Onco/hematology nurses , AML end of life questions.

[annmariern]

Hello,

posting this on the general board as it tends to get more traffic. Spry 72 year old, MD visit last week, general fatigue, fast forward a week. Diagnosis, AML. Has refused chemo/radiation. Going home with hospice. Apart from abnormal labs, feels good. She is having a hard time with the end of life issues, what should she expect to feel etc. The only AML pts I've taken care of had aggressive tx, were young and its been a while.They mostly did poorly. Is there anything in particular to AML I should prepare her for? Imagine a week and your life is just stopped.Boom, 2 months to live. Any info appreciated, I think she just needs to know whats ahead. Oh course I reassured her that pain management will be a priority of hospice.

thanks.

[leslie :-D]

aml pts present variably.

if the rbc's are low, the anemia can cause tremendous fatigue and dyspnea/sob

wbc's low - tremendous risk of infection

platelets low- tremendous risk of bleeding

most of these pts die from overwhelming infection.

esophageal thrush is often a problem.

make sure she's not on any anticoag's, blood thinners.

bleeding to death is not common, but i've seen it a few times.

be generous with that morphine, ativan.

gentle, loving hugs to your pt.

leslie

[miko014]

First off, so sorry to hear about this. AML is awful. Here's a great resource for leukemia. Be sure to check out the "newly diagnosed" section. Hope this helps!!! http://www.leukemia-lymphoma.org/hm_lls

[annmariern]

Thanks for your replies. My pt went home today, still reeling, but with plans to get busy living. Something I guess we all need to do.