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Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

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Unread 06-06-2003, 04:49 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

I'm just at a loss.

My third chemo went so well. Four days of bone pain, but other than that, I've been hiking three miles every day and eating really healthy and just feeling great. I only had to smoke MJ a few times, as compared to many times during the past two cycles. And the supplements I'm taking seemed to minimize some of the pain and nausea.

But I just found out that my counts are too low to proceed with my fourth chemo on Monday. Last time, my white count was 2.7 but my neutrophils were 60, so it was OK. This time, my white count is 2.8, but my neutrophils are 28. Which means I have to start Neupogen shots later today. The nurses are just getting the order from the doctor and then I have to head back to the hospital for my first shot.

All of this is apparently common after three chemo cycles, but so many of you have written that you "just barely escaped" having to have the Neupogen. I am just not happy thinking about two full weeks of bone pain.

I don't know why this is making me cry so much. I just wanted to stay on my schedule and keep moving forward. Now they're telling me that they might need to reduce the dose. I have no idea what the implications of that might be. I am hoping to complete 8 full cycles. But if my counts keep getting smacked so hard, I may only get to do 6.

Maybe chocolate will help. :-(
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Unread 06-06-2003, 05:13 PM
Neupogen, Postponing, Lowering Dose, Etc.

The Neupogen should be very helpful in raising your neutrophils and remember everyone reacts differently--you may not have all the bone pain anticipated. I came close but escaped Neupogen--I had neutrophils actually rise when they were horridly low. As to postponing a chemo--it's nice to be done on schedule, but both times I have had to go to a four-week schedule vs. three weeks because of counts. With the first series of taxol/carbo it was platelets; this time it was red and white cells. Also don't be shocked if the Dr. lowers the dosage. I had my dosage lowered this last time because the carboplatin was so hard on me overall. It did the job just as well. This will all be over soon hopefully and you'll find each treatment different as to side effects.
Unread 06-06-2003, 06:32 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

I understand how frustrating it is to be on a schedule and have to delay a cycle.

had to have my chemo #4 delayed 10 days because of a DVT so I know how you feel. I also had neutrapenia at day 14 after my 4th 5th & 6th cycle. My neutraphills always climbed back to acceptable range by the time for my next chemo tho. My bone pain stopped after the third cycle. Hopefully, yours will too.

Hang in there. You will make it.

Ruth S
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Unread 06-06-2003, 08:24 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

Well, pooh, Siren!

I'm sorry this is happening to you. Hope the Neupogen works fast and doesn't cause too many problems for you.

I really understand what you mean by staying on schedule. We psyche ourselves up for the entire treatment and not only do we want to stick to it because it's part of the original treatment plan but I think we also plan on when it will be done.

Unread 06-06-2003, 08:27 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

I had to take the neupogen shots and they weren't that bad. The bone pain that I had with the neupogen was tolerable and when I didn't want to deal with it, I took a vicodan and was quite comfortable.
Best wishes for an easy course.
Unread 06-06-2003, 08:38 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

Thanks everyone. Shot No. 1 has been given so I'll know more about how it affects me by tomorrow. A plane smacked into an apartment building just down the street, so there was a ton of traffic and I was afraid I wasn't going to make it. But I called the nurse and she said she'd wait for me. Isn't that kind? She is such a nice person. I bought her an orchid a few weeks ago.

The nurse said that sometimes they lower the dose, then switch from Taxol to something else, such as Topetecan or Doxil, for the remaining cycles. She said in some cases, they stretch it to 10 cycles, but added that I'd have to talk to my doctor about that. I wish they would've just told me that this kind of thing is common after three cycles. Sigh.

Ellen, thanks so much for your response and info. If they want to push me to four-week cycles, that's fine. I just want to know so I can make a few changes in things I've committed to doing. I know this probably isn't a big deal in the grand scheme of things. But for some reason, I couldn't stop crying for several hours. It's just so frustrating . . . and I'm not sure why.

If lowering the dose doesn't affect the strength of the treatment, then why do they start with such a high dose? Also, are the earlier doses more important than the later doses? Or is it really all the same, and your body just gives you less pain as it gets used to the treatment?

I won't know my new CA125 until sometime next week.
Unread 06-06-2003, 09:14 PM
Siren, hope you are doing ok today and

that you aren't having bone pain. I will pray lots for you over the next few days. I know what it must be like having to change your chemo dates and the length of treatment. I have mine all mapped out - and I haven't started yet. Hang in there, you can do this too. You will be back hiking in no time. And I think LOTS of chocolate would be enormously helpful.
Maybe you need a cup of coffee, too.
Hugs and prayers to you.
Unread 06-07-2003, 11:56 AM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

I bought and ate an entire pint of Haagen Daz chocolate ice cream. Not my finest "healthful eating" moment, but it did quell the crying.

Had a little bone pain last night and was able to sleep without meds, and feel pretty normal today. I hope that trend continues. Thanks for all the prayers and support!

Oh -- and as to mapping out chemo . . . I've already slipped my schedule twice . . . so map it out in pencil.
Unread 06-07-2003, 01:08 PM
Low Counts = Postponing 4th Chemo = Neupogen Shots to Start Later Today

I'm so sorry you've had this set-back with your blood counts. It sounds as though all kinds of different adjustments can be made for the chemo programme though, so you will complete it. It must be very frustrating to have to move off schedule and make you feel less in control: no wonder you felt like crying. I think the chocolate ice-cream was a good idea. It's what you eat every day that counts, not the occasional treat. I'm sure the psychological benefit on this occasion far outweighed any physical damage!

Here's hoping your blood counts rapidly improve and that you can get back quickly onto your chemo schedule. I will be praying for this.
Unread 06-07-2003, 01:35 PM
. Ice Cream Good For Bones


I think that the ice cream was a nice little treat for your achy bones. All that calcium will work wonders! I give mine a little treat (besides the normal yogurt and skim milk) every once in a while with a reduced fat Klondike bar--but with skim milk poured on top! In total it's no more than 250 calories (180 for the Klondike), I'd say a small treat for a cancer survivor, wouldn't you?

BTW--I seem to recall some research somewhere along the way saying that in some cases lower doses of chemo may in fact be more effective. I've learned in researching over the past 4 years that there are so many opinions, perspectives, views and studies going both ways on just about any issue that there are really very few things written in stone in oncology, or in medicine for that matter. One good example is the HRT debate; several years ago it was being pushed by doctors as having all sorts of benefits that, one by one, more recent studies appear to be refuting in large part.

Keep the faith and keep eating Haagen Daz--as long as they have a low fat version!


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