of frozen peas that I nestled my hands in during the taxotere infusion. Towards the end of my tx's I also used quart ziplock bags filled with 1 part rubbing alcohol and 3 parts water. The alcohol keeps the water from freezing so the bags stays flexible. For my feet I went to a sporting goods shop (like Dick's or Sports Authority) and bought the long strip ice packs that have the elastic and velcro bands on them and strapped them to my feet. By the time the 90+ minutes were over, my hands and feet were really cold, but for me the short term discomfort was worth it. I used the same peas and ice packs the whole time and carted everything to the infusion center in a cooler. For me it worked and I had no nail issues and only a small amount of neuropathy in my right thumb. I know others have used other methods of icing. Hopefully you can find a method that will work for you. Just don't try to eat the peas when treatment is over, they get pretty disgusting with all the freezing and thawing :)"

    https://community.breastcancer.org/forum/69/topics/578284?page=518#post_3516300

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "I brought in frozen, reusable gel packs from Ace Hardware and put two foot sized ones on the floor for my bare feet to rest on and folded another two frozen gel packs over the toes of each foot during the hour or so Taxotere treatment. I also used frozen peas in ziplock bags to plunge each of my hands into up to the first joints. I would take my hands out every so often to check them, before putting them back in. They were quite pink up to those joints.

    My hospital had told me quite a few women used peas on their hands. I just felt I needed something for my feet too.

    The following day when I went back for my Neulasta shot I was asked it I had had any tingling in my feet and I could truthfully answer, no. The nurse seemed both surprised and pleased."

    https://community.breastcancer.org/forum/69/topics/752524?page=1#post_3023862

  • mountainmia
    mountainmia Member Posts: 857
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    From the comment at the link:

    "I used these cool packs, which I saw someone here suggest. I ordered four, one for each hand and foot--not cheap but a great investment, in my opinion. I have no neuropathy and believe it was because of icing. I also had no issues with my nails, hands or feet. These packs stay very cold in a cooler for 8+ hours, and my first few infusions took many hours (nine hours the first time, I remember for sure--it got shorter and shorter). The first fifteen minutes I would wonder why I was icing, but after that my hands would get so numb I didn't care as much. I also sucked on ice chips during the T and C portions of the treatment to avoid mouth sores, which I also did not have but I can't say for certain it was because of the ice chips."

    https://community.breastcancer.org/forum/69/topics/871431?page=1#post_5396682

    ALSO her link to the cool packs:

    https://www.amazon.com/gp/product/B001QFZL1Q/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&pldnSite=1&th=1

  • UpstateNYer
    UpstateNYer Member Posts: 331
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    thanks, Mountainmia😊

  • boogirl
    boogirl Member Posts: 24
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    Hi, great topic. I finished 12 weeks of Taxol + Herceptin a month ago and was a regular polar bear for it - I did cold capping and did save my hair, and also iced my hands and feet (and had an iced eye mask on my brows which I have kept as well!). I never had any neuropathy and my nails also look great, and still no issues 1 month out so I think I made it!

    I put ice on at least 20 mins before taxol and kept it on 20 mins after. I found these cuffs worked well because i could stick my hands /feet in but have a little movement (they are like frozen chickpea size but stay cold a lot longer). https://www.paradicepacks.com/product/paradice-p120-cuff/ They come in diff cuff sizes and are handy to have for future use as the fabric is very high qualit.

    Because they are cuffs I could poke a figure out to tap the iPad and stuff without pulling off gloves. I kept a small lunch size cooler and loaded them up and usually needed 1-2 switch outs during the taxol+pre/post time.

    I’m really happy I did it, and similar to the cold caps the first 20 mins were the worst then it numbed and was less bothersome. I did also have an electric blanket so the rest of me was pretty warm as the head hands and feet got the ice treatment.

  • mountainmia
    mountainmia Member Posts: 857
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    Thanks, boogirl. That's really helpful information. I like the idea of being able to free a finger for using your ipad or phone.

  • JoAnnsLife
    JoAnnsLife Member Posts: 8
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    Thanks so much MountainMia for doing this research! What great resources!

    boogirl...like you I am Cold Capping and Icing. I am using these blue cups and ice in baggies. I put baggies filled with ice on my feet, with thin socks on. Also, check with your facility and see if they have ice you can use. Also, you can suck on some ice, to keep your mouth sores down. Only on my 2nd treatment, but so far so good. Good luck to all!!

    image

  • mountainmia
    mountainmia Member Posts: 857
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    bumping

  • HappyAnyway
    HappyAnyway Member Posts: 380
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    I purchased two types of socks from Amazon.

    Cold Therapy Socks (w/Compression Strap)

    NatraCure Cold Therapy Socks

    I haven't used either yet. I will when I start Taxol in a few weeks. They both have good reviews.

  • dogmomrunner
    dogmomrunner Member Posts: 492
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    I decided to go with the ice packs that someone recommended. Supposed to last almost 8 hours! But I ordered from Amazon and they won’t be here in time for my first treatment tomorrow. I may have to improvise.

  • HappyAnyway
    HappyAnyway Member Posts: 380
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    DogMomRunner, please let us know if you like them. I still need to get something for my hands.

  • dogmomrunner
    dogmomrunner Member Posts: 492
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    HappyAnyway - I will! I think I can get the packs at Walmart also (cryomax). I ordered two 6x6 for hands and two 12x6 for feet. I think you can put hands/feet inside the cover with the packs. It’s going to be a McGuyver kind of thing probably. :

  • beesy_the_other_one
    beesy_the_other_one Member Posts: 170
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    DogMom and Happy,

    I was one of the commenters pasted above who used the cold packs that last eight+ hours if protected in a cooler en route to the hospital; I saw a woman had recommended them on a very old thread on this site (cool packs). I actually found the BCO while trying to research if there weren't something I could do to prevent neuropathy because twenty-five years ago, I had a friend being treated for Inflammatory who wanted to quit Taxol because the neuropathy was so bad after TWO infusions, so I knew it was a real side effect. When she wanted to quit, I asked her if she could live with the possible consequences (she had a two year old at the time), and fortunately, her MO would not allow her to quit. Even so, her "odds" of survival were very low at that time and she beat the odds! She is very much alive, and in her case, the neuropathy did subside eventually, though often it does not.

    I was the one who mentioned sucking on ice chips also. I can't say with certainty that's why I never had mouth sores, but for me it would fall under the category of "worth a try."

    DogMom, plain old ice in a ziploc bag will work. It will be a little more messy, but it will do the job. As other commenters above mentioned, you want to start thirty minutes before the taxane drug and leave on thirty minutes afterward--so you'll just have to ask the nurse helping you to keep you posted on the timing.

    Wishing you all the very best in the coming months. You can do it!

    Beesy

    ps Congrats to Boogirl for thinking to try an ice gel mask for the eyebrows! Never thought of it! With taxanes, you don't usually lose the brows or lashes until you've had your last infusion, and that's what happened with me. Now I'm on my second round of eyelash loss. 😕 At least I was prepared for the likelihood thanks to this forum, and I have some hair on my head this time, which makes it a little easier. This sounds very shallow, but the day the eyelashes fell out the first time was one of the hardest days of this entire experience--it felt like the last indignity. Not to be deterred, I became an expert at falsies. Anyone who needs tips on how to do apply false eyelashes without natural lashes (a serious disadvantage), I'm happy to help.

  • HappyAnyway
    HappyAnyway Member Posts: 380
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    DogMomRunner, good luck with your treatment tomorrow! McGuyver, oh yes! Now I'm going to see if I can find that on Netflix or Hulu!

    Beesy, thanks so much for the info! I appreciate it when those that have come before me provide advice and encouragement.

    I have my last AC on Friday. Milestone one will be accomplished!

  • mountainmia
    mountainmia Member Posts: 857
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    Beesy, great info and thank you so much! As to eyelashes, mine are pretty meager anyway, but I hate the thought of them disappearing altogether. I'll be in touch if I need help on applying fake ones!