“Emergency Department” est Urgences en français
Welcome back! This time we’re going to discuss what happens when you think you might be sick while on Chemo.. Or, what happened to me at least!
When you start treatment you’re informed of things to look out for, infection can be very dangerous to us cancer patients. The first sign of infection is a fever, or rise in body temperature, the tricky thing here is that cancer itself can cause a fever, as can chemo and a number of the supporting drugs we take for side effects.
About a week after my first Chemotherapy was when I experienced my first fever. Our instructions were to call the oncology unit at the hospital if this happened but of course, it happened in the middle of the night, on a Friday evening.. So the unit was closed for the weekend. So, after an hour of watching my temperature rise to over 39 degrees we decided to go to Urgences.
Now, remember this is an account of my experience in a french hospital, it was quite different to my experiences of UK hospitals! When we arrived we had to check in with reception (accueil) where they took photocopies of my passport, since I wasn’t yet registered with the French healthcare system. Once we explained that I was a cancer patient undergoing chemotherapy they moved me to an isolated room and activated protocols for immunocompromised patients. No one was allowed in my room without a mask, gown and gloves. Likewise I wasn’t allowed out!
They ran a number of blood tests, checking my blood for various bacteria and separate blood tests taken from my port to make sure there was no infection in the line, this is particularly dangerous because the port is a direct access to my heart and if an infection was to get in, it could turn very seriously very quickly.
In this instance my blood tests did not show any signs of infection however my white blood cells were extremely low so I was admitted to Oncology again to remain in isolation until either we were able to stabilise my temperature, or my WBC were back to a safe amount. This took about a week. I was allowed visitors but everyone had to wear gloves and masks. My fever continued to come and go, I was given IV antibiotics which made me feel terrible but nothing was ever discovered as to the reason for my fever.
This happened twice more after each chemo. I was given a drug called Neulasta which stimulated my bone marrow to produce more WBC. This worked very well but came with its own side effects. Including more fevers! We were told after the third visit to Urgances that we didn’t need to keep coming back, instead I was to take a paracetamol and see if the fever went down and stayed down. It was clear by this point at the fevers were a side effect and not an infection reaction.
The next time I had to visit Urgances was for a different reason! In 2018 I developed an unusual pain in my armpit, it felt just like a pulled muscle so I didn’t think much of it, however the next day the pain got worse, and worse. It became quite unbearable and what concerned me was that it was on the same side as my Port. I decided I wanted to get it checked out, however of course this also happened on the weekend so back to the emergency department we go!
The doctor who saw me suspected a blood clot however he was not a specialist in reading the Dopler Ultrasound which was needed to detect a clot. So I was once again admitted until they could fit me in for an emergency ultrasound in cardiology. Thankfully this happened the next day, a clot was found around where the catheter entered my “Subclavian Vein.” I was immediately given anticoagulants and the pain started to subside the next day. Thankfully I was also discharged after the scan!
I have been on daily injections of anticoagulants ever since. Because the clot was related to cancer treatment I will need to take the injections every day until I’m no longer on chemo.
As the months have gone on, we’ve gotten more used to the ups and downs of chemo and the various side effects. We don’t panic at the slightest fever anymore, if we get concerned I just get a basic blood test and check my WBC levels, if they’re high enough then I simply email or call my oncologist and let them know whats going on. It’s important your team know what’s going on with your health even if you don’t feel it’s necessary to visit the hospital.
So that was my first few weeks of chemo and reacting to various unexpected events! Next time will be a shorter blog all about hair loss.
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