Neutropenia Management after Chemotherapy

After the chemotherapy Cycle, here comes a period called the Neutropenia phase, which normally occurs between 7 to 14 days, called the NADIR PERIOD. However, in this period, patients experience the suspected side effects of chemotherapy, which may include:

• Nausea and vomiting
• Fever
• Low white blood cells
• Low platelet count
• Low hemoglobin level
• Diarrhea or constipation. Some patients experience constipation as severe as diarrhea.
• Skin discoloration
• Low energy

Precautions in Neutropenia

As in the neutropenic phase, due to low white blood cell count, patients can get infections very easily. The patient should take care of the following.

Avoid going to large, crowded places:

Patients should avoid going to parks, malls, or markets where patients can easily get contagious diseases like flu, tuberculosis, COVID-19, chicken pox, etc.

Avoid using sharp objects:

Patients should avoid sharp objects like razors. This can result in cuts and can lead to bleeding due to low platelet count. Do not use a toothbrush; instead, use the prescribed mouthwash.

Use of hygienic food:

Use boiled water and well-cooked food. Should prefer homemade food. Use fruits after peeling them.

Avoid using public toilets:

Patients can get urinary tract infections very easily from public toilets. So, avoid the use of public toilets when you are on chemotherapy treatment.

Maintaining good hydration:

Keeping yourself well hydrated, by drinking simple water, juices, or fluids containing electrolytes, will keep your kidneys well-functioning so that your kidneys flush out the end products of cytotoxic drugs.

Also, your skin and other systems of the body will be well hydrated. Moreover, it can protect your skin from getting discolored or dull and also help in removing free radicals from the body.

Avoid excessive drinking of green tea or simple plain water:

Some patients drink too much plain water or excessive green tea to hydrate themselves. This should be avoided, for a normal person, around 2-3 liters in 24 hours is enough for normal hydration.

However, too much drinking, such as 4,5 liters, may expel some electrolytes from the body, which could lead to an electrolyte imbalance.

Avoid sun exposure:

People on chemotherapy have susceptible skin. So, avoid strong sun exposure or use a scarf or a hat when going in the sun.

Seeking Medical Attention:

In the neutropenic phase, the patient could have any emergencies; you should be well aware of them after the chemotherapy phase. However, managing them on time could lead to early recovery and prevent them from becoming complicated.

Consult your Doctor in case of a fever of 101°F.

• Bruises in the skin or bleeding from anywhere in the body. This may be in the urine, in vomit, or in stool.
• Have urinary hesitancy or burning in urine. This could be an alarming sign of a urinary tract infection.
• Uncontrolled diarrhea or vomiting. In this case must consult your healthcare provider to prevent further complications such as dehydration or nutritional imbalance.

How to Manage the Neutropenic Phase?

Management of fever:

In the neutropenic phase, when WBC counts are low, patients get infections very quickly. So, fever is the first sign of infection. Your health care professional will manage it by testing your blood, urine, and chest for any infection.

Thus, according to the type of infection, you will be prescribed a course of antibiotics, antifungals, or antivirals along with medications to lower your fever, known as antipyretics.

Low Platelet Count: If your platelets are low. A platelet transfusion will be done to prevent bleeding.

Low Hemoglobin Level: A packed Red blood cell will be transfused according to your hemoglobin levels.

Nausea /vomit: Medication will be administered to control nausea and vomiting. Sometimes diet modification is also done to control nausea and vomiting.

Mouth Ulceration (Mucositis): Try to use a good mouthwash containing anti-fungal instead of using a toothbrush. Furthermore, avoid toothbrushes if platelet counts are low. This may cause gum bleeding.

Isolation: Avoid having so many people visit the patient in the neutropenic phase. If possible, keep the patient in a single room to prevent him from getting infections.

The neutropenic phase occurs after every chemotherapy cycle. Fast recovery from this phase prepares the patient to be ready for the next cycle. So, try to be more careful in your diet and exercise, and following the above tips can reduce your neutropenia time. And get your chemo cycles on the standard time of your course.