Re: Safety... c'mon, lets keep it in perspective h
wilbur
There was a point in time that if a kid was on chemotherapy, they were advised to stay away from other people because of the risk of infection. That meant no school, no play dates, no church, no going to the mall or the movies, and wearing masks when they had to go out. Over time, we started letting up on those restrictions, and the rate of infections in kids on chemotherapy did not change, which shows that those precautions did nothing other than to make life miserable for the kid and his/her family.
The reason for this is that the immunosuppression that comes with being on chemotherapy is in the form of a lowered white blood cell count. The risk of having a low WBC is a higher chance of a bacterial (not viral) infection when you develop a fever without a great way to fight it off.
The thing that wasn't realized was that the WBC is a secondary line of defense when it comes to your immune system, and has little to do with preventing bugs from other people from getting into your body. The parts of your immune system that are the first line of defense and that form a barrier to entry are your skin, nose hairs, mucus, cilia in the respiratory tree, and the lining of the GI tract. Those things all work even if your WBC is zero.
In addition, when bacterial infections are found in kids on chemo with a fever and low WBC, they are bacteria that can be traced back to bugs that grow on your own skin and GI tract. There is no reasonable way to clear out those bacteria.
My advice to my families whose kid is on chemo is that if they are wondering whether doing something will put their kid at risk for infection, pretend like the cancer and chemo never happened. If a trip to the mall didn't worry them before about their kid catching an infection, then go to the mall. If they had a play date scheduled with a friend, and they get a call from the other mom that the friend has diarrhea, then don't go. But that's not because the kid is on chemo. That's because no one should go to a house where a kid is in the middle of having diarrhea.
The speed at which a kid is going to recover from these infections somewhat depends on the WBC recovery for bacterial (not viral) infections. But since bacterial infections are sourced from the kid himself, the exposure from other kids is a non-issue as far as I'm concerned.
Again, a small percentage of my families do put their kid in a bubble. I don't argue with them about that, because if doing that will help them sleep at night, that's fine with me. I just tell them that they can't tell their friends that doing so was my idea.