K
Kimba
Guest
A friend of mine, who lives in VERY rural West Virginia,
called me 3 weeks ago to tell me how rotten she was feeling.
She'd had her period for nearly 2 weeks and was having an
unusually heavy flow. She thought she might be anemic - she
said she was very pale, that her lips were white, and that
she had bruises all over.
I urged her to go to the doctor right away. The nearest was
over an hour away, but her husband put her in the car and
took her. She was diagnosed with AML and transferred to a
university hospital in Morgantown.
Her platelet count was 12, so they transfused her with
multiple units of platelets. She developed pulmonary edema
and had a life-threatening reaction to phenergan, which
included seizures.
She received idarubicin initially and is now receiving ATRA,
po. Her blood counts are much improved, but she's not in
remission, yet.
She was initially told that she'd be in the hospital for at
least a month and that they were considering a bone marrow
transplant. Yesterday, a new team of residents came in and
told her that they were going to send her to a family
residence on the hospital grounds for a few days, then send
her home. She'll need to come in 4 times a week for follow
ups - she lives over 3 hours away.
Everything I've found about chemotherapy for AML strongly
suggests 28 days of treatments, b.i.d., or until remission
is achieved. The ATRA protocol that I found in my searches
is IV, not PO - I found one study where it suggested that PO
therapy is ineffective.
She's got major nausea, which responds well to IV Zofran.
They've told her that she's going to have to learn to deal
with it, without the IV Zofran. She's concerned about re-
starting the bleeding - they initially told her that her
bleeding was secondary to the leukemia; now they're saying
that it's a GYN problem.
I'm really uncomfortable with what they're doing. Seems to
me that she's sick enough to require more constant
monitoring than she'll get if she follows this plan.
I'm an R.N., but my specialty is surgical / telemetry, not
oncology. I'm baffled. Am I off base, here?
Kimba who is grateful as hell to live in a place with a
good number of healthcare options --You did then what you
knew how to do, and when you knew better, you did better.
Maya Angelou
called me 3 weeks ago to tell me how rotten she was feeling.
She'd had her period for nearly 2 weeks and was having an
unusually heavy flow. She thought she might be anemic - she
said she was very pale, that her lips were white, and that
she had bruises all over.
I urged her to go to the doctor right away. The nearest was
over an hour away, but her husband put her in the car and
took her. She was diagnosed with AML and transferred to a
university hospital in Morgantown.
Her platelet count was 12, so they transfused her with
multiple units of platelets. She developed pulmonary edema
and had a life-threatening reaction to phenergan, which
included seizures.
She received idarubicin initially and is now receiving ATRA,
po. Her blood counts are much improved, but she's not in
remission, yet.
She was initially told that she'd be in the hospital for at
least a month and that they were considering a bone marrow
transplant. Yesterday, a new team of residents came in and
told her that they were going to send her to a family
residence on the hospital grounds for a few days, then send
her home. She'll need to come in 4 times a week for follow
ups - she lives over 3 hours away.
Everything I've found about chemotherapy for AML strongly
suggests 28 days of treatments, b.i.d., or until remission
is achieved. The ATRA protocol that I found in my searches
is IV, not PO - I found one study where it suggested that PO
therapy is ineffective.
She's got major nausea, which responds well to IV Zofran.
They've told her that she's going to have to learn to deal
with it, without the IV Zofran. She's concerned about re-
starting the bleeding - they initially told her that her
bleeding was secondary to the leukemia; now they're saying
that it's a GYN problem.
I'm really uncomfortable with what they're doing. Seems to
me that she's sick enough to require more constant
monitoring than she'll get if she follows this plan.
I'm an R.N., but my specialty is surgical / telemetry, not
oncology. I'm baffled. Am I off base, here?
Kimba who is grateful as hell to live in a place with a
good number of healthcare options --You did then what you
knew how to do, and when you knew better, you did better.
Maya Angelou