Neutropenic Sepsis

please watch a film on u-tube A Preventable Death, it is sponsored by the Macmillan nurses, it has been distributed to every A and E department in the U.K. My husband carries a letter at all times, " To Whom it may concern" We always hand it in at A and E on admission, and if necessary bully them to get on and take bloods asap. The letter is from the haematology dept where my husband is a patient, stating his condition and urging immediate action to test for sepsis, it also gives numbers they might contact if in doubt,

keep well, keep smiling, and keep out of A and E whenever you can...........

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  • Very good videos although the focus is on those with medical training.

    Part 1

    Part 2

    Some translations:

    Neotropenia = low neutrophils

    Neutrophils only live about a week in your blood, so unknown to you they can drop quickly. (Note the period of 7 - 10 days post chemotherapy mentioned in part 2)

    - Mild neutropenia (1000 = ANC < 1500) — minimal risk of infection (1 - 1.5 outside the USA)

    - Moderate neutropenia (500 = ANC < 1000) — moderate risk of infection (0.5 - 1.0 outside the USA)

    - Severe neutropenia (ANC < 500) — severe risk of infection. (< 0.5 outside the USA)

    Pyrexia = Fever/Elevation of body temperature above normal range. (Suggestion - know your normal range) You may feel cool with pyrexia!

    Hypothermia = Low body temperature. Characteristic symptoms include shivering and mental confusion.

    Spontaneous Rigor = Shivering or trembling

    With CLL, we can develop neutropenia WITHOUT having cheomotherapy and after chemo we are more likely to have it for a long time, perhaps permanently - one of the reasons why Watch and Wait is the standard protocol for us. (Neutropenia was how my SLL/CLL was diagnosed.) Also note the warning that neutropenic patients don't develop high temperatures. Remind medical staff of this if you seek medical assistance or even better, get a warning letter as mentioned by lartington.

    Neutropenic sepsis develops because low neutrophil counts leave us vulnerable to infection. If you have neutropenia, you need to be much more aware of avoiding infection and if it is close to or in the severe neutropenia range, go on a Neutropenic Diet.

  • Excellent, thank you

  • Spot on Neil... Neutropenic diets are as much about safe food handling as food choices. In Canada CLL patients are generally advised to follow a neutropenic diet in late stages and post treatment for 6 months.

    upmc.com/patients-visitors/...

    Watch probiotics and probiotic yogurts.. they can be a source of sepsis...

    ~chris

  • Thanks for this. I am always learning. Why don't our doctors tell us this stuff? grr

  • OOOoooooppppssss!!!!!.............. My GP recommended probiotic yoghurts for abdominal pain/discomfort and diarrhoea!!!!

    So much for that!!

  • Yogurt may be fine for some patients, but usually caution is required 6 months post treatment. I would take direction from your CLL doc on this one, your GP will be clueless on the subject of probiotic sepsis.

    It is fairly rare and often occurs in AIDs patients, but they have immune system similar to treated CLL patients with low CD4+ T cells.

    So caution and moderation would be wise...

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