Chemo Surprise

So, I had a double dose of not good news regarding my chemo.

First, my white blood cell count has dropped to 1.3, which is too low. (It started at 10; it was 3.5 five days after the chemo),   They want it to be at least 2.0. I was a little surprised because I feel so good, but he (Dr. Yen, who is the substitute for Dr. McMullen, who is on vacation) said that a lot of people don’t feel any change with this sort of drop.

The other bad news is that my hearing test showed a large drop-off in my high-pitch range.  (For those who don’t remember, my chemo drug, cisplantin, is an audio toxin.) I didn’t think that sounded that bad, but the doctor was very concerned as that is the first thing to go. Loss tends to be permanent so they are vigilant in monitoring it.

So, what to do?

1. Continue on the plan and if next dose shows more of a drop-off of hearing, stop the drug (but then I had 2/3^rds of a full dose and much damage would have been done).
2. Change to single doses weekly and, if the hearing continues to decline, stop it earlier (to arrest the level of damage, but the efficacy of the treatment is less). 
3. I could change to another drug right now. (Cetuximab - Brand name: Erbitux) One of the biggest problems with it is horrible rash/acne.  

He asked me if I had a preference and I asked him to make the call.

The doctor was undecided on what to do tomorrow. He would consult with Dr. Seftel (the ENT) about the audio problem and he would ponder it a bit.  The plan: I will go to my appointment tomorrow, but if the white blood cell count is still too low (and I am betting it is), they might delay the treatment for a week. If they go forward with it, he said he would make up his mind what to do tomorrow.  Hence, chemo surprise.

My radiologist, in the meantime, gave my lidocaine to numb my mouth when I eat so it doesn’t hurt. Yay!  And vicodin as needed (no more than 8 a day!)  If I am taking 8 a day, it is time to move up to the next level…Right now, I am planning to just do the ibuprofen and lidocaine, but it is nice to have other drugs in the wings…