One of the more nasty side effects of the chemotherapy drug Docetaxel is something called Febrile Neutropenia. That’s a fancy way of saying that something called neutrophils that are in your white blood cells get dangerously low. Those neutrophils are what help you fight infection, and when they are low, you are a high risk of getting infection. For chemo patients, this can be life-threatening.
The first sign of infection is a fever. Chemo nurses and oncologists drill into you that at the first sign of a fever – 38 celcius or 100 Farenheit – get to the hospital and get checked for infection. This is the reason I take my temperature at least three or four times a day – more often during the first five days after each round chemo. I came very close during the last round of chemo – as high as 37.9 on one day, and sustained over 37.5 for five hours before hitting the 37.9. I never felt ill, didn’t have sweating or chills or general malaise, so I didn’t panic. But I was concerned and watched closely.
Fever, then, is something all chemo patients need to be vigilent about. A friend who is going through chemo at a different facility than I am was given a red ‘fever card’. It identified her as a chemotherapy patient, listed the chemo drug protocol she was on and the fact that she is at risk for febrile neutropenia. Her husband was given the same card. The idea is that when you get to the emergency department (after you hit 38 Celcius and, following instructions, head to the ER), you simply hand over the card and the triage team immediately knows the protocol to follow (check neutrophil count being the first step).
I didn’t get a fever card. Once I learned about the card my friend got, I immediately wanted one. From a sheer safety perspective, it made total sense to me – if I really am disoriented because of fever, having a friend/family member being able to hand over the card to an ER nurse and not explain it myself is a big comfort.
But there’s more to it than that. In many ways it’s about control.
The life of a chemotherapy patient is very much about a loss of control over many things in your life. You are at the mercy of the chemo drugs they pump in to you, and you have to present yourself at clinic appointments and other check ups. A lot of your life becomes managing your side effects.
Little things like a card in your wallet that helps you tell others what’s wrong (or might be wrong) helps you feel a bit more in control. I know the card, in the end, makes little difference, and that the medical professionals will follow appropriate protocols and processes.
But having a card that says ‘hey, pay attention, check my neutrophils and call my oncologist’ makes me feel just a tiny bit safer. And a tiny bit of control of my life has been handed back to me. It’s all a mind game.
I made my own ‘fever card’. It’s in my wallet, and my friends/chemo buddies all have one too.