Folfuri + Avastin and Neupogen Shot - feeling awful

Bellen

Hello Group - I have CRC with several liver mets. Chemo is folfuri + avastin, plus 5 shots neupogen for low WBC counts. I am experiencing so many abdominal side effects plus bone pain from WBC shots - possibly contributing to side effects is a small bowel intestinal stricture which causes painful spasms (partial blockages).  I either have diarrhea or constipation almost the whole time in between treatment (every 2 wks). Some days taking miralax or imodium depending on whether everything running through or not at all. Yesterday, felt okay - at 2pm got very tired, nauseated, painful spasms, couldn't eat (trying not to lose weight), in bed rest of day and felt absolutely awful - took 2 tylenol, 2 gravol.  Today still couldn't eat much - discomfort in stomach. Even Ensure causes diarrhea.  Can't seem to get a hold on how to deal with these issues.  Have had 3 treatments.  Any suggestions would be appreciated.  Sometimes I feel so awful don't know how long this can go on, and then when I feel better, I think I can handle it.

JanJan63

That sounds really nasty. I'm

That sounds really nasty. I'm not familiar with neupogen so I'm no help at all. I just hope you feel better soon. How much longer are you on this treatment for?

Jan

Bellen

Treatment and feeling awful quite a bit

I will be having 3 months of fulfiri + avastin, then CT scan.  I have chemo every 2 wks - avastin, irinotecan + another over about 2-3 hrs, then I go home with 5Fu for 2 days - so actually 3 days chemo, and then 12 days later chemo again. The day after take the 5Fu off, I get 5 days of neupogen shots (WBC), so really don't have a lot of days to recoup, have break, etc - I think that's why I feel so bad at times. Throughout, I have a day when feel okay, then things hit me again. Usually have diarrhea or constipation - never gets back to "my normal".  My health care team is trying to help me, but my side effects are not predictable enough - I really have to take whatever I think will help at the time.  For past 5 yrs, I already had chronic constipation (took miralax every day due to low residue/no fiber diet that was recommended to help) due to a small bowel stricture that causes extremely painful spasm partial blockages, so that sure doesn't help, and probably aggravates.  Just wondered how others felt if they had fulfiri, and how they dealt with the side effects.  Maybe I just have to deal with this the best I can.  I really appreciate any feedback.  Best to all.  Bellen

abrub

Try Claritin/Loratidine

Supposedly taking Claritin (Loratadine) daily in the morning, starting the day of the expected neupogen shot and on for a few days helps diminish the bone pain.  Perhaps someone will step in here with more information, but I know it has research supporting it.  (Yes, the mild OTC allergy med.)

lizard44

I was told either Claritin or

I was told either Claritin or Tylenol before the Neupogen shots would help with the bone pain.  I  tried the Tylenol- took it in the morning before going in for the Neupogen shot and it did work. I never tried the Claritin, but if you  don't get relief from the Tylenol  you might want to try that.

Sorry you're having such a nasty time with the chemo. I can't speak to the other problems- I had eight treatments of Folfox 6 plus Avastin. The major problem I had was fatigue and low WBC count.  I'm now on Irinotecan  and Erbitux-   and aside from  skin problems haven't had any major problems.  With these two, one causes diarrha and one causes constipation, so I think they're balancing each other out.  I do have to watch what I eat beause some foods do seem to trigger   bowel problems.  I avoid fried foods, fatty foods, butter, whole milk, raw fruits and  vegetables, with the exception of bananas which don't cause problems.  I eat yogurt every day and take probiotics which seem to help a lot. Fortunately, on the  rare occasions when I do  get diarrhea, a dose of Imodium at the very first sign pretty much handles it.

Bellen

Folfuri and stomach issues
I am taking 2 regular tylenol 2x per day on the 2 or 3rd day of the neupogen shots and they have definitely helped with the bone pain. It seems my stomach issues (diarrhea/constipation, partial blockages, nausea, etc) may be more related to the folfuri and the small bowel intestinal stricture that I have. Chronic constipation has been a problem for me, and that is why I took miralax daily because staying regular seems to be connected to my partial blockages. Plus I may need to take anti-nausea pills more often, as I think it will help with my lack of appetite, and make me feel more like eating - by mid day don't really feel like eating, and I am trying to not lose too much more weight