Infections – The Ugly Side Effect of Chemotherapy

triage-cancer-blog-infectionsWe are all familiar with the common cold, flu and ear aches.  These are all infections – either caused by bacteria or viruses.  Sometimes these infections need to be treated with prescription medicines, but often times our body just gets over an infection.  This is because our miraculous bodies have a built in protection called white blood cells.  When we develop an infection, our immune system produces more white blood cells to fight the infection.  This is the process in a typical, healthy person.

Unfortunately if you have cancer, you are not a typical, healthy person.  On top of the cancer itself, the treatment of cancer can make you sick.  Chemotherapy, while it may be saving your life, can also be putting you at risk of contracting an infection.  Chemo is a powerful drug that goes into your body and kills the fastest growing cells in your body – the good and the bad cells.  So the chemo kills your cancer cells, but it also kills your white blood cells.  Remember, white blood cells are the things you need to fight infections.  Generally, you will experience the lowest white blood cell count 7-12 days after your last chemo dose, and it could last for up to a week.  This period of time is called your “nadir,” meaning lowest point.  At this point you are at the greatest risk of getting an infection.  During this time you need to be extra diligent in protecting yourself against, and watching for signs of, an infection. Infections during chemo can be life threatening and may delay your ability to receive your next life-saving chemo treatment.

What are the signs of an infection?

Fever is the number one and most serious sign of an infection.  Take your temperature anytime you feel warm, flush, chilled or generally unwell.  At your nadir you may not be able to fight this infection on your own, so you need to call your doctor if you temperature is 100.4ºF or higher for more than 1 hour, or a one-time temperature of 101ºF or higher.  Seriously, night or day, call your doctor.  Make sure you:

  • Keep a working thermometer near you, and know how to use it.
  • Keep your doctor’s phone number with you at all times. Make sure you know if there is a different number to call when the office is closed.  Do not hold out through the night, waiting for your doctor’s office to open.
  • If you end up going to the emergency room, tell them right away that you are undergoing chemotherapy. You cannot wait around in a germ infested waiting room while your infection is left untreated.

Other signs of infection include:

  • Chills and sweats, with no fever
  • Change in a cough, or a new cough
  • Sore throat, or mouth sore
  • Shortness of breath
  • Nasal congestion
  • Stiff neck
  • Pain when you urinate
  • Unusual vaginal discharge or irritation
  • Increased urination
  • Diarrhea and/or vomiting
  • Redness, soreness or swelling near surgical wounds or ports
  • Pain in the abdomen or rectum

If you experience any of these signs or symptoms you should call your doctor immediately.

Can you reduce your risk of infection?

Every school age child knows that you can avoid a cold or flu by washing your hands.  As a cancer patient receiving chemo, you need to be absolutely obsessive about this.  Good old soap and water are the best choice, but hand sanitizers are a good second choice. You should wash your hands:

  • Before, during, and after cooking food
  • Before you eat
  • After you go to the bathroom
  • After you change a diaper
  • After you touch your pet, or clean up after your pet
  • After touching the trash
  • Before treating any wound

Beyond washing your hands, you should also maintain good oral and body hygiene, use disinfectants to keep your household clean, avoid coming into contact with sick people, and try to avoid getting scraped or cut.  You should also avoid undercooked or raw meat and eggs, avoid unpasteurized or raw products, and wash your fruits and vegetables really well.

Undergoing chemotherapy is uncomfortable enough without getting an infection.  Be overly observant and very, very clean and you can minimize your chances of getting infections.

Medical Marijuana: A Post-Election Update

medical marijuanaOn Election Day, voters across the country showed they were in favor of legalizing medical marijuana, and in some states, recreational marijuana as well. California, Maine, Massachusetts, and Nevada voted to legalize the recreational use marijuana, while Arkansas, Florida, and North Dakota passed ballot initiatives legalizing medical marijuana.

Marijuana, whether used recreationally or for medical reasons is still illegal under federal law. However, over the last few years, the federal government has opted to let states pass laws in this area and not to prosecute people who are following those state laws.

We have posted previously about the laws related to medical marijuana, which you can read more about here.

President-elect Donald Trump has nominated Senator Jefferson Sessions for Attorney General of the United States. If confirmed, it is likely that Senator Sessions will take a different approach towards state laws on medical and recreational marijuana.

To learn more about Senator Sessions’ views on marijuana, read this informative article: http://www.politico.com/magazine/story/2016/12/jeff-sessions-coming-war-on-legal-marijuana-214501.

Cancer-Related Fatigue – Fighting Those Zzzzzs

Triage Cancer FatigueHas your treatment left you feeling unusually tired? If yes, you be experiencing cancer-related fatigue.

What is cancer-related fatigue?

Cancer-related fatigue is a persistent feeling of physical, emotional, or mental tiredness or exhaustion related to cancer and/or its treatment. Some of the symptoms include:

  • Feeling tired and it not getting better, it constantly returning, or it becoming severe
  • Being more tired than usual during or after an activity
  • Feeling tired with no relation to any activity
  • Putting less effort into your appearance because you’re too tired
  • Being too tired to do the things you normally do
  • Having no energy and/or feeling weak
  • Feeling tired even with sufficient rest and sleep
  • Spending more time in bed and/or sleeping more
  • Staying in bed for more than 24 hours
  • Not being able to concentrate or focus your thoughts
  • Having trouble remembering things
  • Becoming confused
  • Feeling tired and it disrupting your work, social life, or daily routine
  • Feeling sad, depressed, or irritable
  • Feeling frustrated, irritable, and upset about the fatigue and its effects on your life

What causes cancer-related fatigue?

There are several factors that can contribute to cancer-related fatigue. Some of the causes include:

  • Cancer treatment
  • Anemia
  • High/low hormone levels
  • Loss of appetite
  • Dehydration
  • Lack of exercise
  • Anxiety
  • Depression

 How is cancer-related fatigue treated?

The first step in treating fatigue is to identify the cause. If the cause is not known, you may need to try several different methods in order to figure out which one works for you. Staying physically active can help both manage fatigue and improve strength. Over time, try to build up to 150 minutes of moderate activity (walking, cycling, swimming) per week. You can also add in strength training exercises. Make sure that you are staying hydrated, by drinking enough water.

A psychosocial care professional (e.g., therapist, counselor, social workers, psychologist, psychiatrist, etc.) can help provide you with emotional support, which may alleviate your fatigue. Many patients have also found that acupuncture and yoga can help. Cancer-related fatigue can persist months or years after treatment, so it’s important to receive both short-term and long-term care.

Although common among cancer patients, cancer-related fatigue is not something that should be taken lightly. It is important that you talk with your doctor, or other members of your health care team, if your fatigue is affecting your health and well-being.

For more information on cancer-related fatigue, click here.