What Do I Do Now? - 54

54
SIDE EFFECTS AND SYMPTOM MANAGEMENT /// CHAPTER 37
Infections:
Low white blood counts make you more vulnerable to
infections. These can occur in one place in your body (for
example, an infection of your lungs is pneumonia, in your
intestines is colitis) and will cause symptoms in that area.
If the infection is in your blood, it usually causes more
generalized and serious symptoms.
What affects my counts?
Chemotherapy and radiation can temporarily hurt your
body's ability to make new blood cells. This means that
as your current blood cells die off there are not enough to
replace them. The doctor will order a blood test called a CBC
(Complete Blood Count) to see if your body is low on any
type of blood cell.
The good news is that we can give you more platelets
and red blood cells through your IV in a process called a
transfusion. Usually, we wait for your body to make more
white blood cells on its own, but sometimes the doctor will
give you a medicine that helps your body jump-start that
process. As you go through treatment, your doctor will tell
you more about when and why they will give you a blood
transfusion.
What if my religious beliefs make it
not possible for me to have a blood
transfusion?
This is important information that you should share with
your doctor when you plan for treatment. There are other
options available to you, but early planning is key to keeping
you healthy.
When to Call the Doctor:
» If you have a fever (ask your doctor what magic number
they consider a fever - it's usually around 100.5).
» If you have any signs of Low Counts listed above.
» If you have any concerns.
Sepsis is when an infection starts causing a lot of stress
on your important organs like your heart, lungs and kidneys.
When those organs don't work well, your blood pressure
drops and a cascade of more vital functions shut down,
including making urine, breathing and thinking - a good
thing to try to avoid by treating infections early.
Yeast or fungal infections include thrush, which is a white
coating on your tongue or inside cheeks. More serious
fungal infections can happen especially in patients with low
counts for a long time. Fungus is everywhere, but especially
in soil.
Viral infections include cold or canker sores (caused by a
type of herpes virus.) These are pretty easy to catch from
other people. If these sores happen in your esophagus, it can
be painful to swallow, making it hard to get the nutrition and
fluids you need. Other viruses frequently cause infections in
the respiratory tract (your sinuses, throat and lungs); a " cold "
is usually a viral infection.
We carry bacteria around on our skin, in our mouth and
in our guts all the time, and when counts are low, these
bacteria can get out of control and cause symptoms.
Bacteria are also left behind on surfaces by other people
(table tops, cups, bathrooms.) There are many different
types of bacterial infections but they often respond well to
antibiotics.
When your white blood cell count is low (ANC below 1000,
typically 7-12 days after chemo), it's especially important
to do what you can to prevent infection (see chapter 56 and
57) and to notify your team early so that they can prescribe
medications as needed.
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