I'm sure this question has been asked, but until it directly impacts one the answers seems to slide into the short-term memory and is gone!!!! My WBC is 2.0, RBC 2.96, hemoglobin is 9.8. My platelet count is holding at 192000. absolute neutrophil count is at 1.0, so the doc is beginning the discussion of what if?? I have been reading about procrit and am a bit nervous about it, although, so many people say they feel better after starting it; however, are there any alternatives to get my blood flowing in the correct direction? The doc is hesitant at this point of lowering the riba dose, which is 1200 as it is only the beginning of the fourteenth week and I'm UND at 12 weeks. I'm taking a supplement and extra folic acid. Any suggestions would be greatly appreciated and sorry for the redundancy of the question.
There are a few options dealing with hgb:
1. procrit or similar (like Aranesp)
2. slog thru and expereince the drag of anemia
3. transfusions. but what ever comes up, comes back down
4. reduce riba
For me, #1 is #1. And the talk with the doc is a good idea. For me that talk ended in agreement that hgb target was between 11 and 12, I needed to maintain my brain somewhat. It's time to get off the pot and have a plan in place or taking the steps now.
For me, the first two items on FlGuy's list would be part of my contingency plan if possible, but in the reverse order.
Many people here make the hurdle into using procrit and speak really positively about it. I opted for watching my ANC and Hemoglobin, deciding to not jump in until critically necessary (factoring in that the rescue drugs do not act immediately). Both my ANC and hemoglobin spontaneously rose and for now, in my 21st week, the numbers are not putting up flags. Am I maintaining my brain without procrit, as FlGuy mentioned? Hmmmm....still, I'm used to the low level of activity for now and can't even remember what it's like to multi-task.
Thanks for responding because I'm trying to gather as much information as I can; however, it has been that way for the past 14 weeks--gathering information as I deal with the sx! lol I think the doc will have my latest blood work by tomorrow, so it may be "slogging" my way through with low levels of energy and brain function or take a chance of adding more liquor to the cocktail......hum, wish it really were a cocktail.
I am just going to throw this out there because I remember someone recently having issues with hgb and anc levels saying they are on 1200 of riba and then adding that their weight was down to under 100 lbs.
If that was you, you may have some room to consider a dose reduction on the riba since it is weight based.
Sorry for the brain fog...I'm in week 11 and having hemoglobin issues myself...if not for trial constraints I would personally LOVE some procrit!!! Bartender fill me up with a round o'procrit.....and keep 'em comin!!! LOL!!!
I know that you can read a lot of horror stories about Procrit and I have no doubt that they have validity. I also know that most of us don't want another shot. If you choose to use the Procrit, and I, like FLguy, do believe this to be the best course, you should have weekly CBCs.
The goal is to bring up your HGB about 2 points. With HGB under 10, I don't see how you have much quality of life. It is important to get through this and your best chance to do this is without a dose decrease. Careful monitoring is the key issue. You can greatly improve your QOL.
Just think of yourself as some high preformance bike racer getting ready for the race. It is exactly what they do. All you are doing is boosting the cells that carry oxygen and you need all the O2 you can get.
With weekly CBCs the doctors can monitor your HGB and determine whether you need weekly, biweekly shots and what dose you need. Both FLguy and I waited after the CBC and knew what that was. I then consulted with the nurse on when to take the shot. It helps so much, you will be glad you did. I used it from about week 14 to a couple of weeks after my end of treatment.
I appreciate your views and experiences and have been somewhat hesitatant to start any rescue drugs, but I surely am not accomplishing very much these days except to watch the "spins" on the election in the US. My son is deploying to Iraq for the second time on Saturday and it seems at times I have nothing else to do but feel my body and think about my grandchildren's future. I am on ADs but probably need some procrit to keep me fisty!! Love you people!
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