#neutropenic fever

[mcatmemoranda]

[nerdgirlnarrates]

Flucloxacillin: another pencillin, this time the most commonly prescribed narrow-spectrum penicillinase-resistant penicillin in the UK. Apparently, it was not marketed much in the US and Canada, where dicloxacillin filled its role. Flucloxacillin is used almost exclusively for gram positive infections, especially Staph aureus, though it can be also be used for pre-op prophylaxis.

Zosyn (pip/tazo): One of the big guns. Like augmentin, this combo therapy includes both a penicillin and a beta-lactamase inhibitor; unlike augmentin, it covers pseudomonas. Zosyn is crucial for treating nosocomial infections and often one of the first drugs we reach for when empirically broadening antibiotics. It is also first line for neutropenic fever.

Vote for the best antibiotic

[theretirementstory]

03/11/2024. Bonjour tout le monde, November has arrived and the week has seen the temperatures change and we have had misty mornings. I am in Bar-sur-Aube today 😁. The weather is 7c and could possibly hit 16c, the sun is shining so with any luck the nurse will arrive early and I can have my walk to the supermarket.

J’ai été très occupé this week (is that any change) consequently the jigsaw is not yet finished, I have been lazy with cooking meals and have spent time relaxing in the chair but let me explain why.

After the shock of finding out I had to go to Paris on Tuesday, my friend rang the hospital to find out why I had to go. Turned out it was for an MRI scan, no stay over just there and back. Monday morning I had bloods taken and dressing changed, in the afternoon the man from the laboratory rang to say my white blood cells and neutrophils were very low and to wear a mask when out to avoid any infection plus if I had a fever I was to go straight to hospital 😱. Anie called to see me bringing asters from her garden as well as apple crumble (which unfortunately I couldn’t eat) being neutropenic means I have to make everything myself so that another’s persons hands haven’t touched the food.

I was up at 04:45 on Tuesday as the taxi was due at 06:30, imagine my surprise when he turned up at 06:03 😤. Anyway, we arrived, I seemed to be “fast-tracked” through and before I knew it I was back in the car. Yes I was home by 1:30pm but I was still shattered I had been up just short of 9 hours at that point.

I realised I had three injections in the fridge which were what I needed to boost my white cells and neutrophils, so messaged the doctor in Troyes (while en route to Paris) for a prescription advising the nurse to administer the injections. .

My neighbour went to the pharmacy for my medication, I had only completely run out of one lot of tablets! Then I got a message from a friend who said she would come to see me around 18:00. My reply had confused her and so she didn’t visit. I had also asked Monique to make an appointment for Dr Stefan, at the practice in town, to come and visit me on 8 November. She did that so hopefully now I will also have a doctor in town again.

On 31 October I got a photo of my two grandchildren dressed up for Halloween. My granddaughter looks so grown up it’s just amazing.

Anie brought me apples on Monday and I still had the ones Monique had brought last week 😳 so on Friday I set to and peeled, cored, sliced, froze and stewed them. The freezer is almost full of bags of apples. Got to make something other than crumble though, think I will just have them stewed with yoghurt. It was a beautiful afternoon so I had my walk to the supermarket, not knowing what I wanted to eat I bought food to make a pasta dish.

My cleaner was ill so couldn’t come to do my housework. She also informed me that she is moving to Troyes on the 7 November. Now paperwork is an absolute nightmare here in France (mind you it’s worth it for me to live in this place I love) so I have had to have my head screwed on properly to deal with it. I am keeping my fingers crossed that everything is correct.

“The Photographer” has been busy at his day job but on Saturday he went to Burton upon Trent for the first round of the FA Cup. They were playing Scarborough AFC and he was there to take photos. I prayed for dry weather which it appeared they had. “The Seagulls” were doing really well until midway through the second half when their opponents scored. Unfortunately “The Seagulls” couldn’t even the score and it would be some disappointed fans who returned home. The thing to remember is that their opponents were in leagues above theirs so no shame in the score line, plus they played really well and as we know there can only be one winner. “The Photographer” took some great photos too.

It’s busy old days at work for “The Solicitor” and “The Recovery Coordinator” weeks are flying by so quickly. It is only two months since they were here but it feels such a long time ago. Niece and nephew went to their house on Friday evening, it was a late trick or treat, looks as if everyone had fun. Grandad had even bought outfits for the children to wear.

“The Jetsetter” with the clipped wings, at the moment, is most probably perusing holiday brochures (can you still get those) or is it all on-line now?

It seems to be that the world is not such a nice place. Countries that are against tourists, places where it’s unsafe to go out in the evening (according to the press) wars, floods, droughts good heavens it is probably better to stay home. Although being a bit of an adventurous traveller in my twenties, I understand the need to visit places. I once visited a country which at the time was “behind the Iron Curtain, and I don’t mean Yugoslavia. There were lots of things that were “scary” about it but it all adds to the memories. I laugh when I see adverts for holidays to countries being lauded as “new places to visit” when my holidays there were around 47 years ago!

A bit of a surprise with the music part of the blog this week, I have chosen two women and the songs are fairly recent (well they are to me). The first song is by Leona Lewis, it’s “Bleeding Love” from 2007 and the second is by Dido, it’s “Don’t Leave Home” from 2003.

I really must make some time to lay more cardboard. I don’t have sufficient bark to put a good covering on top but will see if my neighbour can get some more for me tomorrow. The weeds are creeping buttercup, they are coming through from my neighbours garden and they are so difficult to kill off. Some have even managed to come through the bark already (only small but it’s a start). Does anyone know how to kill off these “creepers” without killing the flowers in the borders too?

PS. I have finally out the last pieces of jigsaw into the puzzle. What satisfaction that has brought me.

Another thing that has brought a lot of satisfaction to me is the beautiful cactus I bought a year ago, it has lots of buds some due to open anytime soon. I am so pleased, it is a white cactus and I just left it to its own devices after my previous cleaner, dusted it and broke off all the new buds which were coming earlier this year! I was upset then but now I am just looking forward to the flowers opening.

It also appears that the beautiful orchid I received on the 12 September now has root rot (or similar). “Not my fault Guv, I know not to give it loads of water”.

So on that sad news, I will leave while I search Google for a solution.

Bon dimanche.

[joy-the-poet]

Neutropenic (susceptible to infection)

Straight to the front of triage

This is a public hospital, no money is discussed as almost everything here is free.

I'm placed in the nearest clean room

Waiting for an available doctor

Intern doctor checks me over

Cannula goes into a vein in my hand

I provide a urine sample

I provide a stool sample

I drink water from a small paper cup

Nurses check my temp, 39.8C (103.64F) while asking a million questions

My oncologist has been informed

Eat a cheese sandwich so I can swallow more pills

It's time for a chest x-ray

Antibiotics, IV bag after IV bag

Doctors decide my fever was likely caused by the new chemo

5 days later

I'm home

I can't stop hugging my kids

More chemo on Monday

...

joy-the-poet

[dearophelia]

hey so it’s been a Rough Day (details under the cut) and I need some positivity.

If you could say something nice about me (or my writing, or my GMing, or anything about me really) in the replies, I’d really appreciate it 💖

looked at my CT results in MyChart, the 2+ inch tumor in my lungs that had gone away is back

there’s also some little new stuff elsewhere

Dad got admitted to the hospital with neutropenic fever (he’s going to be fine, but his white blood cell count utterly crashed after one dose of chemo) and he’ll be there for a couple days

I had an utterly insane build at work that has taken two days, is not done yet, I’m not sure I did it right, and people are starting to come at me about other stuff that’s past due

They really undersold how zonked I’d be after gamma knife last week and I didn’t remember this from last year because I was also recovering from brain surgery at the time and zonked from that

[indiamedicaltourism]

Bone Marrow Transplant in India at Low Cost

A bone marrow transplant (BMT), also known as a stem cell transplant, is a life-saving treatment in which damaged or diseased marrow is replaced with healthy stem cells. This complex medical treatment proves crucial for people with chronic infections, illnesses, and cancers.

Bone marrow is one of the most vital parts of our bodies found within bones, and is responsible for the production of essential blood cells such as red blood cells, white blood cells, and platelets. When this marrow becomes infected or damaged it can result in life-threatening illnesses. A bone marrow transplant tries to resolve these difficulties by replacing the damaged marrow with healthy stem cells, either from the patient (autologous transplant) or from a suitable donor (allogeneic transplant).

Types of Bone Marrow Transplants in India

In India, BMT is mostly of two types:

Autologous Bone Marrow Transplant: This process involves collecting the patient's stem cells before undergoing chemotherapy or radiation therapy. These stem cells are preserved and then reintroduced into the patient's body to create new healthy blood cells.

Allogeneic bone marrow transplant: This procedure uses stem cells from a donor who is genetically similar to the patient. Donors might be relatives or identified through donation registries. Specialized testing confirms compatibility and stem cells are delivered into the recipient's body to help with blood cell regeneration.

The BMT Procedure: Step-by-Step

Conditioning: This phase includes initial treatments including chemotherapy or radiation therapy to kill cancer, prevent the immune system, and make room for new cells.

Stem Cell Infusion: Healthy stem cells are injected into the patient's bloodstream, where they go to the bone marrow and begin to produce new blood cells.

Neutropenic Phase: After the infusion, individuals experience weakened immunity, making them particularly susceptible to infections. Antibiotic medication and supportive care are essential during this time.

Engraftment Phase: As the new stem cells take root and grow, the healing process begins, and symptoms like fever and infections may disappear.

Post-Engraftment Phase: This phase involves continuous monitoring, the treatment of problems such as graft-versus-host disease (GVHD), and gradual immune reconstitution.

Several Indian hospitals specialize in bone marrow transplants, providing advanced facilities and excellent medical care. These best bone marrow transplant hospitals are led by renowned medical experts in hematology and oncology, who provide comprehensive treatment and support to patients. 

Bone marrow transplantation remains a source of hope for people suffering from several hematological diseases and cancers. With advances in medical technology and experience, India is at the forefront of BMT, providing patients with life-saving treatments and better outcomes. Through careful treatment, continuous monitoring, and continued support, bone marrow transplantation continues to pave the way for a brighter future for patients across the country.

Al Afiya Medi Tour is a leading medical tourism company in India.  We are offer medical tourism services in India foreign patients. Some of the main countries are Bangladesh, South Africa, Uganda, Zambia, Namibia, Iraq, Kenya, Nigeria and so on. We provide free assistance for TURP surgery cost in India, lung cancer treatment, breast cancer surgery cost, stomach cancer treatment in India, best hospital for heart valve replacement, bone marrow transplant cost, arthroscopic surgery, brain tumor surgery cost in India, kidney transplant cost, liver cancer treatment,best bone marrow hospital etc.  If you are searching for free medical and healthcare consulting to find the best hospitals and top doctors and surgeons in India for any treatment then contact us- Alafiyameditour.com.

Source: https://alafiyameditour1.blogspot.com/2024/02/bone-marrow-transplant-in-india-at-low.html

[trodelvy]

All About Trodelvy

Handling and Disposal: Trodelvy, often referred to as sacituzumab govitecan-hziy, comes in two doses: 180 mg and 200 mg. This medication is supplied in single-dose vials that are colored off-white to yellowish due to freeze-drying. Every vial is packaged separately within a carton. Included is one 180 mg vial with the NDC 55135-132-01 packaging code. It is imperative that these vials be kept in their respective containers and refrigerated between 2 and 8 degrees Celsius. There should never be a freeze on the medication. Because trodelvy can cause harm, it must be handled and disposed of with caution. Numerous Trodelvy Side effects, including as anemia, lethargy, baldness, decreased appetite, coughing, nausea, vomiting, and diarrhoea, can also arise from trodelvy therapy.

Medication For Breast Cancer: Trodelvy is a crucial part of the treatment of metastatic triple-negative breast cancer (mTNBC). The active component that provides the therapeutic effects of trodelvy is sacituzumab govitecan. Both the specific protein and the monoclonal antibody that comprise this medication are necessary ingredients. Its primary benefits are for patients who have had at least two previous treatments for metastatic disease. Trodelvy is performed when surgical removal of the cancerous tissue is not feasible. The main medicinal ingredient is sacituzumab govitecan-hziy, which is a mix of a Trop-2-directed antibody and a topoisomerase inhibitor. It is important to keep in mind that Trodelvy can only be prescribed by licensed medical professionals. To buy trodelvy in India and make it accessible to a wider community,

Available as lyophilized powder: Trodelvy must be given in accordance with FDA-approved cycles, and the dosage is directly correlated with the patient's body weight. An intravenous dose of 10 mg/kg is given twice a day, on the first and the eighth day of each repeating 21-day cycle. Sacituzumab govitecan-hziy must be dosed accurately based on the patient's weight because it is a lyophilized powder. To create a concentration of 10 mg/mL, the vial is mixed with 20 mL of 0.9% sodium chloride injection, USP.Trodelvy 180mg is a reasonably priced medication that is readily accessible in the market

Use In Chemotherapy: As part of the treatment regimen, a 5-HT3 receptor antagonist or an NK1 receptor antagonist is given as a premedication along with dexamethasone. This premedication approach lessens the chance that infusion reactions and chemotherapy will cause nausea and vomiting. The reason Trodelvy is so reasonably priced in India is its unique blend of a topoisomerase inhibitor and an anti-Trop-2 antibody. In individuals who have not responded well to earlier infusions, corticosteroids should be given. For additional information on the trodelvy cost , get in touch with Indian Pharma, a licensed distributor of this drug.

Potency of The Drug : Trodelvy offers hope to patients with advanced triple-negative breast cancer who have undergone at least two prior therapies. What makes it successful is how it interacts with SN-38, a small molecule that is crucial to its mode of action. The drug's potency is further increased by Trodelvy's monoclonal antibody's ability to bind to the Trop-2 protein present on a range of breast cancer cells. An additional advantage of Trodelvy is its cost-effectiveness, which is made possible by Indian Pharma. For individuals who would like additional information regarding the Trodelvy price. Along with anemia, more than one in five patients undergoing therapy for metastatic triple-negative breast cancer may also experience baldness, decreased appetite, coughing, stomach discomfort, and exhaustion.

Use Under Prescription: One of the potential negative effects of Trodelvy treatment is the emergence of severe or possibly fatal neutropenia. It is necessary to temporarily halt the administration of trodelvy in patients who have neutropenic fever or an absolute neutrophil count below 1500/mm3. It is essential to regularly evaluate blood cell counts during the course of treatment. It makes sense to utilize G-CSF for secondary prevention. In patients with feverish neutropenia, anti-infective treatment ought to be initiated promptly. It's crucial to remember that the cost of Trodelvy injection is reasonably priced and accessible for those who have a valid prescription.

Therapeutic Effects : The active component of Trodelvy that promotes its therapeutic effects is sacituzumab govitecan-hziy. Inactive ingredients in trodelvy include trehalose dihydrate, polysorbate 80, and 2-(N-morpholino) ethane sulfonic acid. 180 mg and 200 mg are the available strengths. Sacituzumab govitecan-hziy has shown promise in treating progesterone- and oestrogen-receptor-negative breast cancer because of its mechanism of action.For those who want to buy Trodelvy from India at a discount,

Negative Reactions: Those who have previously experienced a significant negative reaction to trodelvy shouldn't use it. There is a chance of serious hypersensitivity reactions with sacituzumab govitecan-hziy, including potentially lethal anaphylactic reactions. A few of the reactions that could happen are hypotension, wheezing, angioedema, swelling, pneumonitis, and skin reactions. To lessen the effects of the infusion, premedication is recommended. It's also advisable to have an emergency supply of medications and supplies on hand to manage any potential infusion-related complications, such as anaphylaxis, when administering sacituzumab govitecan-hziy. For more information on trodelvy injection price in India.

[hlgfy-blog]

The Interim

Much and more and has happened since his neutropenic fever at the end of September.

A round of consolidation chemo, out patient. He drove home from MD Anderson with a chemo purse to Louis' soccer game. It was a cute look.

Lots of visits to St. David's North for blood products and lots of Benadryl naps. Thank goodness for Tammy.

A ~10 day hospital stay at MD Anderson for RSV over Thanksgiving. Jake's never been more sick in his life, it was very scary. The Infectious Disease team killed it though, the virus and at their job.

Continuous discussions about where and wether Jake should wear a mask or not. My notes from last time show he argued this point then too.

And the consolidation chemo accidentally melted his bone marrow. If he wasn't going to transplant that would have been more of a big deal.

[anantradingpvtltd]

Price: [price_with_discount] (as of [price_update_date] - Details) [ad_1] Updated yearly. Last in July 2018. Over 390 illustrations and color photo's. We added detailed information on the treatment of the the most common admitting diagnosis. 1. Respiratory failure: ARDS. Pneumonia. Exacerbation of chronic lung disease (Asthma, COPD, Bronchiectasis). Pulmonary Embolism. 2. Shock: Hypovolemic (GI Bleed and Diarrhea). Cardiogenic (Acute MI / Infarct). Distributive (Sepsis and Anaphylaxis). Obstructive (massive Pulmonary Embolism. Tamponade. Adrenal Insufficiency / Crisis | 3. Cardiac disease: Acute MI / Unstable Angina. Heart Failure (CHF). Valvular Heart Disease. Hypertension Emergency. Arrhythmia’s with hemodynamic instability (see cardiology module). 4. TRAUMA: massive, involving multiple organs. Rhabdomyolysis | 5. Burns. 6. CNS injury: Stroke. Head injury. Hemorrhage (Subdural / Epidural). Status Epilepticus. Coma. Delirium. 7. Infections: Septic shock. Toxic Shock Syndrome. Meningitis. Neutropenic fever. Endocarditis. Diarrhea 8. Metabolic derangements: Acute Renal Failure / uremia. Diabetic ketoacidosis (DKA) and HHNKS. Severe Hyponatremia or Hypernatremia. Severe Hypokalemia or Hyperkalemia. Severe Hypophosphatemia. Intentional or accidental poisoning (See Trauma-Tox module for Toxidromes). 9. GI diseases: GI Hemorrhage. Acute Liver Failure / Encephalopathy. 10. Hematologic disease: Anemias. Thrombocytopenia. TTP-HUS. DIC. 11. Psychiatric diseases: Suicide attempt. Neuroleptic Malignant Syndrome. 12. Postoperative Crises: Post-Op Confusion | Hypotension | Fever & Infections | Oliguria & Short-of-Breath | Hyponatremia & Other Pearls | Filled with detailed work-ups, treatments, pearls, illustrations, differential diagnosis, references....Everything you ever needed to know about critical care and nutrition issues in an easy to read and navigate format created specifically for the handheld device. Edited by multiple specialists. The perfect text for internists, family physicians, urgent care clinicians, residents, medical students and mid-level providers. ASIN ‏ : ‎ B004I5BTW6 Publisher ‏ : ‎ Primary Care Software, PC; 18th edition (18 December 2013) Language ‏ : ‎ English File size ‏ : ‎ 9265 KB Text-to-Speech ‏ : ‎ Enabled Screen Reader ‏ : ‎ Supported Enhanced typesetting ‏ : ‎ Enabled X-Ray ‏ : ‎ Not Enabled Word Wise ‏ : ‎ Not Enabled Print length ‏ : ‎ 2167 pages [ad_2]

[rnewspost]

Delaying antibiotic treatment does not reduce survival chances in cancer patients with neutropenic fever

Delaying antibiotic treatment does not reduce survival chances in cancer patients with neutropenic fever

In cancer patients with neutropenic fever, delaying antibiotic treatment past 60 minutes from the time of fever detection does not reduce the short-term chance of survival, according to a study in the American Journal of Medical Quality. The journal is published in the Lippincott portfolio by Wolters Kluwer. Neutropenia-;low levels of white blood cells called neutrophils, which fight…

[mcatmemoranda]

ANC (Absolute Neutrophil Count) less than 500 is neutropenia. Neutropenic pts with fever should get blood cultures (peds pts get blood cultures drawn from their port), cefepime. Pentamidine is ppx against pneumocystis jirovecii pna.

Bactrim covers MRSA. Clindamycin apparently can actually be given to children less than 8. There's more resistance to clindamycin than there was before.

[tiffanythielke]

November is #pancreaticcancerawarenessmonth and I’m wearing purple for myself. Today was round 2 of cycle 7 and my 14th overall chemo session. The past week has been difficult with steady low grade fevers since Wednesday last week and then Saturday night through Monday night with several higher fevers over the 100.4 threshold of needing to visit the ER. However, my stubborn self didn’t want to go to the ER since I didn’t want to miss thanksgiving and the ER tends to admit me to the hospital when I go in. So I chanced it. Tuesday I had a mild fever, otherwise I was all ready to head to the ER, I didn’t get a fever today, and my counts were still okay to receive chemo this afternoon. I talked to one of my doctors before getting chemo to let them know about the fevers and they still okayed me for chemo (I’m trying not to have to push chemo back so I can keep my chemo free week for Christmas). If I felt worse or the Tylenol did help the fever then I would have gone into the ER because I’m not that stupid. I do listen to my body and my body was telling me that the ER docs would just ask me why I was there like they usually do. This isn’t my first or second rodeo dealing with chemo fevers and I never would have questioned going to the ER for a fever during leukemia, but there’s a little bit more leeway with this cancer, not much, but more than leukemia. I also wasn’t neutropenic but will be after this last round so I know that if I get a fever over 100.4 then I have to go in because my immune system will be too low to fight off whatever is causing the fever. My fingers are crossed that a fever doesn’t creep up tonight or in the next couple days so I can spend some time with family. After this last round today my oxygen levels are a bit low, hence why I’m wearing my oxygen while snuggled up in bed (for those new here, I usually only have to wear it while moving around) and I’m hoping it’s just because I’m tired. 🤞🏼🤞🏼 I hope you all have a wonderful and happy Thanksgiving 🦃 #cancersucks #pancreaticcancer #stage4cancer #metastaticcancer #tltart #mnartist #artistsoninstagram #artist #chronicillness #fargomoorhead (at Moorhead, Minnesota) https://www.instagram.com/p/ClVNdNPuTHO/?igshid=NGJjMDIxMWI=

[medicology-by-swati]

Fever caused by Neutropenia in Cancer Patients

Neutropenia in Cancer

Neutropenia is a condition in which an individual has a low number of neutrophils (white blood cells). This condition is quite common in cancer patients. More than half of patients who receive chemotherapy or other cancer medicines suffer from a decreased blood count. This is why it is often said that cancer patients have low immunity. Neutropenia in cancer can have a number of effects on the patients including neutropenic fever. 

Neutropenic Fever 

It is the single oral temperature of 101º F (38.3º C) maintained for more than an hour in individuals who already have neutropenia. Since neutropenia can be caused by chemotherapy medicines, cancer and fever show a link. Furthermore, neutropenic fever is considered a medical emergency in severe cases. Other symptoms that can be accompanied by fever are chills, sweating, sore throat, toothache, shortness of breath, cough, and pain near the anus.

 Since most cancer patients suffer from this condition, their treatment strategies play a vital role. Treatment of cancer in different countries is modified as per the genetic mutations found during the diagnosis. Like, Cancer Treatment in Russia is based on the root cause of cancer in the country, i.e., alcohol and smoke. 

Root Causes of Neutropenic Fever

Neutropenic fever may not be caused by the problem. There can be different root causes of this condition. These may include:

Acute and chronic leukemia

Bacterial or viral infections

Chemotherapy medicines

Transplant of an organ

Chronic idiopathic (unknown causes) neutropenia

Deficiency of a nutrient (folate or vitamin B12) 

Chronic idiopathic neutropenia (inflammation in the     collagen)

Cyclic neutropenia

Overactive spleen

Diagnostic Approach for Neutropenic Fever

Neutropenic fever is diagnosed by looking for a number of parameters. The following are some of the diagnostic factors that can be considered while prescribing medicines:

New visible neurological changes like loss of muscle     control, weakness, and insomnia.

Symptoms of COPD (chronic obstructive pulmonary     disease) including cough, shortness of breath, and respiratory infections.

Severe thrombocytopenia (low blood platelet count) with     unusual bleeding.

Gastrointestinal conditions like nausea, change in     bowel habits, abdominal pain, diarrhea, and vomiting.

New pulmonary changes including respiratory failure,     low level of oxygen in the blood, and pulmonary infiltrate.

 In case you experience any unusual signs or think you are at risk of developing a neutropenic fever, be sure to contact your medical professional and get the doubts cleared. Moreover, some patients require dose adjustments to manage severe symptoms. 

  Source: http://writeus.me/fever-caused-by-neutropenia-in-cancer-patients/

[appalachiananarchist]

I know that *technically* the fact that I have a temp to like 102 while critically neutropenic & lymphocytopenic is Very Bad™, but I also know it is from COVID, so I don’t plan on going to the ER unless I actually start dying. I am worried this is going to flare up my TTP again, though, so if the fever gets worse I will have to bite the bullet and go.

[jenthebug]

I get my Covid vaccine on Thursday!

But then I have to get the second one.

I am (possibly irrationally?) scared of getting the second dose, spiking a fever, and having to go to the hospital. I'll ask the oncologist about it.

I'm kinda stoked! But I know it's not a free pass to let my guard down, I still have to stay home when I'm neutropenic because of all the other stuff I could catch.