Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Follow any lower threshold or specific emergency plan provided by your haematology team.
Go to emergency care promptly for:
Shaking chills, confusion, faintness, or severe weakness
Difficulty breathing or chest pain
Severe or rapidly worsening abdominal pain
Repeated vomiting or inability to drink
Rapidly spreading skin redness, swelling, or severe pain
Fever with a central line or after a recent transplant
Tell the emergency team that you have cyclic neutropenia and, if known, when your last low count occurred.
Fever may be the only clear sign of infection.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent medical assessment if you have known or suspected neutropenia and develop a temperature of 38°C or higher.
Do not wait for the next clinic appointment to see whether the fever settles.
3
Does any of this apply?
Book an appointment
Arrange routine follow-up if mouth ulcers, gum bleeding, dental pain, skin infections, or low-count symptoms are becoming more frequent.
Also seek a review if treatment side effects are troublesome, injections are being missed, or your usual cycle appears to have changed.
Every sign above is quoted from the sofidex article on Human cyclic neutropenia. If you are not sure, err upward — it is always reasonable to be checked.