Neupogen is a drug used to stimulate the development of white blood cells (WBC). Chemotherapy patients are often given this shot in the stomach to help the WBCs regenerate. Although that sounds peachy, I always have been a bit skeptical about using a drug to mess with the chemotherapy and artificially cause the bone morrow to produce more white blood cells. However, when doctors tell you that you need it because the WBC count is so low that deadly infections can happen, you agree. However, a few days into it, I realized a few items:
- Not all doctors prescribe Neupogen. When I pushed back on Neupogen, eventually some doctors indicated it was optional, which leads me to the wonder why doctors just give patients such a strong shot without really discussing it in the first place. Giving hospital inpatients drugs without really discussing impact and need is another issue.
- When a nurse found out we had a biopsy scheduled in a few days, she told us to stop Neupogen immediately because it can cause an artificial count of cancer cells (blasts). No one mentioned this previously, but all the Nurse Practitioners and Physicians Assistants at Stanford agreed that we should stop Neupogen several days prior to a bone marrow biopsy.
I know that Neuopgen is prescribed so neutropenic (low white blood cell) patients do not get sick. However, it is always critical to know why it is given, and if it makes sense My continued lesson here is that the need to have patient advocate or be your own patient advocate is so high. Nurses and doctors, no matter now brilliant, do not always have the full picture of each individual's treatment plan, so we need to tell them.