temperatures

Hello everyone

Since I have been feeling SO GREAT the past few days, I have gone in and helped Ken with "rounds" at the hospital.

Since I have been "ill",  he has essentially been working his job and mine. Since we have no disability insurance, or "sick time", it seemed kind of necessary. Not that we have any concerns financially, we have kids in college and a cd on the way, and would like to retire someday........ So we decided that this would work best so as not to let this "bump in the road"  leave us off in a ditch.  (perhaps a tad over dramatic)

ANYWAYS, on the days I feel well, I feel guilty not helping out.

Not sure if it has anything to do with being at the hospital but I developed a fever last night, with chills. 

When you start chemo you are given a list of things to watch for and to "report", one of them is an elevated temperature.

My temperature went to 99.8 and I do feel better today, however people reading this blog seem to appreciate the medical info I explain, so thought I would go into greater detail about this concept here.

The cancer centre instructs patients to seek medical attention if their temperature is greater than 100.3 (or 38 degrees in the rest of the world)

What is done then is a complete blood count.  If the absolute neutrophil count (ANC) is found to be less than 500, then irregardless of whether there are any symptoms of an infection

the patient is started on IV antibiotics, high dose, broad spectrum.

(Neutrophils are just one form of white blood cells, others are lymphocytes(which are the cells deficient in AIDS patients), monocytes, eosinophils, however for the chemo concerns, it is mainly the neutrophils that are affected.) On a blood count you get total white blood count, and then a break down of the various types, usually the highest percentage is always the neutrophil count.

The interesting thing about infections is that often, the thing that brings our attention to an infection, such as pain with a bladder infection, or cough with a pneumonia,  is the bodies response, as opposed to the organism (bug) itself.

So if the bodies immune system is weakened and unable to fight an infection then often symptoms are minimal, until too late.  Years of working with the extreme elderly, it is well known that they rarely develop fevers, and when they do, even if it is minor, it is significant.

So as one might gather from this, it is hard to detect if an elderly person has developed an infection with chemo, so in this group they watch the neutrophil count closer.

As I have mentioned in previous blogs, the drug given to me the day after chemo "neulasta" was given to boost my bone marrow.  The drug seems to have a lot of side effects, and I was wondering if I REALLY need to take it

What I found today is that the chemo regime I am on is associated with a greater than 20 percent risk of febrile neutropenia (the scenario I have described above).

The guidelines suggest that if you are giving a full dose chemo with the goal of potentially curing the cancer, then to give the Neulasta rather than lower the dose of the chemo.

While this may seem confusing, I guess to restate it...

The dose of chemo I am on carries with it a high risk of serious infection, however rather than lower the dose, which would lower the cure rate, the neulasta is given to decrease the time frame that the neutrophil count is low.

Perhaps this is all a long way of saying that I will not be helping Ken out whilst on Chemo.

I guess it is a good thing that we both went to a somewhat part time position last summer.

I will make him yummie dinners to make up for it.

Love and peace 

Janet Bates

jankenb@gmail.com