Chemotherapy for Testicular Cancer Can Result in Low White Cells. Luckily, There’s a Shot for That!

After having to delay chemo for a week before cycle two began, due to my white blood cell counts dropping lower than the required minimum level of 1.0, Dr. Maurer was not taking any chances of further disruptions. He decided I would get neupogen shots after days 8 and 15 in my second cycle.

What is Neupogen?

Neupogen is a man-made protein that works to stimulate white cell production in the blood and bone marrow. It consists of two shots given over two days. After Day 8 in cycle two, I got them on days 10 and 13, and after Day 15, they came on days 16 and 17. Typically, the nurses like to do them back-to-back like in the latter round, but splitting them up doesn’t hurt either.

Speaking of hurting, surprisingly, the actual injection doesn’t hurt much more than a hornet sting, so the actual shot wasn’t a huge production. This wasn’t always the case. When I was about 4 years old, I kicked a nurse when she went to give me a shot. In my mind, my foot connected with such force that she went sprawling across the room, a la Chuck Norris. My mom assures me this is not true, but I don’t believe her. She also said the nurse shouldn’t have come straight at me with a needle, to which I suggested a serpentine pattern would have been better. Needless to say, I didn’t kick the nurses this time.

The liquid itself is cold, so that is a little uncomfortable, but any discomfort is gone about five minutes later. Plus, I get a cool Garfield bandaid to cover my wound.

The real pain of Neupogen comes the following day. 

Aside from recovering from my surgery, I haven’t experienced any significant pain as a side effect of cancer or chemo, for which I am extremely grateful. However, these shots have caused some severe internal bone discomfort, which at times was so intense to the point it immobilized me in bed.

If you’ve ever had the flu, you know how your bones can get achy and sore. Similarly, going outside when it is really cold and you’re not wearing enough layers can cause bone discomfort, too. Take both of these feelings and multiply by ten – that’s how the neupogen made me feel.

I have a pretty high pain tolerance, thanks to running cross country and track for three years in high school. As part of treating the pain of shin splints and knee pain back then, I took some high doses of ibuprofen, which means the same dosage doesn’t seem to be as effective any more. The recommendation to help bone pain from these shots? High doses of ibuprofen and Claritin.

At times, I physically yelled out – it felt like a shockwave of pain was radiating from my lower back all the way out to my fingertips and toes. Luckily, the discomfort wasn’t constant. It would come and go throughout the day. There didn’t seem to be rhyme or reason to what time or day it hit.

One minute I could be cleaning the kitchen up, the next I would be rushing upstairs to get into bed. However, it did appear to be most severe in the mornings and right before bed. When it did hit, I found lying on my side in bed helped.

Finding silver linings as the testicular cancer journey comes to a close

Thankfully, the pain only seemed to last about 1-2 days per shot set. So much down time was kind of nice, because it gave Mallory and I a chance to watch Stranger Things on Netflix. I found myself identifying with Eleven – and not just because of the lack of hair. We were both feeling like lab experiments with side effects we couldn’t control.

The big positive is that the shots appeared to solve the problem of lowered white cells and a compromised immune system. By week three in my first cycle, my cell counts had dropped to 0.6. In week three of cycle two, they had only dropped to 2.4. I’ll take 1-2 days of pain if it means staying on track with treatment.

Today, I began my last (scheduled) cycle, which will culminate in one last short day of treatment. Hopefully my cells maintain that 2.4 (or at least didn’t drop below the requisite 1.0). My levels ended up being in the 8.0 range – one of the highest ranges since I started. I’m not sure if we will do shots during cycle three, as I won’t need to keep my counts up for a fourth cycle.

The most ironic thing I found in all this was my mom wasn’t here during the for the aftermath of the shots, and she’s normally my biggest pain.*

*just kidding.