An Unexpected Hospitalization

After ten months of a “watch and wait” approach for non-Hodgkin lymphoma, I was faced with enlarging lymph nodes, which were threatening to cause damage to my organs. My oncologist and I spoke about possible chemotherapy regimens. After seeing another oncologist at a tertiary center for a second opinion, a decision was made and a plan developed.

Knowing what to expect with chemotherapy and, most importantly, what can be done to manage any side effects must be discussed with your physician. Chemotherapy drugs have the potential for side effects, but not everyone will experience them. The physician may give you additional medications to try to prevent side effects.

Your blood counts will be closely monitored, as chemotherapy can reduce the number of blood cells, which increases your risk of infection, fatigue, and bleeding. White blood cells (WBCs) fight infection, but when reduced, your body cannot fight infection and you may be more susceptible to infection. A low WBC count is called neutropenia.¹

A fever develops

As instructed by my physician, I did check my temperature daily. Ten days after my first chemotherapy treatment, I experienced a fever. I was tired, as well, but did not feel ill. However, my son and husband (who were present when the physician emphasized symptoms to observe) insisted that I contact the physician. It was a weekend, we were out of town, and I really tried to ignore my fever. Yes, denial is a wonderful defense mechanism. As a nurse, I should have known better.

We arrived in the emergency department, a detailed history was given, bloods were drawn, and, yes, my WBC was low, and my fever persisted. I was to be admitted to rule out sepsis. Intravenous antibiotics were started and I spent the next five days as an inpatient. One of the greatest lessons learned was that an infection can rapidly occur and steps must be taken to avoid one, as well as prompt treatment if one develops.

Tips and tricks for avoiding infections

Although our bodies may be more susceptible to infection when receiving chemotherapy, there are some simple lifestyle changes that we can make to try to reduce our risk.¹

• Take your temperature regularly. If your temperature is high, notify your physician or healthcare provider.
• Some infections can be life threatening. Promptly report any of the following: chills, shortness of breath, sore throat, mouth ulcers, vomiting, urinary burning or urgency, redness, swelling or sores on skin, blood in urine or stool.
• Always wash your hands with soap and water. Washing your hands is an important part of prevnting infection. I now have a hand sanitizer attached to my purse and in my car readily available.
• Avoid large crowds and contact with anyone sick. I have refrained from shaking hands during church services.
• Avoid cuts but using an electric razor.
• Use a moisturizer to prevent cracked skin, especially during the dry and cold months. Inspect your skin daily.
• Quickly clean cuts and scrapes.
• Pets can be a source of infection. Have someone else change the litter box, clean the bird cage, or change the fish tank while you are undergoing treatment.
• Get adequate rest and try to keep emotions in check. It is amazing how both loss of sleep and emotional events can reduce my ability to fight infection.
• Discuss with your physician if any vitamins or herbals that you take or are considering may affect the effectiveness of chemotherapy.

Personally, I have also tried yoga and reflexology, which according to research, may help improve your immune system.

A lesson learned

I was able to successfully complete my chemotherapy without further infections. My physician closely monitored my white blood counts, my temperature was monitored closely, and I seriously followed his instructions. While chemotherapy may put you at risk for an infection, collaborating closely with your physician and following the above strategies can help reduce your risk of this complication.