Gemcitabine side effects

I've been feeling, basically, crappy for the day or two following chemo: I run a bit of a fever, have a headache and muscle aches, and have no desire to do anything except lie on the couch with the cat on my stomach listening to music. Then the next day I'm fine.
It's only taken a couple of months for me to figure out that these spells might have something to do with the chemo. For the past six or eight months I had no side effects, so they dropped off the radar and I assumed that they would continue to. But there must be some cumulative effect.
Now I know what others on Gemzar complain about. If you look at the side effects listed below, I'm actually in pretty good shape. Some, like the low blood cell levels of one sort or another, I only have occasionally. Others, like the fever and aches, are no fun, but as long as I know that they're bounded and that they're just a result of the chemo and not a sudden dropoff in my health, I can stand them. I'll just have to figure out how to work around the off days.

From Oncolink
Common Side Effects


Decrease in the number of white blood cells (neutropenia) I've had this
Puts you at risk of infection.
What to do: Call your doctor or nurse for a fever of 100.4 F or greater. Avoid people with the flu or colds. When working in your yard, wear protective clothing including long pants and gloves. Do not handle pet waste. Keep all cuts or scratches clean. Shower or bath daily and refer to Chemotherapy and You (NCI, 1997) for mouth care. Do not cut cuticles or ingrown nails. You may wear nail polish but not fake nails. Ask your doctor or nurse before scheduling dental appointments or procedures. Ask you doctor or nurse before you or a family member has any vaccinations.

Decrease in red blood cells (anemia)
Causes loss of energy.
What to do: Call your doctor or nurse if you feel more tired than usual or short of breath while doing normal activities.

Decrease in platelets (thrombocytopenia)I've had this one, too.
Puts you at risk for bruising and bleeding.
What to do: Call your doctor or nurse if you notice any unusual bruising or bleeding. Do not floss or use toothpicks. Use a soft-bristle toothbrush or cotton swab. Ask your doctor or nurse before scheduling dental appointments or procedures. Use an electric razor to avoid cuts. Do not use medication containing aspirin or ibuprofen without asking your doctor or nurse.

Nausea and Vomiting No vomiting (except when my stent was blocked; but sometimes I get nausea or queasiness.
What to do: Take your anti-nausea medications as prescribed. Try to drink 6-8 glasses of fluid a day. Avoid eating fatty foods, large meals, and acidic foods (e.g. tomatoes, lemons, oranges, grapefruits) and spicy or hot foods when you feel nauseated. Call your doctor or nurse if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time.

Decreased appetite I get this one the day or two after chemo.
What to do: Try to eat five or six small meals or snacks throughout the day. If you are not eating enough, nutritional supplements may help. Ask your nurse for a copy of the Eating Hints booklet (NCI, 1995) and about nutritional counseling services.

Diarrhea Nope.
What to do: Call you doctor or nurse if you experience an increase in the number of stools, an increase in the volume of stool or if the stool becomes more liquid. Take the antidiarrheal medication your doctor has prescribed. Increase your fluid intake by drinking more liquids than usual (e.g. sport drinks, broth, gelatin, popsicles, soups). Eat bland foods such as bananas, rice, unsweetened applesauce, toast, cereal, and potatoes. If the diarrhea continues, contact your doctor or nurse again.

Effect on skin Not so far.
What to do:Call your doctor or nurse if you develop a rash, especially if it is itchy. Your doctor may prescribe a cream or ointment.

Fever Yes, the past few rounds of chemo, but not above 100.4 (Of course, my usual temp is 97.4. Does this make a difference?)
Gemcitabine can cause a low-grade fever the night after your treatment and for 2-3 days after treatment.
What to do:Call your doctor or nurse if you have a fever greater than 100.4F or chills.

Flu-like symptoms Yes.
What to do: Call your doctor or nurse if you have a fever greater than 100.4F, weakness, body aches, decrease appetite or headache.


Uncommon Side Effects: We'll skip those, since I don't have any problems with lungs, liver, kidneys, or any of the other horrors they mention except for thinning hair. Damn it.