I wanted to start a new thread on this topic because few talk about the measures one has to take to avoid life threatening flu, colds and other opportunistic infections, while in late Tx and early post Tx. First off you must not come in contact with sick people - period. You must not ride in vehicles where sick adults (or especially children) have ridden. You must not allow sick visitors, no matter how well meaning they are. If your spouse is sick, sleep in a different room. You must be very careful in hospitals and doctors offices - get waterless hand disinfectant and don't touch anything, especially your face, until you have washed your hands first. You should avoid any public places, public conveyances, banks, shopping malls, supermarkets, sporting events, churches, etc. You should insure that the kitchen and bathrooms at your home are thoroughly disinfected on a regular basis. CDC Atlanta recommends a solution of 1 part bleach to 10 parts water. If you must go shopping, wear gloves to handle door handles and shopping carts (which can be especially filthy -who knows if the little kid that was in there last pee'd his pants in the same spot you're putting your groceries). Bring your own magazine or book to the doctors office. Use gloves when you are pumping gas. Anything that people touch in common is a potential disease vector (touchpads, doorknobs, armchair handles, etc.). I won't shake or hold hands with people who are sick and I let it be known that my immune system is compromised and a common cold or flu could easily lead to pneumonia and kill me. You really have to go the distance with this or face severe consequences. A compromised immune system will take quite a while to recover. Your CBC's will tell most of the tale -make sure that you are aware of what the limits are and the ranges your blood fall into. Always get copies of your bloodwork -discuss it with your doctor.

Additionally the NCCN guidelines also specify a TSH test (for your thyroid) every 6 months for those receiving radiation in the head and neck area (and you should have gotten a baseline test prior to starting radiation).

The radiation oncology center at the CCC, where I was treated, had a separate entrance for radiation patients and signs all over requesting that sick persons wear masks, or better yet, not be there.

It's up to you to protect your health.

Gary

Thanks for all this information ! I agree about staying away from people. Yesterday was the first time we had company. I have not been anywhere since Oct. The only place I have gone to is the Dr.

All friends and family have been on phone. I just did not want to get a cold or flu. I was sick enough.

I think I am doing ok right now. My last treatment was Jan. 20th. I realize now it is a very slow recovery.

Good topic, Gary. I followed all these precautions and *still* ended up in the hospital with a fever, probably from cellulitis, at the end of my treatment. For months after I didn't go out much of anywhere because of fear of picking up somehting. I'm still very conscientious about washing my hands all the time and trying not to touch door handles when I can avoid it.

10 months after treatments, I have a very low end of normal WBC right now. My MO says this is normal for post-chemo and I have enough white blood cells that if I ran into an infection, my body would have enough to fight it off until it made more white blood cells but I still think caution is best.

Another important precaution to be aware of, especially this time of year, is that if you are a gardener you simply can NOT go out and pull out weeds and dig in the dirt no matter how much you want to if you are having treatment or the firts couple of months after treatment. Small scratches and bugbites that normally wouldn't faze you at all can become serious infections when your immune system is really compromised. I am really looking forward to being well enough to garden this year!

I have a question that I've been mulling. How long is our immune system compromised? I've noticed that despite being a year out from treatment that small injuries (like slicing my finger while cutting bagels) seem to take forever to heal. I don't think this is all in my head either, it just takes longer than usual for my body to repair. After a new razor accident, I'm almost too cautious about shaving my legs.

I've become a big believer these days in getting the flu shots and any preventive vaccine I can ask for.

After treatment is there any good medical approved way to BOOST our immune systems? Too many people have brought me "quack" stuff that I'm hesitant to try.

Jen

Jen,
The only way to tell is when your blood chemistry is in normal limits. Pay attention to RBC and WBC levels. They do a histogram of mine every 6 months when I am tested and everything now is within normal limits. It took almost 2 years for everything to be within normal range. That doesn't mean it takes 2 years for the immune system to recover but it does take a long time. It takes 120 days just for the red blood cells that were destroyed in radiation to recover. I waited for over 4 months before I started back out in public and I was very careful.

One thing I just discovered is that red blood cells tend to travel in clumps in the larger arteries so this may explain the large amount of lowered red cell count from blood damaged passing through the carotids.

If you bruise easily or bleed a lot then you probably have neutropenia and need talk to your MO.

To help stimulate your immune system: 1. Execise, 2. Eat good foods and a complete balanced diet with lots of fruits and vegetables. 3. Get adequate rest 4. Stay hydrated - 2-3 liters a day (that inludes water in your food) 5. Follow all of the first post advice about prevention.

The rest will come naturally. Your immune system can only be "stimulated" and the above suggestions are the best and most effective way to do it.

IT IS NOT POSSIBLE to boost your immune system. Don't waste your money on worthless ptoducts, making phony and unsubstantiated claims (including vitamins -multivitamins are ok Vitamin C megadosing is NOT recommended it is best to get your "C" from citrus fruits).

Make sure you get a biannual TSH test as well if you had radiation.

Jen,

I also try to avoid the things that sound like quack supplements. I just take a multivitamin and 500 mg of Vitamin C daily and haven't had even a head cold in probably at least a decade.

For me, diet is very important, as Gary said -- lots of fresh fruits and vegetables, whole grains, quite a bit of fish, and very little red meat.

In the years since my treatment ended, I've been able to travel to some third-world countries and had no problems with local food or travel conditions as long as I observed basic hygiene steps, like frequent hand-washing.

I still see my medical oncologist every 6 months (just saw him yesterday, in fact) and he regularly monitors my blood counts -- so far, so good.

I guess what I'm saying is hopefully you'll find that it gets better for you with a bit more time, and you won't feel quite so restricted in what you can do.

Cathy

The other thing to be aware of is apparently, according to my MO,chemo can make your WBC permanently below "normal", though not by a lot, and yet you can still have an immune system that functions perfectly adequately. And even before chemo, I had a RBC that was often a little below normal--enough so that I couldn't give blood the last two times I tried(which I now think was a good thing since who knows if there were cancer cells in my blood), so the fact that it is back to that slightly anemic level doesn't bother me.

Nelie

Great topic - and timely too. I mentioned in another thread that Kenny had a pretty bad run-in with what appears to be the 'flu'. After three weeks of serious flu symptoms, I am acutely aware of how a 'normal' illness can be very serious for Kenny's weakened immune system.

It has been six months since his last treatments, but with so many complications, Kenny's reserves were bottomed out. He was just starting to feel a bit better and then 'wham!" - the flu put him back in bed for weeks. The suggestions made here about being extremely careful, even after treatements, is so very important. Thanks!
Carol