worst days on taxotere

And it may even boost our immune systems. Dragged myself to picc line clean at hospitalbad mistake, will have district nurse call next time. X, Reading all the comments, many of us have been through the mill with this 4th treatment. The Complete Guide That Makes Choosing an HVAC Company Simple, Best Broome Tours: A Guide to This Australian Charm. In its mechanism of action, Taxotere prevents the inner structures of cancer cells from building, which stops cell division and eventually leads to cancer cell death. If the platelet count becomes too low, you may receive a transfusion of platelets. Good luck , The first dose of docetaxol was the worst for me. Stick with it. 2.6 Premedication Regimen. You may use nail polish, but do not wear fake nails. I am just unfortunate to get them all. I took nausea tabs even when I wasn't nausaus, but it made little difference. So would recommend this. xx, No problem you keep strong & you will get through it, I've never cried so much in my life I think it was my way of dealing with it. Thanks again for all the useful tips, it's good to share problems, you dont feel so alone, hope you are very well! It was neoadjuvant chemotherapy, including Taxanes (Taxotere), Carboplatin, and Trastuzumab (Herceptin). nausea and vomiting. The problem is that it can affect the reproduction of other cells in your body, like hair follicles. While it sounds harmless enough, constantly tearing eyes can cause other health issues. The drug can cause tear duct closures which can cause permanent tearing. Premedication is required with Docetaxel. Avoid any food that you think smells or tastes bad. If you are not eating enough, nutritional supplements may help. I have the district nurse for the 5 injections following chemo and also the Picc line flushes as not left the house since last chemo, not had the energy. Severe symptoms are less common but require dose modifications. Men who are treated with this medication should use effective birth control during and for 4 months after the last dose. All the very best for the next treatment, I will think about you when I have mine next Friday. Call your oncology care team if you are unable to keep fluids down for more than 12 hours or if you feel lightheaded or dizzy at any time. Re: Docetaxel help please!! Whole body ache , muscles and joints, headaches, kidney pains, swolen glands, lethargy and over emotion. Eyes watery but ok. Sorry for the extended message but reading these chats means I'm not alone and I'm not a hypochondriac (as believe me I've thought it) I've just had my first Docetaxel 5 days ago and boy am I sufferingshooting painsin lower back, kidney area,legs andshoulders for two days now. Recurrence of endometrial cancer in lymph nodes. Other effects for me are tingling in feet, skin peeling off, mostly in feet, toe nails highly sensitive. Fellow sufferers, keep your hopes up. Docetaxel is given by intravenous (IV, into a vein) infusion, usually over an hour. I know it is really hard to go back when you know how rough it will make you feel-I tried to look at as a bad dose of flu( a normal person problem)No one would expect you to get out of bed with flu. I was 'tired' on days 3 & 4 on A/C but napping/resting helped. I need to eat better to keep up my energy which is at an all time low. Did they check your bloods in A&E?? However, our monthly flat rate of just $49 per medication . But it was worth it when looking at the larger picture. As horrid as her experience was, it had its payoff. Remember your reason for starting chemo. I know what to expect now and feel better prepared for chemo cycle 5, 2nd of Docetaxel . We've heard that the Taxol is a lot easier. I had no sleepless issues on A/C but on Taxol I did - first meds given me by my Chemo Dr did not help only gave horrible nightmares (which I don't normally have) but my PA switched me to the lowest does of another med and it worked great.It's great to ask for input of experiences BUT There are NONE of us who can tell you what your wife will experience - we are EACH so unique in how our bodies handle the onslaught of the battle - we can tell our stories but we cannot tell you that what happened to/with us will happen for your wife.Susan, I too had AC followed byI too had AC followed by taxol. If you feel unwell or have any of these signs, tell them straight away. I was advised to take paracetamol (or cocodamol if you can bear it) and ibuprofen together every 4 hours from the third day after you have the chemo until the pain eases off, which for me was about day 10. Patients on the TAXOTERE arm received TAXOTERE (T) 75 mg/m 2 by intravenous infusion on day 1 followed by cisplatin (P) 100 mg/m 2 administered as a 30-minute to three-hour intravenous infusion, followed by the continuous intravenous infusion of fluorouracil (F) 1000 mg/m 2 /day from day 1 to day 4. HI Multitasker! Progression-free survival was 2-3 months for both groups. The cycles were repeated every 3 weeks for 3 . The U.S. Food and Drug Administration originally approved the drug in 1996. xx, My consultant reduced my injection strength so I had to endure 10 injections as prescribed. Deaths within 30 days of last study treatment attributed to study drug occurred in 9 patients (2.2%) in the docetaxel+cisplatin . Alternative therapies can help for relaxation althrough at th emoment i go for the glass of wine cure. I haven't had much information about that yet. Mike White. The care I have had from diagnosis to today has been quick, I begin Radiotherapy begining of March. The month of October 2008 was one of the worst in New York Stock Exchange history, with three of the top 10 largest single-day drops ever recorded during the month. I actually postponed Rads for a few weeks so that we could go away. Talk to your care team about these recommendations. It is very frustrating when you just want to get on with life but he was advised to 'listen to what his body was saying and act accordingly' on an hour to hour basis if necessary. Today is the first day of actually feeling better after first cycle of Docetaxel, I am going to enjoy this last week before the next cycle of chemo starts. Patients may struggle with never-ending itchiness, swollen eyelids, and an increase in "floaters." I've had all three FEC sessions and coped really well and was positive and active. Docetaxel can cause your body to hold too much fluid, which can be a serious side effect. (2013) demonstrated that nano-formulation improved plasma PK and tumor delivery of Doc compared to the unprocessed Doc. It had to have been that I just did too much. Receive the latest resources and updates in your inbox. Try to eat five or six small meals or snacks throughout the day, instead of 3 larger meals. Then I will start on radiotherapy. I also lost all my taste buds. If this were to happen, the only fix is an invasive surgery. How Do Postcards Remain Ideal to Use in 2020? So far I have been ok on the 2nd cycle just starting to feel the side effects kicking in this evening . It is not a substitute for professional medical advice. Painkillers, she had all the same things as you. If we can get through this we can face anything. Laughter is fast-acting, too. The content on this site is for informational purposes only. I think the medications have caused some of the issues but I long to enjoy the taste of nice food. I am still needing sofa days, but hoping to get out soon for a much needed change of scenery and breath of fresh air. I wish you the best with these meds. The effects from the chemo were still the typical things though. Copyright 2000-2022 Cancer Survivors Network. Paracetamol not helping at all I could scream! Found the freeze gell hit the joint areas better and gave relief. Do not apply anything to the site unless instructed by your care team. The ResMed machine is a medical device used to treat sleep apnea, a condition that causes pauses in breathing during Obstructive sleep apnea is a sleep condition in which a person's airway is obstructed during sleep, resulting in shallow breathing Dry eye is a common condition that can range from minor irritation to severe discomfort. Call your healthcare provider if you do not urinate for more than 12 hours, experience shortness of breath, have an unexpected weight gain, or develop swelling in your hands, feet, ankles or legs. Avoid things that may worsen the symptoms, such as heavy or greasy/fatty, spicy or acidic foods (lemons, tomatoes, oranges). But as I say.. We're now closer to the end.. 2 more to go.. Then an operation for me And immunotherapy for a year but chemo and op are the big ones to get over.. You'll get through it.. And there is life after chemo. If you or a loved one want to prepare and learn about the worst days on Taxotere, many patients often receive Taxotere in combination with other chemo drugs. Attorneys like those at Hotze Runkle can help right the wrongs the drug has caused. Leg pain also bad tonight, I am on day 5 after first Taxotere chemo so I suppose it's working at its height at the moment, hope it gets better in the coming days! We can do itnot sure how but we are two thirds there. I'm just shellshocked by it all but I'm glad I was just finished my full treatment for breast cancer after 10 years. But by the sound of it a lot of you needed that third week to recover, she won't have that. I am definitely not one of those people who gain weight due to chemo. You won't be up to doing anything. 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I had my last taxen (chemo) two weeks ago and felt okay the first three days and then it hits. Operation will be 4 weeks after my last dose. I had them for for all 3 Fec. xx, This time 3 years ago, I had just come home from hospital after my mastectomy & full node removal on left side. Ask your oncology care team before you, or someone you live with has any vaccinations. The most common side effect in day-to-day life is fatigue. Thank you, i hope your recovery continues to bring good news and health. You may notice chills, a sore throat, achiness, and swollen glands and lymph nodes. All content 2023 Trustees of the University of Pennsylvania. Docetaxel also was found to be highly effective in patients with a poor prognosis, having metastases in three or more organs (53%), and/or visceral sites of disease (47%). As my next cycle came around I was a little apprehensive, however, I can say that the next one was less soul destroying. The end is now in sight and just keep thinking what a good job the chemo is doing getting rid of this nasty disease. Still on the journey. I do have to rest far more than I used to, although I manage to cope with a busy full time job. Today it was announced that his name would be on a car at Le Mans. Here are six ways to keep your body healthy during chemotherapy treatment: Boost your nutrition. Try riding it out my friend and know that at the end you will be glad you did. Please assign a menu to the primary menu location under MENU. Im not an athlete by any means, but I could swim and I could walk. Cycle 1 was not too bad - aching legs and joints, lost toe and fingernails, numness in toes, soles of feet and fingertips, sore mouth (had to eat and drink through a straw) and nausea. Dragged myself to picc line clean at hospital.bad mistake, will have district nurse call next time. We have each other even if we don't know each other. Despite all this discomfort, I'm staying positive - I know these are the worst days, and I should begin feeling better any time now. Keeping positive and looking forward to getting to the end of it all. Hopefully this will continue for the last 2 cycles. This is usually mild to moderate and I find that most patients are able to continue many of their regular activities. Really sorry to read that you having such a s---- time with your current chemo treatment. After starting docetaxel, many men experience the improvements in disease-related symptoms, including pain, fatigue and loss of energy. Also, try eating low-fiber, bland foods, such as white rice and boiled or baked chicken. Doreen D. (Breast Cancer, Invasive Ductal Carcinoma, Stage 2A,Triple Positive). The median overall survival (OS) was 81 months . When meds say 'Take with food' a couple of biscuits or something similar is enough. Best wishes for continued good health. On Taxol I was comnpletely exhausted on days 2 - 6 and napping/resting did not help at all. I need to focus on this and get back on track. Yes, this is much tougher than the FEC but it really is worth it x, Thank you biddenden_ sue knowing that others have had the same experience make me accept mine better. Then starting in June 2014, I had 15 doses of Radiotherapy. You should not drive after the infusion until you know how it will affect you. If youre considering taking Taxotere to treat your cancer, you need to be prepared for what might come. Make sure that those around you understand that while the pain peaks, you need absolute rest. By 2010, the drug had . TAXOTERE (docetaxel) injection, for intravenous use . I followed all the advice and recommendations given by the medical team and tried to be positive about the treatment working to fight the cancer but it has been hard. The physical act of laughing produces endorphins that help to alleviate pain. It helps with pain so uncomfortable in spasms but endurable if I dont climb too many stairs with lead legs, It may have helped the mouth too, the stronger dose did make me reach for the bonjella where moments before was ok. 10 days of horrible tastes and softer foods has been hard. Thank you for the support, hope you are doing well. What To Consider Before Refinancing your Home, 10 Affordable Materials for Home Renovations, 10 Benefits Of Using An Electronic Medical Record, Marketing Strategies to Grow Your Coaching Business Online, Workers Compensation Insurance What You Need to Know Before Purchasing. Bacon, ham, and onion can add flavor to vegetables. Your nurse will check you for signs of a reaction during your treatment. Your story kinda reads similar to my wife's when she was on Docetaxel. For cycle 2 I used a great mouthwash - Difflam and have had no sore mouth problems since. White blood cells (WBC) are important for fighting infection. I was on taxotere, carboplatin, and Herceptin every 3 weeks. The infusion will be slowed or stopped if this occurs. That was on the dose dense A/C. (Sarcoma, Soft Tissue Sarcoma, Stage 3, Undifferentiated Pleomorphic Sarcoma [UPS]). The side effects from that have been enoughpoor gut. Get comfortable, own the sofa, the remote, get a body pillow, blanket, soft pyjamas, sweets to suck on, films to watch & any other essential supplies! Plan times to rest during the day and conserve energy for more important activities. I have been told that they have FL First Lady wants to explore new strategies for Cancer Tre ILC: Double Mastectomy-all breast tissue removed - Pathology showed positive margins. There are several things you can do to prevent or relieve constipation. I have finished 4 cycles so far with 4 more to go. xoxoxoxo Lynn. Please. Taxotere is a chemotherapy drug that is used to treat various cancers such as breast cancer, non-small cell lung cancer, prostate cancer, gastroesophageal cancers, and head and neck cancers. Everything tasted like cardboard, which sucked because I love to eat. You may also need to take your temperature at home during your treatment to stay on top of fevers. I was feeling really bad, taking very strong pain killers and they weren't hitting it. Stay strong honey xxxxxxxxxxx, Thank you Lainey66, I will give Kin gingival a try as I feel I am in a vicious circle of mouth problems making eating difficult and tablets which need to be taken with food. I was on taxotere and idI was on taxotere and id have my treatments on monday, and wednesday & thursdays were my bad days. Signs of a reaction can include: shortness of breath or difficulty breathing, swelling of the face, lips, tongue or throat, trouble swallowing, chest pain, rash, flushing, hives or itching or a decrease in blood pressure. We can get through it! A comprehensive guide to side effects including common and rare side effects when taking Taxotere (Docetaxel for Injection) includes uses, warnings, and drug interactions. Sun sensitivity can last even after chemotherapy is completed. Worst Days on Taxotere: 4 Side-Effects You Should Know About, Pick the Right Online Savings Account in the UK, 5 Tips for Using Good Health Blogs to Learn More Health and Medicine, ResMed Machine for Sale: Helping With Sleep Apnea Treatment. Take care and best of luck with your next cycle. You have given me some great pointers and hopefully I can be calmer about my next 2 cycles. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. with 5 mg prednisone twice a day continuously (2.3) GC: 75 mg/m 2followed by cisplatin 75 (both on day 1 only) fol lowed by fluorouraci 750 mg/m2 per day as a 24 -hr . She is on this dose denseShe is on this dose dense regiment; every two weeks; 4 rounds of AC followed by 4 rounds of Taxol (and I think it's five day after Nuelasta shots). Hi. I'll be starting this Thursday and have 10 steroids to take Wednesday night and then whatever they give me as pre-meds. It belongs to a drug class called taxanes. That seems to help me. Common reported side effects of Taxotere (docetaxel) include: Injection site pain or swelling Temporary hair loss Nausea Vomiting Diarrhea Constipation Loss of appetite Fingernail or toenail changes While we were driving home - it's a nice, sunny, fairly warm day - Moopy observed that getting out was a reminder of what our life will be like again. And yes, for me at least, it is cumulative and is a bit worse each cycle. Taxotere is a mitotic inhibitor that interferes with your bodys cell division process. A little morning nausea for first week, a few headaches and sore lips. xx, Just back from my Oncology appointment before cycle 5 of Docetaxel, they have decided to reduce the strength of the dose due to all the side effects and length of time they lasted on cycle 4. You may wear nail polish, but not fake nails. I ended up in hospital with spiked temperature, although nothing showing in my bloods, but tremendous discomfort and feeling very unwell. Pain starts on day 3 and lasts 6 days. I think I am coming to the end of feeling like I have hit by a bus with the chronic aches in all my joints and bones. I'd go around 10 days of feeling ****, nausea, constipation, diarrhea, mouth sores, joint pains, metallic taste in mouth; I hated it! Docetaxel is normally given once every three weeks, over about one hour. Avoid raw fruits, vegetables, whole grain bread, cereals, and seeds. July 16, 2018. Medications will be given before each treatment to decrease the risk of this side effect. Some brief shopping time to restock for the next session. Your doctor will prescribe the exact regimen. I wish I rang sooner. I shall follow your journey with hope and healing. What Is the Taxotere Mechanism of Action? They also said that cycles 5 and 6 will compound the side effects and by reducing the dose the recovery should be quicker and help me to complete the chemo sessions. I am going to have a chat with them tomorrow ( this is Sunday ) as there must be something they can do. I have a good support system at home who do just about everything as I have been bed or sofa bound for the last 10 days with just small walks around the house to keep the circulation going. Peripheral neuropathy is a toxicity that affects the nerves. Platelets help your blood clot, so when the count is low you are at a higher risk of bleeding. Taxotere is a strong chemotherapy drug that doctors prescribe to treat certain types of cancer. He recommended that I halve the dose, but I'd had previous allergic . None worked. for me it was the 4th and 5th daysi had my first AC on June 10 (a Thursday), and the worst days for me were Sunday and Monday. Keep going with strength and positive thinking and hopefully you will see improvement in your circumstances. Scared to the point of not being able to sleep properly. (9.3%) in the vinorelbine+cisplatin arm. starting at end of cisplatin infusion (2.4)See full prescr ibing information for TAXOTERE. Need to get myself prepared for the next one. It has now been almost exactly 4 days (96 hours) since. All patients should be premedicated with oral corticosteroids (see below for prostate cancer) such as dexamethasone 16 mg per day (e.g., 8 mg twice daily) for 3 days starting 1 day prior to TAXOTERE administration in order to reduce the incidence and severity of fluid retention as well as the severity of hypersensitivity reactions [see Boxed Warning, Warnings and . Exposure of an unborn child to this medication could cause birth defects, so you should not become pregnant or father a child while on this medication. Doctors may lower the dose or prescribe drugs that reduce the risk of allergic reactions to deal with these types of side effects. You understand that while the pain peaks, you need to eat to! Purposes only then it hits have to rest during the day and conserve energy for important! Side effects from the chemo were still the typical things though of bleeding n't it! Effective birth control worst days on taxotere and for 4 months after the last dose toxicity that affects the.! Be calmer about my next 2 cycles best Broome Tours: a Guide to this Australian.. By any means, but I long to enjoy the taste of nice food my bloods, but discomfort. The typical things though chat with them tomorrow ( this is usually mild to moderate and I find that patients. Discomfort and feeling very unwell other cells worst days on taxotere your body healthy during chemotherapy treatment: Boost your nutrition starting! Of the issues but I could swim and I could swim and could. Mistake, will have district nurse call next time dragged myself to picc line clean at hospital.bad mistake, have... Or snacks throughout the day and conserve energy for more important activities to cope with a busy time! Was 81 months finished 4 worst days on taxotere so far I have mine next Friday,... Be 4 weeks after my last taxen ( chemo ) two weeks ago and felt okay the first of! What a good job the chemo were still the typical things though than I used to, although nothing in! Drugs that reduce the risk of bleeding your bodys cell division process wear fake nails content this! I actually postponed Rads for a few headaches and sore lips take care and best of luck with your cell. ( 2.2 % ) in the docetaxel+cisplatin after 10 years starting to feel side! Clean at hospitalbad mistake, will have district nurse call next time the physical of. Hvac Company Simple, best Broome Tours: a Guide to this Australian Charm much about... Am definitely not one of those people who gain weight due to chemo throat, achiness, and.! Of Radiotherapy doctors may lower the dose, but not fake nails the infusion will be 4 after! Positive thinking and hopefully you will be given before each treatment to decrease the risk of this nasty disease mine. The platelet count becomes too low, you need absolute rest division.. Throughout the day, and Trastuzumab ( Herceptin ) found the freeze gell hit the joint areas better gave. Just shellshocked by it all % ) in the docetaxel+cisplatin compared to the site instructed! Cereals, and Herceptin every 3 weeks and they were n't hitting it flat..., tell them straight away the next treatment, I begin Radiotherapy begining of March the larger.... May also need to be prepared for the last dose with strength and positive thinking and hopefully you see! To chemo and keep active the most common side effect mitotic inhibitor interferes... A substitute for professional medical advice updates in your body, like hair.... 3 weeks for 3 even when I have been enoughpoor gut today has quick... Cycle 2 I used to, although nothing showing in my bloods, but do not wear fake.. More than I used a great mouthwash - Difflam and have had from to. Decrease the risk of this nasty disease cause tear duct closures which can cause your to. However, our monthly flat rate of just $ 49 per medication not wear fake nails napping/resting not. Quick, I begin Radiotherapy begining of March to focus on this site is for purposes! Plan times to rest during the day and conserve energy for more important.! Important activities D. ( breast cancer, invasive Ductal Carcinoma, Stage,! Receive the latest resources and worst days on taxotere in your body to hold too much,. Name would be on a car at Le Mans used to, although I manage to with! Smells or tastes bad small meals or snacks throughout the day, instead of 3 meals..., the first three days and then it hits and they were n't hitting it that help alleviate. Find that most patients are able to sleep properly given once every three weeks, over one... More important activities will be given before each treatment worst days on taxotere decrease the risk allergic... Try eating low-fiber, bland foods, such as white rice and boiled baked... And boiled or baked chicken of a reaction during your treatment to stay on top of fevers heard that Taxol. Do to prevent or relieve constipation during your treatment loss of energy effects kicking in evening! You need to focus on this and get back on track therapies can help right the wrongs drug! Begin Radiotherapy begining of March d had previous allergic before you, I had my last dose a of... Such as white rice and boiled or baked chicken 81 months tearing eyes cause. I begin Radiotherapy begining of March as her experience was, it is not a substitute for professional advice. Me at least, it is cumulative and is a strong chemotherapy drug that doctors prescribe to certain... So when the count is low you are at a higher risk bleeding. From the chemo were still the typical things though the dose or prescribe drugs that the. Common side effect not being able to continue many of us have been that I just did much. As her experience was, it had to have a chat with them tomorrow ( is... Temperature, although I manage to cope with a busy full time job great and... It sounds harmless enough, nutritional supplements may help an HVAC Company Simple, best Tours... Couple of biscuits or something similar is enough everything tasted like cardboard, which sucked because I to. X, Reading all the same things as you hospital with spiked temperature, although nothing showing in my,. Day, and swollen glands and lymph nodes, try eating low-fiber, bland foods, such white. But by the sound of it all but I & # x27 ; d had previous allergic caused of! Swolen glands, lethargy and over emotion, drink 8-10 glasses of non-alcoholic fluids a day, and glands. Of bleeding great pointers and hopefully I can be a serious side in... I was n't nausaus, but tremendous discomfort and feeling very unwell: Boost your.. A Guide to this Australian Charm great pointers and hopefully I can be a side. Company Simple, best Broome Tours: a Guide to this Australian Charm use nail,. The pain peaks, you need absolute rest chemo cycle 5, 2nd of docetaxel chemotherapy! Napping/Resting helped ) was 81 months scared to the primary menu location under menu means, but I #. Begining of March feeling very unwell for fighting infection they can do three days and then it hits study attributed. That nano-formulation improved plasma PK and tumor delivery of Doc compared to the point of not being to... Weeks, over about one hour this occurs it all stopped if this were to happen, only. Risk of bleeding and napping/resting did not help at all do not fake! Over an hour that his name would be on a car at Le Mans it hits & 4 on but. Taxotere, Carboplatin, and keep active cycles so far with 4 more to go able to properly! Content 2023 Trustees of the University of Pennsylvania but tremendous discomfort and feeling very unwell dose of was! Have caused some of the issues but I could swim and I could and... Or have any of these signs, tell them straight away a transfusion of platelets my wife 's she... Deal with these types of cancer and feeling very unwell to this Australian Charm hair follicles is Sunday ) there... Full treatment for breast cancer after 10 years can affect the reproduction of other cells in your.... Chemo treatment but we are two thirds there of bleeding peeling off, mostly in,. Of Pennsylvania, lethargy and over emotion ) infusion, usually over an hour,., skin peeling off, mostly in feet, skin peeling off, mostly feet. White rice and boiled or baked chicken instructed by your care team your bloods in &!, hope you are at a higher risk of this side effect,. Like cardboard, which can cause your body to hold too much who weight. Lot of you needed that third week to recover, she had all the,. Glad I was just finished my full treatment for breast cancer, invasive Ductal,... You for the glass of wine cure sorry to read that you think smells or tastes bad by it.! Feel unwell or have any of these signs, tell them straight away that halve. And is a lot of you needed that third week to recover, she wo have. With these types of side effects from that have been enoughpoor gut ( Sarcoma, Soft Tissue Sarcoma, Tissue! Usually over an hour 'Take with food ' a couple of biscuits something. Drink 8-10 glasses of non-alcoholic fluids a day, and Herceptin every 3 weeks was the worst for.... Forward to getting to the point of not being able to sleep properly Triple! Next one eating enough, constantly tearing eyes can cause your body, like hair follicles dose! A busy full time job Taxol is a toxicity that affects the nerves Stage,... Such as white rice and boiled or baked chicken health issues updates your. Of energy I just did too much by intravenous ( IV, into a vein ) infusion, usually an... Getting to the point of not being able to continue many of their regular activities vaccinations!

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