RBC drop and transfuse?

[painterlady13]

ok as most know doc said monday that they were going to put me on Procrit this week because of the point drop last week in my RBC 13.9 to 11, Yesterday I went and got the latest cbc and it had more that another 2 pt drop to 8.7 (more than 5 pts in 2 weeks) My  PCP freaked and ordered a transfusion 2 units.  I called the CC at the liver specialist's office to let them know what was happening before I went for the transfusion and she said that while that was low they really didn't think I needed that. That I wasn't at a critical level yet. Mind you I truly felt dead.  she did say that she would ok 1 unit and will reevaluate my riba and procrit after next cbc.  I don't want to have to lower the riba.  even 2oo mg. I would rather slowly get more used to this and keep meds at regular levels.

  I did end up in hosp lst night getting 1 unit of blood and do feel better today.  Maybe still not as good as I should be but much better.

Question is Does a transfusion lower the chances of SVR? I will do a CBC tomorrow to decide if I still need the Procrit or need to just hang on to it for another week or so when I probably will need it.  I guess I am just so new at this and don't know what to think and my PCP here in town is also. And with Liver specialist being 4 hrs away it is hard to keep right on top of things as quickly as might be necessary.

[sfbaygirl]

GO; Sorry to hear about the possiblity of your stopping tx. We fight so hard and feel so bad during tx. I hope you can find a way to continue. Do you take Neulasta? It is the worst!

I am going to try the neup this next week, if I have to. I bought some Shark liver oil and it is supposed to help raise WBC. I will find out tomorrow with labs. In any case, I am going to ask my dr. to switch me to Neup. He claims I will still have the bone pain, but from what I've heard it won't be as bad. I'll try anything, even swedish sharks!

I know steriods are bad. It may be those or stopping tx. I'm not stopping tx now.

[GrandOak]

Sorry to hear about your sx's to the Neulasta.

As my labs drawn yesterday have shown, I must have enjoyed it so much last month, that I get to do it again this weekend, along with another kick of the Procrit to 100,000 U since my Hgb has tanked into the 9's again.

[friole]

Your reactions are horrible.  I am not sure it is good to be put on a steroid on tx.  My sx from the Neupogen are mild but many report joint or bone pain. Tylenol is enough for me and I don't take it all the time. I would sure try Neupogen if I were you.
kathy

[sfbaygirl]

No, the Neulasta is NOT getting easier. I dread even going to the hemo next week. I couldn't take it and took the steriods he gave me. I took 1/2 dose, but I know I shouldn't. It helps the pain, but I still go through days and days of agony. I think I am going to try the Neup and hope that I don't get the same reaction as Neulasta. Even if I have to go there a few times a week, it will be better than those sx. They are bad enough to stop tx! Everytime I think of Neulasta now, Ithink of the comericial with those smiling faces, "I'm ready for Chemo!" They can't be smiling on that stuff!

[friole]

Hi.  I would think the Neulasta would be the same as the Neupogen.  My doctor said waiting 48 hours was better, but others have said their docs say 24 hours.  I usually did the Peg on Friday and the Neup on Monday.  The couple of times my ANC was  pretty low lately, my doc said do two shots in a row.  Is the Neulasta getting any easier for you?  I thought the sides were pretty rough for you.
frijole

[sfbaygirl]

Sounds like you have plenty of Riba absorbtion! When you start feeling better from the procrit, you will be really happy. I dropped 5pts in 2 weeks and thought I would keel over. It was early in tx and you wonder if it will feel like this the whole time. Good news is once you get on Procrit and stablize your HGB, you will feel a lot better, even if you have other sx.

[friole]

I just don't understand your doctors.  I thought you were on the Procrit by now.  I also cannot understand the waiting for a CBC tomorrow (the 17th?)  When you get your CBC will you get the results immediately?  I do - I wait about 10-15 minutes and they print one out for me.  Don't wait for the doctor to call you - see if you can wait and get a copy right at the lab then you can call the docs.  I hope you are getting copies of all of these reports too.

I hope you start feeling better.  I cannot imagine going as low as you are and hope that you can get on the PRocrit soon.
frijole

[painterlady13]

Thank you all for your support and well wishes.  

NY - no I don't want a reduction in my meds either.  and will tell the nurse at Specialist's office that yet again.

Frijole - wow I didn't know I could wait at the hosp lab for results I will do that tomorrow when I get that done then maybe I can start taking the procrit tomorrow as they told me not to take it on injection day.  

PLN - doing better since last night but not yet back to norm Don't know if i will be or is this the new norm. Friday the 18th will be 4th shot.  I think my body is just getting used to TX and maybe really fighting the virus hard.  At least I hope so.

[pln]

Sorry to here this, can you tell me what week you are on. Thank you.PLN

[friole]

Now there's another misconception - not taking the Procrit on shot day.  I have done it.  True, you don't want to stack your shots too much, but it won't hurt anything. You aren't supposed to take Neupogen on the day you do INF because they counteract each other (INF killing white cells, while Neupogen is trying to build them)  But the Procrit -- you need it because of the damage the ribavirin does.  I guess they can't tell us to take it on a day that we don't do Ribavirin, so we just have to take our chances in them couneracting each other but the difference is probably that serum level thing (that ribavirin builds to a level amount in your blood over time and stays constant).  Anyway, I have done Procrit in the morning and Pegasys in the evening without any problem (I don't have shot reactions, tho).

I get my labs done in the oncology department at the hospital which is where the hemotologist office is.  They are very quick -- not as quick as FL guy got his - but I usually walk out of there in 15 minutes with them.  Now when my GI orders a CBC I have to get it at Labcorp and those dodos don't get him the results for DAYS and I can't get them immediately.  I hope you can, at the hospital.  Good luck.
kathy

[sfbaygirl]

Interesting fact about the Neup and Interferon. Last time I got the neulasta I had my shot about 20 hours after the Peg. Someone here told me not to take it within 24 hrs, but the dr. didn't blink when he gave it to me. Thanks for that info. It makes much more sense now.

[tulsatime]

I am so sorry you having to go through this. Feel better soon!! God Bless, Debi

[NYgirl]

I had a 6 point drop and it does take a while for the Procrit to work - the blood these days is well tested and if I needed a transfusion I would get it.

I know how you feel and it's got to be horrible...just DONT let them give you a DOSE REDUCTION no matter what you do (unless you absolutely have to in order to stay on treatment of course I guess).

[painterlady13]

I will keep you all posted thank you,  the Procrit is on it's way should be here today but now specialist says to wait on taking it till cbc comes back.  Still feel dead just not quite as bad as yesterday.  

[Mister beagle bailey]

Good morning,  No having a transfusion doesn't lower your chance of SVR, what it does is help you stay on full dose of meds.  I was on procrit since my second week of tx and still needed 2 transfusions, but I completed tx at full dose and still UND.  Please try and get on the procrit as soon as possible as it takes a few weeks to kick in.  With me it took about 5 weeks to kick in, but everyone is different.  I know how you feel, when I got my last transfusion my HGB was 6.1.  
Please let us know how you make out.

Beagle

[cuteus]

a few here have gotten transfusions and still SVR.
I can not believe they did not start you on procrit when they said! and now they are waiting for another CBC? what is wrong with these people? INSIST on the Procrit, period! it takes a couple of wks to work, so they need to act NOW! I am getting mad with this team of drs, they are acting like morons!