Back In The Saddle

On June ninth I began my new chemo, Eribulin. It is a very quick chemotherapy that is given as an intravenous push in just 5 minutes. While it is an easy chemo to receive, it has a host of side effects. The most common of these include low white and red blood counts, hair loss, nausea and peripheral neuropathy. 

A few days after receiving my chemo, I noticed a thick white coating on my tongue and my mouth and throat felt sore. I was extremely tired and very weak. I was not eating or drinking much and would vomit if I did. I found out that the thick white coating on my tongue was “thrush” caused by the chemo, and chalked the other symptoms up to the chemo as well. It was an awful week.

On June seventeen, Mark brought me to Dana Farber for my chemo treatment. I was so tired and weak I needed to be in a wheelchair. I felt terrible. I had my blood work done, and then proceeded to go get my treatment.

My oncology nurse came out to the waiting room to let me know my white counts were very low, and I would not receive chemo today. While she was speaking with me she noticed right away I did not look well. She brought me to get my vitals. My temperature was 102.2. Not good. Not good at all. My nurse called Dr. M and right away and they whisked me over to Brigham and Women’s Hospital. 

I had febrile neutropenia. In a patient with neutropenia, there is an abnormally low number of neutrophil granulocytes (a type of white blood cell) in the blood. Febrile neutropenia is the development of a fever, often with signs of infection in the patients with neutropenia. I won a wonderful five day stay at the Brigham.

I was first treated in the emergency department. I was asked so many questions by so many people. I remember being so tired answering these questions. In addition to the storm of questions, I was given IV antibiotics, fluids for dehydration, an EKG, and blood was taken for tests and cultures. When a room was ready, I was admitted.

I met with a doctor who asked more questions. When he left I met the night nurse. She explained I would be hooked up to two different antibiotics around the clock. I would also receive fluids, a lot of fluids. The nurse swabbed me for the flu and a couple of other illnesses. I finally was able to go to sleep.

That night I remember the nurse coming in quite often to change IV bags, take blood, and check my vitals. I wished I was home.

Morning came fast. An attending Doctor and interns came to see me bright and early. I didn’t realize how serious neutropenia was until I spoke with the Doctor. She told me I had hit rock bottom. Damn! I could have died! Mark and I will always be grateful we were at Dana Farber the day before, my nurse was quick acting, and the great care I got at Brigham and Women’s Hospital.

My days in the hospital revolved around getting my vitals checked every four hours, antibiotics and replacement of electrolytes. I was also treated to a blood transfusion (for low red blood counts) and a brain MRI. My white blood counts started to come up by themselves and the docs were all very happy.

Although I had many tests, swabs and cultures to find an infection, the docs think maybe my left index finger was infected. Weird? I never noticed anything until my first full day in the hospital, when I showed a red dot to the docs. It did get worse, and then better, during my stay. I was sent home with an antibiotic to take for a few days, just in case the finger was the cause of an infection. 

It was wonderful to be home and I felt great. Wally dog was happy to see me, and I him. I drove for the first time since the end of March. Whether it’s the chemo working, or all the antibiotics, fluids, blood transfusion, etc. I received in the hospital, I have not felt this well in months. 

After this ordeal, I was very nervous getting another round of Eribulin. Dr. M lowered my dose and I started giving myself neupogen shots to help keep the white blood counts up. I had my second dose of Eribulin four days ago. I am tired, I lost my hair, and my eyes are tearing.

Neutropenia is scary, but I feel better having a lower dose of chemo and taking the neupogen shots.  I also monitor my temperature very closely. For now, I’m checking it at least a few times a day. When you receive chemotherapy you’re suppose to monitor your temperature. Anything over 100.4 warrants a call to your oncologist. 

As for the side effects that I had after my first dose of Eribulin, were they due to the chemo? Low white counts? Infection? Who knows. I’m just happy to be back in the saddle again, as Aerosmith would say.