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Staying strong and facing an uncertain /certain future

Caregivers | Last Active: Jun 22, 2023 | Replies (60)

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@valandsheri

Two days of treatment behind us! Val is feeling quite good. He is a big fan of the pre-Med dexamethasone. His knees and general body aches have gone away😊

Lori, I’m hoping you can answer my question. I understand that right after chemoimmunotherapy Val would be in nadir. How much precaution needs to be taken to prevent infections of any sort, other than the usual things we would do and have been instructed to do. Is it safe for him to go to the grocery store masked and wipes in hand? Is the danger time only during nadir or at all times during his treatment? Would he be “safe” to visit a friend or too, masked, outside? I just haven’t been able to figure out just how at risk he is. I understand anything is possible, and so much is out of our control, but just want to do the best we can.

Thank you for being here❤️

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Replies to "Two days of treatment behind us! Val is feeling quite good. He is a big fan..."

Hi @valandsheri! That’s all good news! I am going to burst your bubble a little bit though. Your husband is riding high on the dexy right now so he’ll feel pretty well. But don’t be surprised if he begins feeling fatigued as the chemo starts doing its job.
Nadir, or neutorpenia is another name for it, will take place between 7 and 14 days. At the time of nadir, the lowest point where WBC are greatly diminished, he may feel physically weak too. That’s normal! But he will also be at his most vulnerable to infections. In terms of 1-10 on a risk level, he will be at an 8 or 9 during that time.
Once his neutrophils increase again then he’ll start feeling better and more like being active. Visiting with limited friends may be ok. Just mask up! And no hugging…it’s not forever. 🙂

Masking with an N-95 or KN-95 anytime he is with people. Outside too because of the risk of fungal infections. I believe you’re in Arizona and he has to be mindful of Valley Fever which is a fungal infection prevelent in that area.

It’s a good idea to take his temperature at least 2 times daily and report anything over 100.2. It can be a sign of a neutropenic fever and he will need to be on antibiotics as a precaution. Just keep an eye on it!
Here are some basic protocols for avoiding illness during neutorpenia:
Wash hands frequently with soap and water, or use an alcohol-based hand sanitizer.
Avoid people who are sick or crowds where you’re likely to come into contact with a sick person.
Avoid injuries like scrapes, tears or cuts and care for wounds immediately if your skin is damaged.
Prevent the spread of germs by washing fruits and vegetables, keeping meats away from other foods, preparing meals in a clean kitchen and cooking foods to the proper temperature.
Avoid eating at buffets. No coldcuts from delis. All meats should register at least 160 degrees to kill bacteria.
Don’t share utensils, cups, food or drinks with others.
Don’t share towels, razors or toothbrushes with others.
Wear gloves and masks if you’re gardening or working in the yard.
Avoid picking up pet waste or changing a newborn’s diaper (use gloves and wash your hands afterward if you can’t avoid it).
Avoid lakes, ponds, rivers and hot tubs.

A couple of good websites for more information.
https://www.verywellhealth.com/nadir-and-chemotherapy-513861

https://www.healthline.com/health/neutropenic-precautions#food-safety

Husbands don’t like this part, but now’s the time when you have full permission to be watching him like a hawk! Prodding, nagging, coaxing…whatever it takes to keep him safe. ☺️