how low is too low?

i just got my copy of blood test.
My question in how low is to low my WBC is 3.5
the RBC is 4.20 right at bottom of normal
my HGB is still good at 13.0
and PLT are down to 100
i know thw wbc is low and so are plt but what i dont know is how low is to low
i did shot 7 this week and i started taking celexa.
i have been feeling crapy but still doable
for those that remeber i was worried a bout work ihave taken leave, cant do my job safly when i am dizzy not worth the risk

THANK YOU IN ADVANCE
DEE

[GoofyDad]

The short answer is you're in good shape. Platelets and WBC could go to 30% of current values. Hope you're feeling OK.

[GoofyDad]

Haven't heard from my pal from the south in a while. Where is that girl????

[sparkie#2]

thanks,
i was pretty sure i already knew but i needed to hear it from some one else just to confirm
Thanks again
Dee

[fishdoc]

Yeah, and while we're at it, any word from Snook?  Hope his dad is doing OK.. I don't read all the threads, so I may have missed him... but it seems like he is absent without official...

sindog: my dad was born in tensleep, still have folks in worland, casper,....green river..

One week down, won't do the next shot until tomorrow, but I feel just great-probably better than normal cause I was so worried about how I was going to feel... hubby went with me to hold my hand through the first shot, sat there with me very attentively... he was being so good.  On the way home that little ole devil that rides my shoulder said "roll your eyes back in your head and twitch around a little......" but i'm older now and wiser and didn't want him to wreck the car... but dam that would have been good...

[Moniker]

I've had 10 HGB for many months now. The doctor says I don't need Procrit. I feel tired, and can't really do my work very well, and Procrit would help, but the doctors says no. Does it seem like a good decision the doctor is making? He says I'd have to fall below 10 HGB before he'd prescribe Procrit.

Bob

[Mister beagle bailey]

I was told the same thing that my HGB had to drop below 10, and I had anemia before starting tx.
A vial of procrit cost around $3500. and there is only 80,000 units in a vial, enough for 2 shots.  That's probly why they wait till your below 10.  Even though my HGB is 8.7 now and I'm worried about being taken off meds,I feel fine. I'm not tired like I should be, I guess it's because I've had thalassemia anemia since I was born.

Kalio-- You said the symptoms are hard to handle, do you mean with the anemia or from the procrit?

                          The Beagle

[GoofyDad]

My doc does Ins approvals at 11, and I started injecting at 10.5. I was actually lobbying against starting at the time - hoping I could wait it out. HA!

BB: Your procrit costs sound higher than what I've heard, which is about $600 or so for 40,000. But I don't know either way.

[Mister beagle bailey]

I was worried about the procrit and the ins. co. paying, so I ask the price in case I had to pay.  Couldn't believe it was so high, the range given was between $3,000. and $4,000 a vial so I avg. it's cost.

Does any one out there know the price?

             BB

[Mister beagle bailey]

I'll trade HGB with you any day. Those numbers are great, having a 13.0 HGB your doing fine.

                The Beagle

[Mister beagle bailey]

Just checked a few sites and you are right, also call my ins. co. to make sure. Someone a while ago on forum for cancer posted that as the cost.  The cost was broken down like this: 18 vials @ 20,000 units per vial cost $4726.77, the 18 vials = 9 shots at 40,000. units.  So the cost over treatment during tx can run between $20,000. and $40,000.  Depending on how much and how often given.  Some are getting 40,000 units every 5 days.

Sorry about that.  Hope all is well today.

                        The Beagle

[GoofyDad]

Looks like 'bout 500 buck-a-roonies.

http://www.drugstore.com/pharmacy/prices/drugprice.asp?ndc=59676034001&trx=1Z5006

[MissMiss]

Hello everyone!  

All this talk about Procrit made me take the energy to post.  I was trying to work a full forty week and actually did so for three weeks.  Custodial work cleaning an entire elementary school.  Just prior my hgb was just over 12 and was told to skip Procrit until I dropped below 12 so skipped for two weeks and worked.  

Well, hgb got down below 10 fairly quick and I was upped to 80 units of Procrit in one injection.  Had to quick working, couldn;t breath, walk very far, nausus(sp), lots of sides, bone pain bringing tears for hours and could only lay around.  No energy to even read the forum!  Two weeks since not working I am at 10.3. Platelets have gone from 70's to over 100 too.  Whoopee!  Still on one Neup per week

So, I think the magic number may be 12 and if ins. won't pay, maybe you can get help with one of the programs.

Also having some HR trouble at work.  Haven't told anyone and don't plan to till I am done.  But, I think they all think I am dieing.  I know from past experience their "How are you doing?"s are not heart felt but to protect themselves someway.  Need a bit higher blood numbers to really think it out as to how to respond to them.

Today is 23/48, 1000 Riba 1b,grade 3-stage 2, 38 years into this.  I can never remember anyone's name here so forgive me.  Brain fog is a real pain in the head.

Congrats to all posting good news and my thoughts to those with problems, hoping solutions are found.

Missmiss

[NYgirl]

Beamer...just roll it back and forth between your hands for a while...making it too hot might do something to negate the medication or something that we (they) don't know about...plus it sounds dangerous like you could possibly inject a sliver of the bottle if something were to happen.

Scary.

I just roll it back and forth until it's not COLD any longer...then inject SLOWLY.  Nothing is really going to make it a pleasant experience really = it's just the meds.

[friole]

sparkie - your counts do look good except for the platelets (but I am no expert there)  If goof says they are still okay, I would say you are okay there too.  

beam - have you read somewhere about putting the Pro in hot water?  I just set mine out in the bathroom about a half hour before I am ready.  That seems to work.

My hemotologist allowed me to start at 10.8.  I was wiped out at 11 and begged her.  My insurance co okayed it with no problem.  Now even with the Procrit, I have never been above 11.8 so, in answer to the question,Beam,  are you in for the duration, I would say yes.  I am on weekly CBC's - hate them, but it sure lets us gauge what is going on.  Have changed from every 14 days to 10 days on the P to try to get my hgb into the 12's, but it hasn't been long enough to tell.  I think it is important to find the right dosage and the CBC's will tell you.  You don't want to go too high -- it is dangerous.  The papers with the Procrit say you don't want the hgb to rise more than 1 (whatever the unit is) per week.

As far as the cost, my copay is $45 for 4 vials of 40,000 units. I asked the pharmacist to look up the retail, and it was $2100 -- so that falls in line with the $500 per shot.

For anybody whose doctor won't rx -- I was assigned a case manager by my insurance company and he is a gem. Can you contact your insurance companies to see if they have a program like that?  A case manager could work the ropes of the system tell you if the ins co would approve the Procrit.  Would your doc's approve it then?  

NYgirl -hahahahahah take more riba and make your hgb drop.   That is like some of the near death things I used to do in the old days .... the days that got me here.

[beamishboy]

my doc started me when i dropped below 10.5-hgb ... insurance is paying-below 12-and i think the cost is more in line with what gooffydad quotes.$500 or 600 per shot..still the stuff is gold..i immerse in microwaved hot, hot water in a cup do reduce viscosity;helped w/ trapped air bubbles&injection-plus it was nice&warm.....did 2nd shot yesterday,just waitin for some good results.....once you start procrit usually stay on til end of treatmnt? as my insurance situation is gettin restructured i'm little leary of adding $4ooo to my monthly trx costs...what are my chances of stoppin procrit before stoppin trx?? any studys?

[GoofyDad]

Whoa Beamster!

If it were my procrit, which of course it ain't, I'd be leary of dunking that stuff in hot water. Nestle the vial between the family jewels or something if you want get it marshmallow warm. Heck, wrap it up and shove it where the sun don't shine. But boiling water doesn't sound too safe to me.

'Course take all this with a grain of salt - I don't even remember reading the product literature at this point. Maybe that's what it tells you to do.

[beamishboy]

i use hot not boiling..How warm is too warm?? i just warmed it to maybe 110-did i mess-up???

[GoofyDad]

I have no idea dude. Didn't mean to alarm you. My threshold would be 98.6. But what-do-I-know?

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[NYgirl]

LOL Been THERE and done THAT!   ;-)

God it's great to have people who get it.....it really is!

[beamishboy]

thanks for responses to "heating procrit"-i suppose the intrnal temp wasn't over body temp-really!!- as it didn't feel like a hot shot,just not so darn viscous!!but i certainly won't do my little home remedy technique again...can i blame this on brainfog?or do i have to accept the fact that i am blunderin blindly towards SVR-thanks to this forum,i have developed just enuff attitude&knowledge to be totally dangerous-lol-"Not a physician cannot heal thyself"....

[felinesrme]

My dr's office just prescribed the Procrit and my hgb is 8.4, of course it is difficult to go from one room to the next without being out of breath.  The nurse did suggest placing the vile out for about an hour before injection.  Not looking forward to another injection, but if I can do something w/o getting out of breath it will be worth it.

My pharmacy prints the retail value on the bottom, for 4 bottles, the cost was $1,344.12 with my co-pay I paid $30.00.  Can't even imagine if I didn't have ins.

Take care

[Mister beagle bailey]

I know, I feel bad for any one who doesn't have ins. What do they do?  How many do they get treated?

      BB

[NYgirl]

The Epogen is slightly more expensive at about $6000 according to my pharmacy who did everything they COULD to get it approved for me. The insurance company just did not want to pay it.

Take an extra Riba or two...that way maybe the hemo will go down and you can get the Procrit!  hahahahahaha  

It makes no sense to make people wait till they are at 9.8 instead of 10 to me at all.  It needs to go by how FAST it drops and how a person is managing instead of just a static number. That is just ridiculous!

[cuteus]

that wasn't very smart of the doc to tell you to stop the Procrit completely! geesh!
he should have waited a bit longer until it got to 13 or so, and then space it to one shot every 10 days or every two wks.  Don't let him do that stunt again!

take advantage of HR's 'concern' and ask them to have your coffee ready and hot every morning.

I hope the Procrit kicks back in quickly, now it might take longer to get you back to 12, longer than the 2 wks it took to get you below 10!

[friole]

missmiss -Wow - that 80,000 just knocked your socks off.  (personally) it seems to me to be too much in one day.  You do physical labor.  That is a whole lot harder than working at a desk.  A couple of weekends ago I shampooed my livingroom floor, and then had to take a nap and was wiped out most of the day anyway. So, I understand why you had to stop working.

I have told no one at my office except my partner yet I know some suspect.  Some days I think -- what the heck, I will just tell them all, and other days I think, I've gotten this far (#32) why not just go the distance -- so I hear ya.

I hope your hgb levels out soon.

felines - oh you poor dear - I am so sorry they let your hgb go so low.  It will get better once the Procrit kicks in.  I didn't want another shot either, but am so glad that it is available, because it does help.  hahahahah - the "secret" compartment on the door of my fridge that my hubby used to keep his garlic in is sooo full with my injectables, there is no room for the garlic (don't want it tainting my shots either).  Procrit burns a bit going in but it is still better to do it slowly.  When will you start?

NYgirl --- somehow I missed crossing a few lines......