JmJm question about my labs

[snowbyrd]

Hi Jim I have posted a few times to you about my Labs I'm having a real problem deciding if i want to do these neupogen shots. The DR has been monitoring my blood weekly. My Nuetriphils are steadily on the decline now they are 0.7 they want me to start the shots. I know that you have let yours get a lot lower and mine were 0.5 a while back went up for one week and now they are going down 1 to 2 points each week. Not only is my ANC dropping but so are other things.

WBC 1.6
MCHC 309 high
platlet counts 67
Lymphocytes  0.7
My RBC has abnormal morphology.

I Guess my question is...I only have 5 shots left. I'm doing the short course. 16 weeks total. If things are declining this fast do you think i can do it without rescue meds. The Nurse is already telling me i cant go out in public, because of bacterial infection, eventhough i have kids that i'm sure bring things home from school, and a husband who is a firefighter and deals with sick people every day. They don't want me to bruise or use cutting utensils....what the heck is going on? Should i be concerned and just do the shot. I'm terrified of more meds. I'm so sick now. And after last nights shot my heart was doing some weird beating.   I Have to back to see the specialist tomorrow and i feel like i can do this without the rescue meds. Is this being unrealistic? How Much danger am i putting myself in? And i don't thing the Neupogen does anything for platelets anyway, does it? Thanks Jim Sorry I'm so long winded.

[jmjm530]

Having no medical degree and no access to your medical records, etc, all I can do is share my experience and those of some others who have posted here. My ANC was below ".7" for much of treatment and I was never prescribed Neupogen. As stated previously, ANC can bounce up and down a lot. One week mine was 320, two weeks later it was over 1000. No Neupogen taken. My doctor rarely intervenes with Neupogen and waits until ANC is around 200-300 and stays there.

As to not going out in public, I was never cautioned about this, and in fact, some newer studies suggest that Neutropenia (low WBC) is not associated with a higher infection rate in those treating for HCV. In fact, one fairly recent study that measured several levels of low ANC down to 500 states "It was found that patients who developed neutropenia during treatment of chronic hepatitis C virus infection with a combined therapy based on pegylated interferon-alpha2a plus ribavirin did not show a higher infection rate or increased severity of the disease."
Abstract here: http://tinyurl.com/qjtfz  You might want to print this out and bring it to the attention of your treatment team.

Can't comment on your heart issues but possibly that's from low hemoglobin, not sure because you didn't post.

-- Jim

[snowbyrd]

Thanks Jim, My hemoglobin is ok. I'm going to look at that website. I just want to hang in there for 5 more weeks. Thanks for your support as always i appreciate your experiences

[FlGuy]

If you go in the direction of neupogen there are a couple of things to keep in mind. First, in my expereince, neupogen did not cause me any discernable side effects and I've never read where use of neupogen in any way adversely affected the effects of the tx meds.  Neulasta (the pegylated version) can come with more pronounced sx's than neupogen.  Second, Neupogen is pretty fast acting and will raise the anc's in sort order. Again, in my expereince, use of neupogen was on 'as needed basis' and the need was every few weeks - not every week.  So, it's possible that if your doc's suggestion to use Neupogen you might find that with only 5 weeks to go it might be a one-time kind of thing anyway.  I think that you mentioned before that Mr. Snowy's insurance coverage was ample so I expect that cost is not the issue for you.  Good luck in whatever you decide.

[snowbyrd]

I already have the neupogen i have had it for 3 weeks, but my wbc and nuets went up for 1 week so they told me to hold off then steady my bloodwork has taken a dive. I just was told that i need to take it evey week, but i think i  will bring up both yours and jims ideas at my appointment tomorrow. Thank you for posting you made a good point, if i only had to do a couple of shots i might be ok with that. Thanks again.