Nuelasta Injector

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debb
Posts: 191
Joined: Sun Dec 21, 2008 9:03 pm
Location: NJ

Nuelasta Injector

Postby debb » Sat Mar 28, 2020 12:02 pm

Hi guys...I am due for a Folfiri & Avastin treatment on Monday. The usual plan is that I go back for disconnect on Wednesday for disconnect and also get a Nuelasta shot at that time.

Years ago, when I was receiving treatment at a different facility, I would go back for disconnect on the given day, and then have to come back the next day to get a Nuelasta shot. I hated having to go back in the office another day! Then, the injector came out and I was able to save a trip on the day after treatment because they applied the injector at disconnect, which was great. The injector goes off 27 hours after application.

I asked last week if I could get the injector applied on Monday, while I'm getting treatment. The nurse said no because I have to receive the shot after disconnect and obviously that's longer than 27 hours.

So, I just emailed my doctor to ask if I could disconnect at home (I've done it once or twice over the years) and also get a prescription for the Nuelasta injector that I could apply myself at the recommended time. Obviously I am asking all of this to minimize my time at the center, given this coronavirus pandemic.

My question is...has anyone every applied the Nuelasta injector themselves? I know I won't get an answer to my email to my doctor until Monday, so I thought I'd ask you all for your experiences.
Thanks!
2008, Stage 3C, age 42, mom of 4
Folfox 9/08-2/09
Met to right ovary, both removed 7/10
HIPEC 8/10
VATS 7/12, right lung
10/14 Stivarga clinical trial
3/15-7/15 Folfiri & avastin
8/16 Folfiri & avastin
Break! 10 months of freedom
1/18 - 4/23 many Folfiri & Avastin
6/23 Clinical trial REGN7075. Progression
8/23 radiation to femurs and L4
9/23 rechallenged Folfox. Allergic reaction at 4th infusion
11/23 will start Bot/Bal

KimT
Posts: 695
Joined: Sat Feb 20, 2010 8:53 pm

Re: Nuelasta Injector

Postby KimT » Sat Mar 28, 2020 2:27 pm

I gave myself Nuelasta injections with a regular syringe and needle in the stomach. I would think it would be an option for you unless it has changed in the last 8 years since I did it. I got a prescription and filled at the hospital pharmacy. It came in prefilled syringes that I kept in the fridge. As I recall I had to do the injection so many days or hours after my treatment.
2/10 dx colon cancer
right hemicolectomy 3/19/10
Stage 2a 0/43 nodes
Lynch syndrome
3/14/10 colon resection/ removal of metal clips
Nov 11 dx ovarian cancer

boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: Nuelasta Injector

Postby boxhill » Sat Mar 28, 2020 7:19 pm

I always got my nulasta shot at disconnect, which was the standard 40-something hours. I've never heard of a delayed injection device!
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

Dionca
Posts: 48
Joined: Sat Dec 02, 2017 2:04 am

Re: Nuelasta Injector

Postby Dionca » Sat Mar 28, 2020 7:29 pm

I was given a choice to either inject Neulasta myself or have a home care nurse come in the day after the disconnect to give me the injection. I chose the home care nurse, so would pick up the Neulasta from the hospital pharmacy, take it home and the nurse would inject it the next day. But I think it’s pretty common to give yourself the injection.

I recall reading here at the time, that some had the injection at the same time as disconnect, which would make things easier, but my hospital protocol was to do it the next day.
stage 3b T3 N1b MX 2/27 nodes (surgery 4/2015)
moderately differentiated
PNI - positive
LVI - positive
Folfox 12 sessions (w/out oxi for 11 & 12)
Neulasta with 3-12 due to low WBC count
CEA at diagnosis 8.6
CEA after surgery 1.2
CEA during chemo 4.6 / 3.3 / 2.3
CEA after chemo 1.5 / 1.2 / 1.2 /1.2 /1.2 / 1.4 / 1.1 / 1.2 / 1.9 / 1.3 / 1.6 /1.4 /1.5
neuropathy
recurrence in left lung (surgery May 2020)

debb
Posts: 191
Joined: Sun Dec 21, 2008 9:03 pm
Location: NJ

Re: Nuelasta Injector

Postby debb » Sat Mar 28, 2020 8:48 pm

Thanks for your insight. I will ask about the possibility of giving myself the Nuelasta shot. They could possibly fill it at the pharmacy while I’m in the chair. I usually take the shot in the stomach, because my arms bruise so easily. I go to MSKCC Monmouth for treatment and see my doctor in NY every 3 months.

FYI...the Nuelasta injector is a device that is applied (stick on) the back of your arm. I would get it applied at disconnect and then 27 hours later, it would go off. A light would start blinking and I’d feel the slightest prick and after about 30 seconds the light would stop and I could take off the device. It was oval, about the same size as an egg. I haven’t used one in years, so maybe some things about it have changed.

Thanks again. I definitely want to keep my WBC up, especially right now. Be well.
2008, Stage 3C, age 42, mom of 4
Folfox 9/08-2/09
Met to right ovary, both removed 7/10
HIPEC 8/10
VATS 7/12, right lung
10/14 Stivarga clinical trial
3/15-7/15 Folfiri & avastin
8/16 Folfiri & avastin
Break! 10 months of freedom
1/18 - 4/23 many Folfiri & Avastin
6/23 Clinical trial REGN7075. Progression
8/23 radiation to femurs and L4
9/23 rechallenged Folfox. Allergic reaction at 4th infusion
11/23 will start Bot/Bal

KimT
Posts: 695
Joined: Sat Feb 20, 2010 8:53 pm

Re: Nuelasta Injector

Postby KimT » Sat Mar 28, 2020 10:06 pm

I would think they would agree to keep you out of any treatment center as much as possible. Everybody is trying to eliminate non essential visits to any medical facility. My husband would fill my prescriptions while I was in the chair and we took it home with us and put it in the fridge until I was supposed to give myself the injections.
2/10 dx colon cancer
right hemicolectomy 3/19/10
Stage 2a 0/43 nodes
Lynch syndrome
3/14/10 colon resection/ removal of metal clips
Nov 11 dx ovarian cancer

Jannine
Posts: 204
Joined: Wed Jun 20, 2018 7:46 am
Location: Maryland, USA

Re: Nuelasta Injector

Postby Jannine » Sat Mar 28, 2020 10:51 pm

I gave myself a Neulasta shot 2 days after disconnect, with a pre-filled syringe. I usually was able to pick up a couple of them at a time from the hospital pharmacy. They did have to make sure that my insurance would cover my administering it myself, which wasn't a problem for me.
DX: sigmoid colon cancer 5/2018. 48 F
laparoscopic sigmoid resection (24 cm removed); no stoma.
7.5cm adenocarcinoma -- mod. diff.
1 noncontiguous tumor deposit removed; 0/31 lymph nodes
T3 pN1c M0
5/18 before surgery, CEA 11.2
6/18 began FOLFOX
7/18: CEA 1.9; added neulasta post infusion
9/18: CEA 2.8
10/18: 25% chemo reduction
11/18: CEA 1.8
7/19 CT scan clear

debb
Posts: 191
Joined: Sun Dec 21, 2008 9:03 pm
Location: NJ

Re: Nuelasta Injector

Postby debb » Tue Mar 31, 2020 12:20 pm

Hi..I received the supplies to get disconnected at home and my Nuelasta will be shipped to me for me to inject tmrw at disconnect. So thank you for your advice. One less trip out is a relief. Be well, friends.
2008, Stage 3C, age 42, mom of 4
Folfox 9/08-2/09
Met to right ovary, both removed 7/10
HIPEC 8/10
VATS 7/12, right lung
10/14 Stivarga clinical trial
3/15-7/15 Folfiri & avastin
8/16 Folfiri & avastin
Break! 10 months of freedom
1/18 - 4/23 many Folfiri & Avastin
6/23 Clinical trial REGN7075. Progression
8/23 radiation to femurs and L4
9/23 rechallenged Folfox. Allergic reaction at 4th infusion
11/23 will start Bot/Bal


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