WBC low already, is this normal?

[Chelee]

I am so new to all this...but I read that usually after your first chemo they will give you Neulasta to keep your WBC up. My first chemo was Herceptin, Taxotere, & Carbpotin. Well the following week he checked my WBC & said it was low. But didn't do anything about it? But that 2nd week I was only having Herceptin so I thought maybe that is why he wasn't as concerned. I know they worry more about the Taxotere it seems.

So now...this is my 3rd time down there as of today...and I ONLY got the Herceptin again. I did see my ocologist PRIOR to infusion. He had all my lab work that I did this morning. But obviously didn't look at it hard enough because when I got home after my infusion of Herceptin...he calls me and says he didn't notice but my WBC is down. I said you told me that last week. He said yes..and went on to explain this is different...something about my ANC WBC? I am lost. Don't know what he means. But he said they don't like it to every be under 1000...and mine right now is 116. So he told me my surgery for my port which was scheduled for this week is canceled as he is concerned about infection. And he always wants to cancel my NEXT infusion which would of been ALL THREE drugs again, verses just the herceptin. Which I feel that would of been important.

Why didn't he notice this when I was right there in his office...he had my lab work. He was looking right at it. Then he says "I did write you a prescription for a antibiotic didn't I"? I said, "No". So now he wants me back down to his office tomorrow to get a shot of Neulasta....which will be my first shot of that. Then get a script of Cepro. (Antibiotic) just in case I get sick. He said if I get a fever or infection to call him right away.

I am frustrated that he knew the FIRST week my count was DOWN. He told me so. But I don't understand the difference he is talking about when he said my count the first week was 2.4. Verses the one he is talking about today...that ANC...which shouldn't be under 1000...and mine is 116?

Is this unusal to have my count down this low after only one REAL infusion of the three drugs...and the following two only Herceptin. Shouldn't he of given me a shot of Neulasta after my FIRST infusion of Herceptin, Taxotere, and Carbpotin? I read that is how its usually down...but I dont believe everything I read. But why did he wait so long with me?

Now I am sitting her concerned I am going to get real sick. Heck, after my herceptin infusion today I went out to eat at a breakfast place. And the first thing he said is don't be going out any place...especially fast food. (Hello...too late...no one told me my count was that low until AFTER the fact.) I have been busy all week here at home...now they say I am at real risk of getting sick. Is all this normal...shouldn't he of caught this sooner!

Shouldn't I of had the Neulasta the first time he saw my count down. Can any one shed any light on this. Maybe its all normal? But I asked him if this was normal...and all he said is my bone marrow is very sensitive. (I am not buying that.) I think it was a geniune over sight on his part and he caught it after the fact. (I could be wrong...but now I am really worried about getting sick.) I don't want any hosptial visits. Plus this has put off getting my port and my next infusion.

Do I need to wear a mask at home or what? They never tell me anything it seems. What do I need to worry about? I wash my hands alot...but do I need to change all my bedding and not touch my dogs...what?

Has anyone been through this..especially this EARLY into treatment? Thank you.

[MCS]

The infusion nurse, not the onc, told me that wbc fluctuates a lot. Even within hours.

when i had low wbc, I was scared also. The neulasta should kick in soon. For me it was around the 7th day after chemo.

Stay home, don't come in contact with sicky cold folks. I had to do that too. Keep hand gel handy if you have to go out.

they will probably do the port in between chemos, once the wbc is up. don't despair. the herceptin can be given anytime, weekly or in three weeks span. the chemo does not disappear, it keeps kicking in all the time

MCS ( Maria)

[AlaskaAngel]

The "2.4" is an abbreviated form of the white blood cell count, meaning "2,400", so it sounds to me like your count was 2,400 at that time.

The "ANC" (absolute neutrophil count) is different. It is a number that is calculated by a formula that is applied to the blood cell count. Below 500 is sort of a breaking point where they start to caution you to be more careful, so 100 does mean you need to be careful, for example staying away from anyone you don't really need to see, not doing any cleaning for example, no gardening because of the contact with dirt, and for the time being even see if you can avoid the dog. You want to do everything you can think of to avoid infection so that you don't end up sicker or end up delaying treatments. Mine got down to 300-400 most of the time and I chose at the time not to get Neupogen and my treatments were delayed because of that but I did not get any infections.

AlaskaAngel

[Alice]

Your white counts will go up and down. If I remember right they should hit bottom at about day 8-10 and then start to go back up.I landed in the hospital after my first chemo on day 7 with a ANC of 15 and a fever of 101 had serious IV antibiotics and had to be in isolation until my count hit 1000 .It didn't take as long as I thought it would only 3 days. After that I was nutropenic after every chemo. If your onc seems to be not paying attention to your counts make sure you ask every time.

Sometimes they can be low enough to delay chemo and other times they may just be low but within acceptable range.
If in doubt ask ask ask.

Good luck, Alice

I have severe problems with my blood counts -- white and red. First round I didn't get the neulasta shot but ended up getting a series of 5 neupogen shots. Now after 3 rounds of chemo (A/C) my oncologist automatically gives me a shot of neulasta and I end up getting a shot of procrit every week. Hang in there. Remember, chemo has a cumulative effect.