As a mother of two small children who attend school daily, I was constantly aware of my risk of infection throughout chemo.  I also have asthma & take a prescribed inhaled steroid daily, which helps the asthma but can reduce your body’s ability to fight some infections.  This combined with the increased risk for infection from chemo made a respiratory infection a risk for me.  I wanted to do my best to protect myself & be cautious.

Aside from cancer cells, chemo also kills important cells such as white blood cells, red blood cells & platelets.  Most chemo causes low blood count, also referred to as neutropenia.  The goal of chemo is to destroy the cancer cells while still allowing good cells to regenerate.  Neutropenia typically lasts four to seven days, but varies from person to person depending on their treatment plan as well.  Ask your doctor when your blood count will be the lowest.

Reducing Risk of Infection

Take an Immunity Booster – Your doctor will most likely prescribe an immunity booster such as Neulasta which helps rebuild white blood cells.  These can aid so much in reducing your risk of infection by helping your body rebuild those important cells more quickly.

Avoid Crowds – It goes without saying there are a lot of germs being shared in a crowd.  I basically tried to avoid any public facilities that I didn’t frequent regularly prior to treatment.  I basically kept it to home, the grocery store, my appointments & my two favorite restaurants that I absolutely cannot live without.  This is especially important when experiencing neutropenia the days following treatments.   If you do have to venture out during that time, wear a mask to protect yourself.

Avoid others who are Sick – Let your friends & family know you’re at increased risk & if they’re not feeling well, postpone your plans to get together.  If someone in your home becomes ill, do your best to avoid direct contact as much as possible.  Be sure they get to the doctor quickly, if the virus may be contagious, in order to get them on antibiotics as fast as possible.   My hospital suggested having my family use plastic utensils if they weren’t feeling well so they could be tossed immediately rather than spreading any germs prior to being washing.

If you have Children – As difficult as it may seem, no kisses on the lips!  Kisses on the cheeks, forehead, and top of the head all fine, but absolutely no mouth kisses with those sweet, but germy kiddos!  Be sure they know to cover their mouths with their arm rather than hand when coughing to help minimize spread of germs.  As well as using a tissue for runny noses, not arms or hands.

Use Hand Sanitizer & Wash Hands Regularly– And use it!  Carry it with you at all times, keep one in your car, etc.  I always make sure to use it before meals at a restaurant & as soon as I get in my car when leaving the grocery store for example.  It’s important to be sure the other members of your household are sanitizing or washing their hands regularly as well, especially when not feeling well.  Remind your children to wash for the length of time it takes to sing happy birthday to ensure they’re washing thoroughly.

Some key times to wash for you & your family members to keep in mind:  Before, during & after cooking, before eating, after using the bathroom, after helping a child use the bathroom or changing a diaper, after coughing, sneezing or nose blowing, after touching trash, before & after treating a cut, after petting or feeding an animal or cleaning up after a pet, after using a grocery cart or entering any public facility & handling door handles, money, etc.

Shave with an Electric Razor – To reduce risk of cuts which can lead to infection, it’s best to use an electric razor throughout treatment.  I have to admit however I didn’t head this advice myself, I don’t think electric razors get a close enough shave & I seriously cannot sleep if there is anything prickly on me, so for that reason, I continued with the regular razors.  The hair on my legs didn’t grow back very quickly so I didn’t need to shave often, therefore making the risk a bit more minimal in my opinion.  When I did I was sure to use a new razor, shaved very carefully putting no pressure on the razor to avoid cuts & I never did it the days immediately following a treatment.

Don’t pick or pop any pimples – It should go without saying, but this can irritate & obviously increase the risk of infection.

Don’t trim cuticles – Again any small cut exposes you directly to more germs & increases risk of infection.  If you get a manicure during treatment be sure to let them know you don’t want your cuticles trimmed & let them know why.

Good Oral Hygiene – To reduce risk of an oral irritation & infection you may opt to switch to a softer tooth brush & avoid flossing.  Definitely ask your physician if it’s okay for you to floss.  An alcohol free mouthwash such as Crest ProHealth or a mixture of warm water & baking soda should be used after each meal & at bedtime to prevent mouth sores from developing.  In a pinch if you’re out & about, at the very least chew a piece of sugar free gum to help clear your mouth of any remaining bacteria or food particles after a meal.

Avoid Raw Fruits & Vegetables or Juices – If you are experiencing low blood count it may be a good idea to avoid these as they can harbor bacteria which could lead to a systemic infection.

Avoid Processed Meats – This is probably a good idea in general throughout life, but especially during chemo.  Deli meats & hotdogs can pose an increased risk for some infections.

Avoid Raw Meat & Seafood – No steak or tartar, no sushi… it’s a sad time I admit, but eventually we can resume these items to our diet.  Though many probably won’t even miss these items, I on the other hand missed sushi terribly!

Avoid Unpasteurized Products – Pasteurization kills pathogenic bacteria so any products missing this step carry an increased risk for infection.  This was another challenge for me, I love most unpasteurized cheeses, such as feta, brie, camembert, goat cheese, blue cheese, gorgonzola, etc…

Stay Hydrated & Eat a Well Balanced Diet – This is important to help restore those necessary cells.

 Watching for Infection

Monitor for Fever – Take your temperature regularly, especially if you feel warm, flushed, chilly or are just not feeling well.  Your doctor will most likely provide specifics to watch for, but a temperature of typically 100.4⁰ F or higher for an hour, or a one-time temp of 101⁰ F would justify a call to your doc.  If you go to an Emergency Room, be sure to tell them you’re a cancer patient undergoing chemotherapy.  If you have a fever, you may have an infection which could be life threatening & you should be seen immediately.

Watch for Symptoms of Infection – Your doctor will again most likely provide you specifics to keep an eye out for, but in general these symptoms can be a sign of infection.  Chills & sweats of course which can be a sign of fever.  Any new cough or change in an existing cough, especially when accompanied with mucus.  Any difficulty breathing or shortness in breath, wheezing, etc. should be brought to your doctor’s attention right away.  Signs of a cold or viral infection to watch for are sore throat, runny nose or nasal congestion.  Diarrhea lasting more than 24 hours that you’re not able to control with adjustments to your diet should be reported.  Any vomiting that’s not caused from your chemo directly & not aided by medications could be indication of a systemic infection or flu.  Burning or pain during urination could be indication of a urinary tract infection & should be reported right away.  Any new pain, changes to the skin, rash, swelling, even a stiff neck could be cause for concern.

Basically anything that may seem out of the norm to you should be reported to your doc.  Listen to your body & heed its warnings.  Be sure to contact your physician promptly if you have any concern, it’s better to be proactive than to wait & find yourself in a situation that could have been avoided.