I saw my doctor yesterday regarding my continuing treatment plan. We will never know exactly what caused my fever. It was either a reaction to the chemo drug, Taxotere (a highly unusual response), a virus (which seems unlikely for 8 days and that occurred before my white count ever dropped), or a reaction to the Nuelasta shot - which helps to rebuild your white count after it drops from the chemo.
The doctor suggested the following options listed here in order of her preference:
1. Do taxotre again without the nuelasta shot. This leaves me with a 1 in 3 chance of winding up neutrapenic (low white count) and thereby vulnerable to infection…. And infection would put me in the hospital on iv antibiotics again and be potentially life threatening.I have agonized over this decision the last few days and have not been able to concentrate on work. (I am performing so badly at my job right now. I feel terrible about it.) I have been really emotional about the decision making and I keep tearing up every time I try to talk about it to someone. It's kinda hard to have a productive conversation when you are crying.....
2. Do taxotere again and instead of the nuelasta, I would take nuepogen shots daily for 10 days. Nuepogen is the short acting version of nuelasta. So if I start to have a bad response again, we could stop the drug and it would be out of my system in 24 hours. The down side - daily injections in my tummy:(
3. Go back to drug #1 which we know I can tolerate well. This option is about 2-3% less efficacious as option one, but has less dangerous (and more tolerable) side effects.
4. Quit. She says 4 sessions (which I’ve had) is the minimum standard. Less than 4 is not efficacious, 6 sessions is more efficacious - by maybe 3-4%.
So... stopping is not an option. Yes - days out of the hospital I was frustrated and tired and said I was ready to quit. I have some perspective now and know that I want to keep going. Yet - I HATE the idea of winding up sick in the hospital again. I was miserable! On the other hand, I don't want to have a recurrence 3 years down the road and live with the regret of not having tried the most effective treatment because I was afraid of 10 days of fever, bone pain and a trip to the hospital. Hmmmm.... 10 days of illness vs. years of life on earth. The answer is becoming clearer now.
I finally pulled it together this afternoon and have decided on option #2 - Taxotere with the daily nuepogen shots. I want to know that I did everything that I could to prevent a recurrence. I want to pursue the most effective and aggressive treatment that has the best statistical outcome.
To do Taxotere without the Nuelasta comes with a risk of life threatening infections that I'm not willing to chance. To do it with the Nuepogen shots comes with some additional pain and hassle and still the possibility of fever and bone pain - but it is not life threatening and allows me the option to stop if my blood counts are okay and the pain is too bad. I will still have to play the game of checking blood counts and cultures to make sure the fever is not indicative of an infection. I could very well end up in the hospital on IV antibiotics again if the fever doesn't abate quickly. But overall it feels like the safest way to reach my goal.
God I hate making decisions like this!
So the infusion is Thursday morning at 10:00 a.m. Ben will have to get instructions on how to give me the shots. At least I can do them at home vs. a daily trip to the doctor. I also got daily shots in the stomach while I was in the hospital and they didn't hurt. It just sounds awful because I think we all grew up with the horror stories about what would happen to you if you were bit by a dog with rabies! Our parents used the threat of 10 days of stomach shots to keep us away from stray mutts! Am I right? Although the shots don't hurt -they leave one heck of a dark black bruise. I will have a very colorful stomach!
So wish me luck. Not sure what the next week will bring or when I will feel like posting again. Please send positive thoughts, or prayers, or do a voodoo dance that will keep me out of the hospital this time. I can take some pain and discomfort - just don't want to be incarcerated and tied to an IV pole again!
As always - I'll talk to you from the other side of this treatment.
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4 comments:
Keep hanging in there, Sherri Jo! I would have chosen #3 or #4, but as I said before, no one knows what is going on with you except you, and you have chosen the best one that fits you. You have so much courage...really. You have faced a tough decision, and made a relatively choice. You are getting better at it. As always, I pray that everything will go well, and that your last experience was just a fluke.
Love, Cathy
I left out the most important word--quick--you made a relatively quick choice.
Sherri Jo,
Today is 08-08-08! That has to be lucky. I hope it's a feeling-really-good day for you and you have a great weekend with your family.
Your decision to continue with chemo is so well thought out, as is always your style. I will remember you with healing thoughts and prayers, especially on Thursday.
Savor life! Judi
Sherri Jo,
Way to hang in there. You have always been strong willed and tough as as nails and this is no different! I'm actually glad you have decided to finish this and I hope as I type this you are recuperating at home from the last treatment and this too shall pass. Too many years behind us and too many yet to come to quit now! Get well and please call if you need ANYTHING!
T:)
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