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MedHelp Member's Question

Low WBC and low ANC

by hph5477, Apr 15, 2004 12:00AM
I'm a 1B, Beg VL 596,000; 12 wk VL 370, 24 wk VL>10.  Do 27/48 tomorrow. I used to see Erin (GIPA) til she relocated up north.  Had my first appt with the NP yesterday.  Erin had suggested I extend tx to 60 wks since I was a slow responder (based on her info from conferences she attended); also Erin would intercede with Procrit or Nuepogen if my numbers fell below the mark.



My WBC was 1.6 and ANC .7 at 24 wks.  I asked the NP about it and she said she didn't get concerned with these 2 items b/c chemo patients oftened went much lower and did fine.  Then I asked about the additional med to bring numbers back up and she was a little wishy-washy b/c they are expensive.  Never actually got a yes or no from her that she would prescribe the nuepogen or procit if needed in order to keep me on full dose; just that she would keep me on full dose as much as possible.



Here's my questions:

1) should I be concerned if the WBC and ANC drop further and not doing anything to bring the numbers back up?

2) I go to the Gastroenteroldy Assoc in Ft. Worth.  Anyone else in the FW area that sees a different doc?



Thanks for all your help and advice.
Member Comments (15)

by oldhippiechick67, Apr 15, 2004 12:00AM
To: hph
Well, I pretty much agree with Scott, you didnt say if your RBCs/hemaglobin is low?  All I know is from my experience is that both my reds and whites went low around 12-14 weeks and again around 27wk.  I know the symptoms of low RBCs is weakness and shortness of breath, dizziness.  My GI doc sent me to a very kind and caring hematologist/oncologist and he ordered the Procrit and Neupogen.

Are you having any symptoms?  The low WBCs and ANC can make you more suseptible to infections.  If your insurance will cover the cost I would DEFINATELY get it.  The Procrit gave me back some energy and I would insist on that if you get as low as 9ish or less on the hgb.  I was falling down from dizziness and imbalance/weakness, extreme short of breath and nosebleeds and gums bleeding, so I felt it was important.  My WBC and ANCs were as low as yours and the oncologist didnt blink about ordering Neupogen for me...so maybe your doc is a little less cautious about it, but do you work?  Do you go out around people?  I wouldnt want to be that low and worry about catching

a cold, that could turn into bronchitis or pneumonia... or getting a wound that wont heal. It already takes me 2 weeks to get a small cut to heal and I am on Neupogen! Its a shame you lost Erin, she was one of our superheros of advice in here!

by hph5477, Apr 15, 2004 12:00AM
To: OHC
My Hemoglobin actually went up a little to 10.8 so I think it's okay.  I do seem to tire more easily some days than others.  I'm fortunate to not have to work right now but I do stay active (walking, bike riding, etc) and social.  I just wasn't sure if I should concern myself if the WBC or ANC dropped any further.  Needless to say, I wasn't very impressed with the NP; especially after losing Erin...she was very good.

by BD146, Apr 15, 2004 12:00AM
I agree with Scott 100%.



My wbc dropped to 1.5 and was quickly put on Neupogen... This is my second week and honestly have not had any sides.



My dr. did not want to lower my peg/copegus dosage because I am a non-responder from previous tx and she wants me to treat more aggresively this time around.   (genotype 1b)



Continued recovery to you and all.... Edgar

by audreywald, Apr 15, 2004 12:00AM
Hi everyone.  I hope you all remember me.  (a joke mostly)



Just wanted to check in and let you all know what is going on. It is two weeks since they took me off of tx - hair is still falling out, stomach still hurts a lot.





On the good side, energy is improving as well as mood.



I am thinking of you all.

by DebbieDo, Apr 15, 2004 12:00AM
To: audrey
Glad  you are feeling somewhat better......I think it takes time for your body to rid itself of the meds........thinking about you

          Deb

by DebbieDo, Apr 15, 2004 12:00AM
To: dumb question?
What does PCR stand for anyway..........i know its a test done at 12 weeks.......but, what does it stand for.......sorry for the ignorance  :(

by Honey15637, Apr 15, 2004 12:00AM
To: Nolee, Audreywald
Neal...So happy for you and that is so great about your cirrosis reversing! I imagine you are so happy and minimal sides also.Great! Keep checking in when you can as we love to hear things are going good for you!



Audrey...Glad you are finally getting some energy back now and sorry to hear about your stomach pain  and hair still coming out.  I still haven't experienced that part yet....I would be thinking you would be having a let up on sides somewhat now and was curious to what your dr thought.

by harley dude, Apr 15, 2004 12:00AM
Hey everyone, this is just a comment for the post before this one about 2b- It depends on the damage of your liver whether or not your doc will stop at 24 weeks if clear or go onto 48 if you have fibrosis stage 3 or higher- I had a low viral load 350,000, but had geno 2b and  fibrosis stage 3, so my doc highly reccommended going 48 weeks to try and help reverse some of the fibrosis and make it an almost 95% chance of svr, I was clear at 24 and it was my choice to continue since my sides were not that bad- so just because your geno 2b doesn't automatically mean your going to stop tx at 16 or 24 weeks. It all depends on the condition of your liver. The odds of svr geno 2b is appx. 88%, if you go 48 weeks your odds jump over 95% svr- take your choice- If my liver had just a small amount of damage, I would have stopped at 24, but unfortunately I had stage 3 fibrosis, so I was stuck (in more ways than one) to go all the way (48). The good news is after tomorrow I'll have only "4" left--"YEA BABY"- can't frickin wait.-- See Ya'll- Harley Dude *Live to Ride-Ride to Live*

by DebbieDo, Apr 15, 2004 12:00AM
To: scott
Thanks for the info.....i read it, but, didn't completely understand, the reading,like you mention is enough to put you to sleep.....lol........thanks for answewring my dumb question.

I knew what the test was, but, didn't have aclue what the initials meant   ..I will get my results Monday.......info is now at the 16 weeks.....Didn't get the 12wks, it wasn't back in time.....and i use a hospital clinic, so i always have to wait.......The first time it was taken at 11 weeks.  My doctor was gone and the resident doctor couldnt locate the blood results for that particular test.I insisted on having blood drawn again to make sure, just incase it was lost. Theygave me another test and i will find out the results of both and then also the blood drawn this past Monday. Sorry if this sounds confusing......it is.......lol......I want to know if this is working for me......I'm a 1b......low viral load  5.9 or 778,000, something like that. I have mild fibrous between stage 1-2.......i feel positive.......PRAY FOR ME THIS WEEKEND>>>PLE~ASE              Deb  :)

by goinseagle, Apr 15, 2004 12:00AM
To: Everyone,Audrey
Hi the other day i dais i was going to stop tx well i've decided not to I am going to keep going. My friends at work have really pulled together for me. they are throwing a benefit for my family and i have had hands layed on me. I am not very religious for some reason I felt the strength to keep going. I hope you will prAY FOR ME TOO. I am trying effexor to stop all the boo hooing and see if i can get a litttle more energy. Thank you Audrey and everyone. you will be seeing alot of me now can't get rid of me that easy.lol Tomorrow is no 8 40 to go may 4 i will know whether my viral load has dropped ill report in the mean time keep up the fight i am I am glad your mood is getting better Audrey i just hope you belly feels better soon love ya

by berlynn, Apr 16, 2004 12:00AM
To: goingseagle
I am glad you decided to hang in here for the long haul. I know that this isn't easy...but thankfully..there is alot of support out here from your brother and sister heppers.You sure have your hands full between working and the teenagers...but you CAN do this. Stay on top of the meds..if the effexor doesn't work for you, keep trying until you find one that does. My doc says to do what you've gotta do to get through this. If you see me on aol..im and let me know how you are doing. Take care, my prayers are with you, kim



Audrey, hi hon..it was good to see you are starting to get back to normal..(whatever normal is ..lol) Sorry about the tummy though...did you ever try nioxin for your hair? It takes a long time for the riba to wear out of our bodies. I pray that you will be feeling GREAT soon, kim

by GI.PA, Apr 16, 2004 12:00AM
To: hph5477
Your counts are right on the borderline of concern but many patiets sit there for a long time and never go lower, particularly with the WBC and ANC.



Hope you are otherwise doing well.



Erin

***@****

by hph5477, Apr 16, 2004 12:00AM
To: GI.PA
Thanks for the response.  I know I'm only borderline now but was concerned if the counts do drop any further what action would be taken.  I left my NP visit with the feeling that if the counts continued to drop no action would be taken to bring them back up.  And my next visit is July 14th (3 months away), although I will have labwork done 2x between now and then.



Hope you are doing well.  Sure do miss you as my doc and miss all your comments on the board.

by audreywald, Apr 16, 2004 12:00AM
To: Kim, Helen, Honey
I really hate to say this, but it appears that the skeptics are right on when it comes to docs taking you off tx - they are basically done with you. Am I being ridiculous to think that maybe they could call just to see how the patient is doing once in awhile - especially after having muti bad reactions to the tx? I have a great internist who does this so I guess I am spoiled by this human man! My internist is following up with tests on my tummy troubles.



And some of my sides are better. Energy and mood mainly. The rest will come (I hope and think)  Anyway, I hope to get back to the gym next week. (wish me luck on this lofty goal)



Helen, I think you are doing the right thing. I think I remember you saying that you are at level 3 in fibrosis. You want to stop this if humanly possible before it gets any worse. Is it ridiculous to ask if some of the older kids could maybe pitch in?



Thank you, Kim, for your good thoughts. How are all of you feeling?



Honey? You ok? Chevy? 12 week test today?



Helen, you hang in there honey, I have faith in you.



I am thinking of you all.



love, Audrey



ps - funny story:



I was watching TV yesterday, a show called birthday - about high risk pregnancies and deliveries. I heard them say, and Dr Ar### delivered the baby.



It was my brother!!!! Too cool, at least the black sheep is proud of the success of the others. I am happy to have grown up enough to be happy for others that make better choices than I did!!!

by Honey15637, Apr 16, 2004 12:00AM
To: Audrey
No...Its not too much to ask! You have been through so much with all your sides and your DR should have the nurse calling your house to see how you are doing!  I'm glad you are still here and keeping us all posted and looks like at this point we are waiting on some more results to finish out the 12 week for alot.  Chev..and I think maybe Fubar is up soon also and someone else but can't remember at the moment.  Looks like there is now some at the finishing line also so we need the cheering.  I wanted to tell you that I have been to Dr. Cecils site and he says that there is something new that will be out in about 4-5 years and hopefully sides will not be near as bad.  Hang in there...you are an awesome lady!
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