Weekly paclitaxel and blood results

Good morning 

just a few questions which I’m hoping someone can help me with. I’m currently on weekly paclitaxel and had my fourth dose yesterday. However I got my blood results from the day before and my white cell count and neutrophils had dropped significantly in a week. 
Wcc from 4.9 to 2.9 and neutro 3.2 to 1.9 

asked nurses if I would need the injections to prevent a further drop and avoid missing any chemo and also as I had neutropenic sepsis after my first EC. They were very dismissive and said would see what results were Thursday. 
now my anxiety is rising as can’t find any information about when They are likely to fall. On EC I knew what days when my ‘nadir’ was predicted however can’t find anything about weekly regime? 
anyone know anything that might help I’ve made the decision to isolate a little as know that I’m at higher risk this time. 
many thanks in advance 

Angela x 

Hi crazycat

The uncertainty around so much of our treatment can be difficult to handle, especially if you feel the hospital has been dismissive about your questions. Like you, I got neutropoenic sepsis during EC treatment and it’s not an experience you want to repeat. I played ostrich and just let them get on with things so I can’t answer you question. I remember that I moved straight on to my first paclitaxel two days after being discharged which rather shocked me but then, after week 4, I was given a week off because of blood results and then resumed paclitaxel for the remaining 5 treatments. I believe the ideal number was 1.5 to resume treatment or at least 1.0. To be frank, I just wrote off the weeks I was on paclitaxel as I had no idea when I’d have a good day (rare) and when I’d feel totally drained. The cycles were too close to ever feel well but I expected to be a functioning human being for the last 2 days of each treatment week. It didn’t always work out of course.

Although it sounds like your team could have handled things differently, the fact is we all respond differently and it’s impossible to say when we will feel ourselves so it’s likely the person you asked was not in a position to answer your question. Needling to feel in control of what’s going on, knowing what to anticipate and planning our life around treatment can be a disadvantage at this point but trust in your team is essential so I’d suggest you ring your adjuvant treatment nurse on Monday and ask for a conversation about your treatment. Your BCN is less likely to have the answer than your oncologist or supervising oncology nurse. Meantime, you are going to have a horrible weekend unless you find a way to let this go. Your treatment is in their hands and they know what they are doing. It’s just unfortunate that they cannot be definitive about how you will be, It’s like with the subsequent radiotherapy (I was given an extra week’s break before moving on) - no one can predict how you will be affected. I had 15 sessions and experienced only an slight itch on my shoulder blade whereas I know of some women who felt like their breast or scar site was frazzled and couldn’t complete the course! Nothing is definite in this except for the fact that it’s worth writing off a few weeks if the reward is to be declared cancer-free. Isolating is probably unnecessary but, since you’ve had neutropoenic sepsis, sounds like a reassuring idea for the first few days of a cycle, inconvenient though it is.

Wishing you all the best for the remaining weeks. You’ve got through the EC which is the biggest challenge and you’re halfway through your treatment schedule.

Jan x