昂貴升白針之副作用

骨痛

每種能醫治某種病，卻又能帶出某種副作用。升白針，無論貴或平，也不例外。

昨日醫生助理很憐憫我，免費給我注射昂貴的升白針Neulasta（可譯作白血球生長素），三千美元以上一枝，能維持十二天的日子，只是不知這藥屬效力高，故副作用在今天很明颢出來了。

骨痛－－令我卧在床上，轉輾反側，無法入睡；上兩次打便宜的那隻升白針Neupogen，也不用吃止痛藥，今次卻要；

發燒－－早上十時半許量體溫，是100度，向神祈禱求不要再升；

呼吸出現急速（acute respiratory distress syndrome－－ARDS, 急性呼吸窘迫症候群)－－今次明顯需要更多力氣呼吸了；

輕微頭痛－－昨夜及今天都感頭重重，無法安心入睡，連吃有催睡的Tylenol，也不能使我可安然入睡；

再看下去時，發現這隻昂貴藥原來有可能會損害我的肝功能，真是一個循環。打升白針，主要是針對肝炎藥拉低我的白血球指數；打了升白針，卻原來又可能會令脾臟破裂，帶來更嚴重的肝病問題。真是只有向天仰望，祈求神施憐憫！

肝炎醫生覆我昨日的電郵

Mena's question:

Dr Steady,

Sorry, yesterday I mis-heard the WBC result.

this morning I got the result from the Lab, and noticed the yesterday WBC is only 1.3, the raising rate is only 0.3 even after injecting 300mcg Neupogen,
and within one day the WBC will drop down again, that means I need to keep going to do blood drawing for my CBC test, and need to have Neupogen injection very frequently, so, I wonder if I could reduce the hepatitis medication again,
let's say, from 1/4 tablet every other day to 1/4 tablet every 3 or 4 days,
and eventually stop this medicine.

I request this, because my WBC is still very low,
and my PLT is getting worse, the following symptoms now I have:

1/ a rash of pinpoint-sized reddish spots already appears on my lower legs;
fortunately the rash is still in control.
2/ prolonged bleeding cuts;
esp after the injection and blood drawing,
3/ finally, I keep coughing and feel fatigue very easily during this week.

My next week Herceptin IV has been postponed to the following week,
that's the 2nd time being postponed due to the extreme low WBC.

thus, I need your advice to see if it is possible to reduce the medicine again.
thanks a lot.
Mena
2008.9.5

Steady's reply:

Mena,
You can reduce the Baraclude to 0.25mg every 3rd day. If you wbc come back to fast while on minimal doses of the antiviral agent(抗病毒劑) your hep b can flare（突然增加，向外張開） and cause you to get very, very sick.
Dr. Steady
2008.9.6

May God bless your prayer.