Thoughts of flu with cll

[578999lme]

Hello again - Is there any precaution one should take if they do have CLL and develop a respiratory or intestinal flu? Just treat it as you would normally? Thanks to all you people out there you are my Merck Manual. lme

[Cllcanada Top Poster CURE Hero]

You want to be pro active... anything odd, needs to be diagnosed as soon as possible... you can't wait days...

Please don't self diagnose and self treat with OTC either, many things look like flu and are not and flu looks like many other things... A firm diagnosis, will chart a course of treatment.

During treatment for CLL the landscape changes and the use of prophylactic treatments should be on your list to discuss with your hemaetologist.

Secondary infections can be extremely swift and life threatening as I recently learned, so know when to call you medical team or head to the ER.

Both pneumonia of various types and sepsis are common causes of death in CLL, later stages.

The usual precautions apply generally, regular hand washing, use of alcohol gel , safe food handling and kitchen cleanliness... masks my help a bit in crowds and try to avoid sick children... keep your vaccinations up to date and get a Prevnar13 pneumonia vaccination,.

You don't want to become paranoid about this, but you need to be aware...

~chris

[DMary]

I just went through16 days of flu and my CLL team was not happy that I didn't call or see my PCP. Said tamiflu could have saved some days in bed. Next time I won't keep waiting to get better like the rest of the family. Our immune systems aren't what they should be and it's not wise to forget that.

[Jm954 Administrator in reply to DMary]

That's an important message about Tammiflu. It inhibits the new viral particles' chemical ability to escape from the infected cell so the virus is restricted to a smaller number of cells and the body's immune system has a better chance of killing the virus.

I recently had flu and I had Tammiflu and antibiotics within 24 hours of my flu starting. It definitely reduces the number of 'bed days' and I was able to get up after just 3 days (didn't get dressed for another 2 though!).

[DoriZett]

I have invested in 2 good forehead thermometers, one for home and one for work. CLLers need to move fast if we get a fever. I have been told if you are in treatment , temp of 101 requires intervention. Those with CLL but not yet in treatment, temp of 103 is the level. I am recovering from a cold now - about 10 days thus far. Temp never got above 98.8 and while congested, I could easily breathe. Luckily I have 2 doctors appointments this week so will see an MD tomorrow, and have my annual physical on Friday. If the congestion without fever is of any concern, the MD's can advise. My CLL specialist tries to balance being proactive with not panicking and says to see either my PCP or contact his office if I have any concerns when ill. If there is no fever and no problems breathing, and the cold is running it's course with improvement every few days, I just stay the course and rest and hydrate. Did the same in September with the stomach flu - although I did reach out to my oncologists office where they had me reporting my temp and symptoms. We are all different though and our immune systems are impacted to different degrees so definately ask your own CLL specialist what his/her thoughts are in your specific case when you are ill, and at what point they would want you to take action.

[Mijoed]

Even the NHS website raises questions about the effectiveness of Tamiflu.

My conclusion of what I´ve read is that it may reduce the duration (from 7 days to 6.3 was quoted), it needs to be taken early on in the flu cycle, it not guaranteed to prevent further complications, paracetamol may be as effective, and it has some side effects such as nausea & vomiting.

Not a proffessional opinion.....just Dr Googles 🤒

[Cllcanada Top Poster CURE Hero in reply to Mijoed]

Here is a major study... of Tamiflu

Oseltamivir (Tamiflu) and zanamivir have small, non-specific effects on reducing the time to alleviation of influenza symptoms in adults, but not in asthmatic children. Using either drug as prophylaxis reduces the risk of developing symptomatic influenza. Treatment trials with oseltamivir or zanamivir do not settle the question of whether the complications of influenza (such as pneumonia) are reduced, because of a lack of diagnostic definitions.

The use of oseltamivir increases the risk of adverse effects, such as nausea, vomiting, psychiatric effects and renal events in adults and vomiting in children. The lower bioavailability may explain the lower toxicity of zanamivir compared to oseltamivir.

The balance between benefits and harms should be considered when making decisions about use of both NIs for either the prophylaxis or treatment of influenza. The influenza virus-specific mechanism of action proposed by the producers does not fit the clinical evidence.

onlinelibrary.wiley.com/doi...

[DMary in reply to Cllcanada]

Thanks! My natural impulse is to avoid waiting rooms for anything that other family members also have if I don't run a constant fever. Fever and chills were a part of this last one but others had it and it was intermittent. Maybe I made the right choice. I want to be smart but not overtreat. Another fine line to walk!

[cartwheels]

I think I have the flu day 3 and can't muster he energy to get out of bed. Full of flem but not running a temperature just body aches and head cold not sure if I should notify my clinic or not I am making sure I get fluids down and paracetamol interesting thread here but I feel it's one that's hard to answer as non of us are doctor's