Chest infection

[Alfiebhoy]

My husband who has been on 200mg of Venetoclax for two years now has been ill since New years day, first the doctor thought flu because his chest sounded pretty clear however she gave him 7 days amoxacillan just to be on the safe side, covid tests negative, he has now got a full blown chest infection, given five days doxacycline and prednisone, still no better, he's extremely weak, drowning in phlem and his colour is grey, not eating, no temperature during the day but terrible night sweats. He has had to cancel his consultant appointment and won't see her till the 30th of January, any advice from you wonderful people would be great x

[MisfitK]

Do you have an O2 monitor? A BP/heart rate monitor? If not, I would grab these, and if the numbers get alarming, go immediately to the ER. You're use of the word "grey" alarmed me, and I'd want to make sure it's not from any of these factors...Also, if he won't eat or drink, I would also go immediately to the ER - dehydration, especially with the night sweats, can become an emergency quickly.

As for helping him at home...

While he won't eat, have you been able to push calories and fluids through drinks?

Is he sleeping laying down or more sitting up?

Is the doc still having him take the Ventoclax?

Has he been able to get any fresh air outside?

[Alfiebhoy in reply to MisfitK]

Thanks for your reply, yes I've got a monitor, his oxygen was down at 81 but now back up to 93, he is drinking plenty, taking 100mg of venetoclax at the moment, I think it's just going to take longer to recover from this.

[MisfitK in reply to Alfiebhoy]

Anything that drops below 90 again should be an immediate doc phone call, and if unanswered immediately, an ER trip...under 85, do not wait, just put your spouse in a car or call an ambulance and go directly to the ER. The docs should have never let him be at home if it was truly 81, and not an initial recording error.

[Alfiebhoy in reply to MisfitK]

Thank you for your reply

[mdsp7]

How is his throat? In Paris I caught something in October that was very fast moving and started with a very bad sore throat and quickly moved into my lungs with nasty sticky bad tasting phlegm and next my into my larynx, almost total laryngitis. A doctor made a house call and gave me a Z-pack, it helped but it took me time to get well, even though my blood cells were all in a pretty good range. Being so sick is an urgent situation, and so scary and uncomfortable. I feel concern for you and for your husband and will send prayers and hope for his rapid healing. I agree with MisfitK, do not hesitate to bring him to a good hospital if necessary. Better safe than sorry. Wishing you both well!❤️🍀

[Alfiebhoy in reply to mdsp7]

No sore throat, I will take all the advice on board, thank you

[Justasheet1]

Alfie,

Take him to the ER. Immunosuppressed people don’t always run a fever. He sounds like he has pneumonia and the beginning of sepsis.

Just my opinion.

Jeff

[LeoPa in reply to Justasheet1]

That was my thought too. A saturation of 81 is not a joke. Watch out for sepsis.

[Newdawn Administrator]

Hi there,

My advice would be that as your husband is under ongoing treatment care, responsibility lies with his haematological team and you should have been given a card to ring in case of urgency. Give them a ring and ask for advice. An assessment can be done on the haematology ward or the haematology day unit daytime hours. It could be his condition is associated with or exacerbated by his treatment and I think he needs to be seen by his specialist especially as his last appt had to be missed.

Give them a ring for advice. Sending best wishes.

Newdawn

[Poodle2]

I would go to A&E. Whenever I was unwell while on Venetoclax, I would ring my heamato-oncology helpline. They would always send me to the nearest A&E if I had any symptoms that looked like an infection - even without a fever. If he is bringing up grey phlegm, it is definitely an infection. They should test his phlegm sample to figure out if they are giving him the right antibiotics. He might require something much stronger, perhaps even intravenous...The oxygen reading of 81 certainly looks worrying and I would defo wanted to be checked by a doctor. Better to be safe than sorry - that's my motto. No one will think you are over reacting.

[skipro]

so sorry to hear about it all

My thoughts as a physician and CLL patient on my second go with treatment after relapse include

1. Have a full scale viral PCR profile. It is a nasal swab and tests for about 20 different viruses.

2. Have sputum cultures so that you know what you’re treating. The best samples are obtained by a respiratory therapist from deep in the respiratory tract as otherwise you would get positive results for what’s called normal flora.

3. Have a chest CT.

4. Start a full blown respiratory treatment with an inhaler, like albuterol, coughing, deep, breathing, incentive, spirometer,

5. Stop the Ven until the infection clears. Also make sure that your absolute neutrophil count is normal. If it is not, you’ll have a hard time fighting bacterial infections, and Venetaclax can cause a significant drop.

6. And start a medication that breaks up phlegm like. Like guaifenesin.

7. Get a full blown lab work up, including comprehensive, metabolic panel, CBC, with differential, blood cultures, urine analysis, with urine culture, stool guiac to look for internal bleeding, LDH to evaluate for Richter,

8. Also, look into a swallowing test to make sure that he is not aspirating any of his secretions, which would cause the pneumonia and Slim to deteriorate exponentially.

any doctor could order all of this will it be primary care, and Instacare, emergency room, or hospitalization physician.

God bless and hope that all goes well.

Skipro.

[Alfiebhoy in reply to skipro]

Thank you everyone taking time to reply x