Low Platelets

[boxhill]

Despite feeling great, I wasn't able to be infused for Round 4 today. My platelets had sunk from 104 last time to 63. My WBC has gone down to 2.4 (I started out at 2.9), but it's the platelets that have taken a nose dive from a starting point of 179.

I told them I wanted to power on through if at all possible, but the oncologist said no way. If the platelets went down further after this treatment I could be in serious trouble. So my infusion is being put off for a week, and they are considering reducing the oxaliplatin dose going forward.

I'm frustrated, and worried that I won't derive maximum benefit with a lower dose. But it appears that there is basically nothing I can do to bolster the platelet production.

[DebZ]

My new norm for platelets is low 50s and I still get chemo. My oxali is around 60 to 70 % strength, and we have to stretch it out to every three weeks. We've been tossing around different things to try to get the platelets up because it's a real concern. Disqualifies me from some trials.

[boxhill]

And this week it's neutrophils! Down to 0.7, won't treat under 1.0, afraid chemo today would push it below 0.5 and I would be open to potentially serious bacterial infections. I'm willing to risk it, but my oncologist isn't.

My platelets are back up to 175, my hematocrit has just edged up into the normal zone for the first time at 34.6, and Hgb is the highest it's been, at 11.8. The ANC was probably even lower last week, I'm told, which may be why I had a sore throat starting Thursday that went away on Monday.

Now the plan is to go back Tuesday and hope it has recovered enough. I'll receive a prophylactic shot of Neulasta on Thursday when they remove the pump. He plans to reduce the dose of Oxi, and/or possibly the bolus of 5FU. My bone marrow just isn't cooperating.

I am SO frustrated. This means I will have missed a full 2-week cycle. And I feel fine. I get all geared up for the infusion and the pump, go in, and nada. I'm trying to be philosophical, but failing. It is such a roller coaster.

[Aqx99]

I know how you feel. My final cycle of chemo had to be delayed twice because my platelets were too low. The first week they were at 78, the second they dipped to 69, then when I went back the third week they were just at 100.

[mobrouser]

I have posted here previously about my platelet and neutrophil issues. My oxaliplatin was reduced to 90% for round 3, and has been at 75% since round 5.
I just completed round 9 last Friday and I am 6 weeks behind schedule because of low counts. It is a constant in the back of my mind that all of this could be increasing the potential for mets to develop.
I console myself with the fact that I started off with no mets, and have done everything the doctors have asked of me to get through the treatments.

Prior to round 8 I was prescribed Grastofil, the generic version of Neupogen, to help with my neutrophil levels as even with the oxali reductions my platelet and neutrophil levels were tanking each round.
I give myself daily injections for 7 days following completion of each round. One of the side effects is bone pain. I was pleasantly surprised to find that so far I have not had any.
The preferred injection site is the lower abdomen, but I have been doing it in the upper thigh area and found that the skin there is less sensitive so there is no pain inserting the needle.
I am also on daily blood thinner injections, even with my platelet issues, so my abdomen is so sore from 6+ months of those daily injections.
But I have to believe that I will get through this with flying colours. And you will too!!!

mob

[stu]

My mum had reductions , delays , the lot . It sill worked . Keep on going !!
Stu

[lovelife789]

hmm... I kept revisiting this thread, many times I wanted to share my experience but hesitated thinking probably people is not gonna believe me. BUTT, oh well, even if one person believes me and I can help that ONE person, it's all worth it.

So, I did 13 rounds of FOLFOX, full dosage of Oxi. I never missed one round, I got all my treatments on time - one time my platelet count was at about 55 just three days before infusion and the doctor wanted to put a hold, but I got it back up on the infusion day to 110. I also didn't get any shots to help get my counts up. I really didn't want anymore needles and side effects. Starting round 3 my platelets started to drop and by the 9th round, my WBC went down as well, but they never gone down to the point they would delay treatment. I was able to keep my platelets up with a tea that my mom made for me at home, nothing funky but the ingredients are not that easy to get.

I'm Asian, so the recipe we had was peanut skins (not the peanut, if you put in peanuts, you get a nasty oil layer on top of the tea and you don't want that) with black dates. The question from folks in North America may wonder where do you get the peanut skins? Well I ran a search on Amazon, and I found a few shops selling them. I emphasize NOT the WHOLE peanut, just the skin and better not buy a whole bag of peanut and peel the skin off, just not worth the time. And you also wanna order black dates from Amazon. You put in a FULL adult man palm size of peanut skins with 5 rice bowls of water with about 10 black dates (better slit it on the sides to give it more flavor), bring it to a boil and let it on medium heat until it looks like there's only one bowl is left.

Drink it once everyday. If you put enough dates, it won't taste bad. It is tiny little bit bitter which is often covered by the sweetness from the dates. I personally did not really believe in it, I just drank it to calm my mom down... until my platelet went down to 55 and I got it back up to 110 in 2 days drinking two bowls of this tea daily.

So here is my sharing, in case there's anybody who wants to give it a try. Both are edible stuff so it's nothing that will hurt you. The worst is just not working as well in you as it did in me. It mainly works for platelets, WBC was a bit tougher, I just ate a lot of protein and drank massive amount of date tea...

[boxhill]

So, is it the peanut skin part that is supposed to work, and the dates are just there for sweetening? I ask because I have T2 diabetes and thus have to avoid carbs.

[lovelife789]

So, is it the peanut skin part that is supposed to work, and the dates are just there for sweetening? I ask because I have T2 diabetes and thus have to avoid carbs.

Mainly the peanut skin, but according to the herbal tea guru and acupuncturist (mine does both) black dates are supposed to bring benefits to blood cells. I have thalassaemia, so the dates were extra important to me... (now I come to think of it... it was amazing that I could keep my blood work so perfect the whole time!), but if you have diabetes, I wouldn't put the dates in or put much less. I have some patient friends who used my recipe but without so many black dates, just 2-3, the tea still works.

[boxhill]

Went in yesterday, Tuesday, and hurrah! My blood counts were all good, so I had infusion #4, two weeks late. The oncologist reduced my oxi dose by 20%, in hopes of keeping my platelets up, and I am scheduled to get a shot of Neulasta on Thursday when I am unplugged to combat the white blood cell problem.

I have abdominal and thoracic CAT scans with contrast scheduled for July 10th, and an appointment with the oncologist--and presumably Cycle 5 infusion--on the 12th if my numbers hold up.

The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...

[lovelife789]

Went in yesterday, Tuesday, and hurrah! My blood counts were all good, so I had infusion #4, two weeks late. The oncologist reduced my oxi dose by 20%, in hopes of keeping my platelets up, and I am scheduled to get a shot of Neulasta on Thursday when I am unplugged to combat the white blood cell problem.

I have abdominal and thoracic CAT scans with contrast scheduled for July 10th, and an appointment with the oncologist--and presumably Cycle 5 infusion--on the 12th if my numbers hold up.

The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...

Awesome to know the numbers went back up!! Keep your spirit up!!!

[mobrouser]

How often do you take the dexamethasone?

mob

[LPL]

....The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...

How are feeling now? Please be careful, contact your Oncologist. See my signature. My husband’s blood glucos just kept going up and he had 408 (!!!) when we got him to the hospital. That was after chemo Nr3. From Nr4 and so on they stopped the steroids. He had to be treated with Insulin for a rather long time due to this.
I didn’t know this but here they say the following:
"Glucocorticoid-induced hyperglycemia is common in patients undergoing cancer treatment ... We recommend that all cancer patients receiving gc be screened for hyperglycemia at least 4–6 hours after gc administration." 2013 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851349/

[boxhill]

I only get the dexe at infusion.

Today--unplugging day--my fasting BG in the morning was 166, which is still way over what I would like, but definitely a big improvement over yesterday. It will be interesting to see how long it takes to get all of the way back down.

[LPL]

I only get the dexe at infusion.

Today--unplugging day--my fasting BG in the morning was 166, which is still way over what I would like, but definitely a big improvement over yesterday. It will be interesting to see how long it takes to get all of the way back down.

My husband also only got the steroids at infusion. And after he reacted with hyperglycemia they removed it.
Good to hear that your BG is improving