Hi Lorraine,
Sorry to hear about the reaction to the chemo. My Mom's history was very similar and also very different.
After the second round she had a similar exhaustion and her WBC was about 3500. Now the one thing the oncologists do not always mention is the ratio
of viable, healthy cells to cancer cells. My Mom was around 40000 count after 1st round, but the ratio was not good. Only about a 15% of these were healthy cells.
After the second round about 25% were healthy (so around 850) - it was a tough time for her. She did not have to go to the hospital right away. We really had to force her too eat
and keep hydrated. In her case fruit really came to the rescue along with vitamin water dilutes to 50% and an Ensure-type supplement. I was watching her diet as carefuly as
she would allow. Now my Mom had a host of skin problems that followed - the diagnoses ranged from who knows to scabies. Eventually her fever began to be consistently high
finally peaking at over 103F. There were several doctors involved in her care and they just shuffled her back and forth - one would prescribe an antibiotic and the next would change it or add to it
She had her treatment changed about once a week. Finally she had to be admitted because of the fever out of control and it was difficult to heep her eating and hydrated.
There were 2 huge issues. The first was the lack of concensus among the Dr's. The only one that was adamant (the dermatologist) said this is a reaction to the chemo. This was emphatically
denied by the oncologist when I said I had read about a reaction, and basically told me that I did not knopw what I was talking about. The infectious disease guy at least listened when I asked about
Multiple Drug Hypersensitivity (which he had never heard of) and asked if I read it "on some popular public website" and cautioned me against "inacurate information ciculating on the internet".
He was surprised when I cited the JIACI - Journal of Investigational Allergology and Clinical Immunology article http://www.jiaci.org/issues/vol15issue04/9.pdf
So I went home and id my research on the Teanda website and printed out the information supporting my claim - right there on the first page.
The lack of agreement by the doctors and the past couple of weeks of constantly changing antibiotics, corticosteroids and a couple of topical Rx had compromised my Mom's ability to cope with all of the rollercoasting of chemicals. MDH - Type B reactions are hypersensitivity reactions that are unpredictable and not dose-dependent. They lead to objectively reproducible symptoms or signs at a dose tolerated by normal people.3 Type B reactions comprise about 10%–15% of all ADRs. Drug allergies, which comprise 5%–10% of ADRs,4 are hypersensitivity reactions that involve an immune mechanism (IgE- or T cell-mediated, or, rarely, involving an immune complex or cytotoxic reaction). All other hypersensitivity drug reactions without an immune mechanism (5%–10%) — or in which an immunological process is not proven — are classified as non-immune (or non-allergic) hypersensitivity reactions (Box 1).3
She did not get better the first 2 days in the hospital - then second day her fever was worse than ever even though she was on constant IV antibiotics. After I read the article about hypersensitivity and confronted the Dr's, her oncologist called then nurse and asked her to discontinue everything except the medication - oral for her itch. IN 12 hours her fever was gone, and she was eating and drinking very well. After 2 more days on no or little fever she was released. She has not had anymore chemo.
The next day the oncologist came in and retracted his statement sbout the Treanda and its effect on her skin, but that the fever was something else. The infectiuos disase guy came in and said that yes it was likely that my mom had MDH. She did quite well for a week or so, and then again having skin issues - another round of Dr's appointments and again she landed in the ER. Again admitted - this time for an infection/cellulitis on the trigeminal nerve next to her eye which caused Bell's Palsy and and outbreak of shingles (her 2nd in 2 years - the first episode was attributed to a reaction to antibiotics.
The second critical issue is communication. I watch the Dr's dealing with my 80 year old mother. They treat her with patronizing tolerance. Like THEY are doing HER a favor. She tries to tell them what SHE is feeling, how here body is reacting. Only one of the 7 doctors that have been treating her actually listen. Nor do they seem to really communicate among themselves, and if I do not hound them or go to every appointment with my mom they don't seem interested in my concerns.
Why am I telling you all of this ...
The Treanda did well vis-a-vis then WBC, but the complications were close to devastating. My Mom's oncologist has agreed that she cannot have another round and basically said he has exhausted any treatment plan, so hopefully her numbers won't climb because he won't be able to help her (he has since been fired by us). Explore the Teranda website http://www.treanda.com/
Ask for copies of his bloodwork and do some research. Not everyone agrees on what blood tests actually mean. My Mom's oncologist basically looked at WBC and the proportion of cancer cells to healthy cells, but I had to ASK every time about neutrophils and eosinophils. When they tell you this is an infection - then why is the WBC staying constant? This is an allergy - then why aren't the eosinophils elevated? I don't know what else is going on with your husband - one would thing the cavities would raise the WBC - but - in my Mom's case the antibiotics were actually getting in the way of her bodies ability to get going on its own. You probably already know that everytime your husband gets chemo it is like the first time. Nothing stays the same and the environmental and emotional factors are constantly changing. The latter is so volatile and I watched my mother sink into deep despair when there would be periods of no improvement. Also the time treatment is scheduled is important. Our Dr. wanted to stick with every 21days no matter what - we did have to say re then 2nd round that she was still to week and made him delay. I can definitley say that the knee-jerk to prescribe massive amounts of antibiotics is rampant and has done my mom more bad than good.
I hope some of this helps. At least know that you are not alone. I have learned the hard way that you have to press and stand your ground. If are not getting then treatment and response you think appropriate, ask for the hospita's Patient Advocate or Quality Assurance person - you will not a definite difference in bedside manner. Prayers and positive energy to you and your husband.
