Celebrating The End Of Chemo Week With A Shot

No, unfortunately this is not the alcohol version served straight up in a shot glass.  This is a shot of Filgrastim which is poked right into the arm and served in a syringe.

Matt just finished his week long chemotherapy treatment.  For the most part he is doing well physically but is a bit fatigued from 15 hours of treatment this week.  There’s also some random nausea that comes and goes. It’s really a chemo side effect roulette each time. You never know what to expect. With this particular chemotherapy though we can expect his white blood cell to take a hit sometime during the following week, but hopefully we can avoid side effects from that this time around.

White blood cells are measured in ANC (absolute neutrophil count) .  A normal ANC count is somewhere in the 1500 range.  One is considered neutropenic (low on white blood cells) when the white blood cell count is below 1500.  One is severely neutropenic when the count drops below 500.   After the last time Matt had this treatment his ANC count was a 0.  You read that right.  A goose egg.

Why does this matter?  For Matt, when his white blood cell count drops too low he gets a lot of random pains.   Last time he had severe rear end pains, teeth pain and mouth sores for days which led to several trips to CVS for some relief.  It was a real pain in the rear end both literally and figuratively. The body does eventually produce more white blood cells but you play the long game to get numbers back up.  This is where Filgrastim comes in.  Filgrastim is an injection used to treat neutropenia. It helps the bone marrow to make new white blood cells. The last round of chemotherapy our oncologist had us do 10 consecutive days of this shot following chemotherapy.  The problem is that even with all those shots it still took a while before ANC came back and pains disappeared.

The other problem having a very low ANC is the risk of infection.  Your white blood cells are the immune system army that fights on behalf of your body to ward of colds, flus, covid and any other disease floating around.  When you have a low ANC you basically have no army to fight your battles.  If you catch any of these types of viruses you’re at a high risk of infection.  In fact we are told by our oncologist if at any point Matt gets a fever over 100.5 you go to the ER.  Directly to the ER.  Do not pass go.  This is a big reason why we need to avoid crowds in our daily lives.

This time around we are going to try (once again) one megadose shot of Filgrastim instead of many small shots.  The hope is that this megadose shot will be enough to get ANC numbers back up more quickly and keep away other random pains.   We did try this type of shot about 2 years ago and it did shoot ANC up real quickly.  However, it led to back pain so severe for Matt he was bedridden for two weeks.

This happened because when Filgrastim is released in a big dose it sends a message to your immune system. The immune system ends up overreacting to the presence of this megadose shot in your body and releases a truckload of histamines.  Overabundance of histamines then causes inflammation which leads to severe bone pain which in Matt’s case was in the back.

So what are we doing different this time to hopefully avoid this?  Claritin.  Yup, the allergy medicine.  Claritin is an anti-histamine.  Matt started taking it daily over a week ago.  The thought is that once these histamines start flooding the zone there will be enough anti-histamines in Matt’s body to counteract it.

We’re hoping it works this time around. Giving Matt those daily shots was nerve racking preparing and injecting.  And Matt was looking like a pin cushion by the last shot.  One and done would make things much easier.