Aml

  1. Does anyone know the usual prognosis for AML? I have a very nice pt w/ this, he's only 45. I wig out a bit, accessing his port when his WBC count is only 0.9! I'm sooo scared that anything less than perfection in my sterile technique will result in death for him. He's also going to a gun show this weekend & I lectured him about avoiding crowds. I feel like if he dies it's my fault. It's hard to face this, someone with a wife & kids, a life, who's a good person shouldn't die from going into a crowd. Sometimes this profession is too heavy. Thanks for letting me fret & vent!
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  2. 5 Comments

  3. by   abooker
    I cut & pasted this from the MedlinePlus Medical Encyclopedia here:

    http://www.nlm.nih.gov/medlineplus/e...cle/000542.htm

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    Complete remission occurs in 70 - 80% of patients. Overall, about 33% of persons under age 65 survive free of disease at 5 years from diagnosis. This 5-year survival rate drops dramatically (4%) in those older than 65. In general, patients who are younger have a better chance of survival than older patients. This is partly due to one's ability to tolerate the strong chemotherapy medicines.

    Patients who have not experienced a relapse during these 5 years are considered permanently cured, since most relapses occur within 2 years of diagnosis.

    Without treatment, life expectancy is about 3 - 4 months.
    -----

    Good luck with your patient. It sounds like he is getting excellent care and treatment.
    Last edit by abooker on Mar 31, '07 : Reason: typo
  4. by   Wave
    Hmmm...
    I don't know the particulars about his condition or where he stands as far as the course of his treatment, but it makes one wonder if this pt truly understands his condition or if, perhaps, he is in some sort of denial, if the picture is as dire as you paint it. I realize that some people might say that they don't want to let the disease run their lives. They want to keep on going, living their lives as they always have. But come on!, a gun show? V.S. staying home with my family, avoiding crowds (to reduce the risk of infection). Where are his priorities? In my book, my family would come first. I would want to stay as healthy as I could to lick this thing. The previous post/ link seems to indicate that the odds are in his favor, being as young as he is. There will be other gun shows, many more, in fact, if he remains healthy. Is this his business/ livelihood? I don't know, there's something just not quite right about this picture.

    As far as how you feel, just think of this: It's always a pt's prerogative to refuse treatment/ medical advice. I agree, it's sad to see someone seemingly throwing their life away, but... if you have explained the risks (and I'm sure his doc has gone over this with him, too) and he still wants to go, you have to respect that. He's a big boy and your not his mother (in response to lecturing him about crowds). Given the proper info -which you have done, he can make his own decisions, but the consequences are his to answer for if something bad happens and not you. Hope this doesn't sound callus. good luck and God Bless (both of you).
    Last edit by Wave on Mar 31, '07
  5. by   MIA-RN1
    google the leukemia and lymphoma society. They have tons of info and maybe stuff that would benefit your patient too.
    You cannot control what your patient does or what he doesn't do. Think of it this way---you feel bad that he has a terrible illness, right? So don't tell him he can't go where he wants to go, instead, give him tools to make it as safe as possible. Give him some masks, some hand gel, etc. When my husband got leukemia (CML) he still did things that he wanted to do, he just did the carefully. Granted, his counts never went down like AML, but still, he was sick, more prone to infection etc. And you know what? I urged him to get out there. "Wash your hands, stay three feet away from people and remember to have a good time." Im a big advocate for letting people with terminal illness live their lives with the tools to make it as safe as possible. If I had AML, I would not stop my life but I would just be careful. The AML would stop my life soon enough anyway.
    You also are definitely not in control if your patient dies or not. He will make his own choices and his disease will also progress in its own fashion.
    Remissions are certainly possible with AML but the transplants are rough., I know someone who did three before she ultimately passed away.
    Give him the tools to enjoy the life he has left and know that by doing that you are doing more for him than any lecture.
  6. by   nurse4theplanet
    I only have two first hand experiences with AML...one was my grandmother who was hospitalized, diagnosed less than a week later and died the next day. Another was a pt who had been in remission for 6+ years and was doing great after chemotherapy, and was hospitalized for an unrelated condition. Everything that I have read seems to indicate that the condition has a relatively good prognosis as long as it is identified early and treated properly.

    I agree with the others who advised that you should not get too emotionally involved in your pt's compliance, or lack there of. There is only so much we can do for our pt's to help them have all the available knowledge and resources necessary to experienc a good outcome and stay healthy. We can't force feed them an AHA diet, make them take their BP meds, or keep them away from their hobbies... like attending a gun show, even if it is in their best interest.
  7. by   Irishgirl
    I saw the pt today, ran into him. He's fine, up & about. He DID go to the gunshow, but swears he stayed away from crowds. It's just hard to see a young man w/ a family so ill. Sometimes you end up feeling responsible for them b/c you're the caregiver in a way.

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