Platelet count & RBC?

[Chelee]

I just had my lab work & weekly herceptin this last Monday.(5-8-06)
I didn't get to see my oncologist again this time. Lately she seems to be too busy each week to see me? She leaves most up to my infusion nurse.

But this week I am a little concerned as usually the week I have JUST the herceptin I feel pretty good in comparison to the first week with the herceptin, Taxotere, & Carbpotin. This week SHOULD of been nice. I have been feeling SO FATIGUED and tired...out of the norm tired. Hot, cold, chills...you name it. I checked my Lab Work sheet tonight from this last Monday, and I see that my RBC is at 3.98...not too's low yet since the normal range is: (4.5-10.8) But still low just the same...and I do know it makes a difference in how I feel.


But I also found my platelet count lower then I have ever seen it since I started chemo. On Monday it was at 98....verses the normal range being: (150-450). If it was 98 on Monday....its probably even lower today? But I am NOT feeling good tonight at all. Kind of weak, tired, mouth is very sore, tongue sore, achy.

Does anyone know what they consider the "standard of care" as to how LOW they can let your platelet count go? I don't want to end up in the hospital...and getting a blood infusion. They have NEVER let my platelet count get this low. I usually check the day I am in there...but this one time I didn't.

Also I know the RBC isn't that low yet...but how low can they let that get too? Does anyone know? I have found out if I don't speak up and ask for things...I don't get much. (I was in the hospital already ONCE thanks to my first oncologist ignoring my counts...I don't want it happening again! I was in the TEN LONG DAYS...boy was I SICK!

Any help in this area I would appreciate. I am getting worried tonight because this is the first time my tempeture is getting up there. Usually I have a sub-normal (low) temp. But tonight I am just burning up...soaking wet one minute...and my temp is running at 99. 5, & 99.3...etc. Its never that high. Its not that far from the 100.1. Since I just had herceptin Monday...I would be right on time for a problem. I don't want to go to the hospital. I want to keep my temp DOWN.

I also notice this time I have a sore throat? But I notice that happens every time they let my RBC get low for whatever reason.

Help...anyone.

Chelee...

-- -------------------------------------------------------------------------------Stage IIIA, Her2/Neu 3+++, Er & Pr positive, 5 of 16 positive nodes, 9 of 9 on Richardson scale.

DX 12-20-05
Mastectomy 1-3-06
Started chemo in Feb. 06
Herceptin, Taxotere, & Carbpotin

[al from Canada]

Chelee,

If you have an infection your WBC will be elevated. Low RBC will cause fatigue because it is your RBC's that move the oxygen around. Often this is a result of low iron so I would check those levels as well.

About seeing your ONC, make this your priority. I get very rattled when I read posts like yours which almost imply that you know something is wrong but don't want to put people out, by requesting to see the onc. Do you know that it costs the same to see a nurse as it does the onc?

Demand attention from the expert!! you are sick and entitled to the best care available and the next time the nurse wants to play doctor, refuse! Tell her you are sick and you demand to see your onc! We have rfused treatment once just to make that same point. That really perks-up the treatment room!

I have always maintained that if you sit and wait for others to cure you.....it ain't happening. You have a life-threatening disease and if you don't get the best care.....you can answer that yourself. I would want to know why your temp is high, why the sore throat, why the low RBC and platelets. Don't Ask the right person and you will never find out the answers..... one of the problems with onc's is that some feel that they don't need to treat you untill you are really sick because they figure they can always pull you back (from the brink). Don't subscribe to this philosophy!

Good luck,
Al

[IRENE FROM TAMPA]

Hi Chelee-

In response to your question about your platelet counts -

I don't know what chemos you are on but of course some of them do make your platelet counts go down more then others since chemo affects our bone marrow and that is what produces our white's/red's/platelet, etc. Do you know what the count was before you started chemo? If they reduced drastically I would certainly ask about them.

You are not in a dangerous zone with 98, but I would certainly ask about them. I had a stem cell transplant back in 1999, and my platelets have never fully regained - they go up and down everytime I get my blood checked and I have even had liver surgery with them as low as what you have without any problems. I never receive platelet transfusion's but I always do keep an eye on them (as well as all of my counts) I never feel bad about asking questions. Remember, you are your own best advocate and know your body the best.

Good luck to you Chelee

[Kim in CA]

Chelee,

I too struggle with my blood counts, (mostly reds) and I haven't even been on any chemo since 2003. I had a stem cell transplant in 97, and chemos twice after that, so it will always be a problem for me. My platelets seem to stay around the 150-175 range, so you do seem a little low. I would definitely ask about this. I don't know if Aranesp helps with the platelets, but it definitely gives me an energy boost when I'm feeling anemic.

Take care, Kim

[AlaskaAngel]

It is good to keep an eye on your labs and get a feel for what is abnormal for you. As a general rule, when counts are off plus you have symptoms of infection while on chemo it is best to question until you get a good answer.

However, I'm thinking that it may be true that people getting traztuzumab may tend to run a low temp... and have drainage that would make the throat sore... can anyone besides Chellee who is getting it speak to that?
A.A.