Good morning, Howard. Generally, chemo taken in cycles such as yours, follows a monthly pattern. About a week or so after your last dose, your blood numbers will have fallen significantly…white/red and platelets. That may leave you feeling pretty fatigued and possibly some nausea. Or you may not feel much at all. Everyone is different.

But that is the usual reaction to chemo because the goal of the drug is to stop the proliferation of the quickly dividing cancer cells. Unfortunately the chemo can’t discriminate with cells and so it will also deplete your entire blood count. The lowest point of this cycle is called a nadir period. (You can read about that online) At about week 3 your marrow will start increasing the production of cells again and your energy should return…just in time for your next session.

From experience, I have a few guidelines for you:
One thing to be aware of, this lowering of your white blood count can leave you more prone to illness and infection. Sometimes people on Chemo can develop what’s called a neutropenic fever because of the severe drop in the white cells. It’s important if you feel ‘off’ to take your temperature. If it reaches 100.4 for more than an hour, call your hematologist for instructions.

Try to avoid situations where you have exposure to sick people, wear a mask in public settings, wash hands frequently. Make sure you wash fresh fruit and veggies well, cook foods to proper temps, etc. Another thing to be mindful about is gardening. I don’t know if you’re a gardener or not but wearing a mask and gloves when working in soil is important right now to avoid fungal infections. I know, life just got a little more complicated but this is how I’ve lived for a few years now and it’s all doable. ☺️

Occasionally when taking chemo, platelets will drop to a very low level. If you notice nose bleeds or unusual bruising or prolonged bleeding from cuts that warrants a call to your hematologist. It’s not uncommon to need platelet infusions when taking chemo.
Will you have any followup bloodwork between cycles?