how fast does chemo act?

chemoqueen, BSN, RN · Dec 12, 2004

Could be toxicity from the chemo. What agents did she receive? Has she been eating and drinking? could she be dehydrated? What is she being given for nausea control? Phenergan/ ativan can cause confusion. And it could be dz progression. Hard to know w/out a chart. You poor girl, you have your hands full. I'm thinking about you.

my mom, who was dx'd with aml was admitted to the hospital a few days ago and has been receivng chemo qd x10 days.
i've spoken with her a few times each day and even though she sounds tired,
we've been able to converse.
i spoke with her this a.m. and she sounded so tired but still, sounded like my mom.
around 1/2 hr ago i called her again and didn't recognize the voice that answered the phone. i had to ask for diane......
when she told me it was her, i couldn't believe the acute deterioration....
she told me she felt like death warmed over and couldn't even stay on the phone more than 1 minute.
now she's 75 and her prognosis is very poor, especially with the subtype of aml that she has; it's the hardest type to treat...
can chemo act that quickly where you're alert then hours later you can hardly talk?
it's well known the elderly are distinct in the treatment of this cancer but i was so shocked that i didn't even recognize her voice.
is this a common scenario?
my sister who is finally done with her chemo, NEVER sounded like this and at best, she c/o fatigue and all her meds worked re: nausea, anemias, etc.
what's going on with my mom?
a couple of doctors have already told us that chemo is futile for her type but this is what mom wants...
i just don't know what to think....
any onc nurses know of sudden deterioration?
any input, please.
with peace and gratitude.
leslie

gaulkari · Dec 12, 2004

If she has N/V/D it could be as a previous poster said hypovolemia, also we have had pts that had Hypokalemia that their families said have deteriorated quickly like that. It could be a lot of things depending on the type of chemo and also her reaction to it. Seven to ten days after chemo is usually the time that blood counts bottom out also. I am sorry that your family is going through so much. If you have specifics on the type of chemo she is recieving now I would be happy to send info to you.

leslie :-D · Dec 12, 2004

If she has N/V/D it could be as a previous poster said hypovolemia, also we have had pts that had Hypokalemia that their families said have deteriorated quickly like that. It could be a lot of things depending on the type of chemo and also her reaction to it. Seven to ten days after chemo is usually the time that blood counts bottom out also. I am sorry that your family is going through so much. If you have specifics on the type of chemo she is recieving now I would be happy to send info to you.

i think it's called ara-c (???) and doxirubicin.

yesterday they put her on a morphine drip.

and i did find out that she had an extreme reaction to the chemo so whatever they gave her, seems to have helped a little. when i spoke to her last night at least i recognized her voice. she started chemo last monday so it's been around or pretty close to a week.

one of the oncologists my sister spoke with was pretty blunt about her prognosis and said that he wouldn't even bother putting his elderly pts on this chemo. even though i didn't appreciate his bedside manner, i did appreciate the honesty.

but this is what my mother wants........

any info would be much appreciated, for sure.

God bless.

leslie

leslie :-D · Dec 15, 2004

i just got back from the hospital in virginia.

she's in icu and totally unresponsive.

she has sepsis; is on a dopamine drip and they're doing everything NOT to put her on a ventilator.

her large and sm bowel are grossly infected with peritonitis and sepsis running through her body.

she's on iv vanco, genta, flagyl and cipro. yet they offer little hope in these abx working since her wbc is 535 and she's critically ill.

the oncologist wants to put her on hospice but my mother, before she lost consciousness, wanted everything done.

and this is because of the chemo.

will keep you updated.

leslie

OBRNinTN · Dec 15, 2004

Oh Leslie, I'm so sorry. I know we don't know each other, but I do want you to know that you and your family are in my prayers.

Christy

BeenThereDoneThat74, MSN, RN · Dec 20, 2004

I'm so sorry to hear this. What a quick turn of events. Ara-c can have some horrible neurological side effects, and combined with the morphine and antiemetics (and now sepsis), that would explain her changes. WBC of 535 (thousand???), or 535 (I've seen both #s post chemo)? Sepsis is never good, esp. in oncology. AML is a toughie (not that any cancer is good). In kids, the first 4-8 weeks are absolute hell. Very tough nursing assignment. My thoughts are with you.

leslie :-D · Dec 21, 2004

I'm so sorry to hear this. What a quick turn of events. Ara-c can have some horrible neurological side effects, and combined with the morphine and antiemetics (and now sepsis), that would explain her changes. WBC of 535 (thousand???), or 535 (I've seen both #s post chemo)? Sepsis is never good, esp. in oncology. AML is a toughie (not that any cancer is good). In kids, the first 4-8 weeks are absolute hell. Very tough nursing assignment. My thoughts are with you.

the wbc was 535 and went down to 200.

she did end up on a ventilator.

ended up with ascites as well as bil pneumonia and cellulitis with no improvement in the infection in her lg and sm bowel.

after much dialogue between myself and the doctors, everything was stopped at 2 pm and she passed away most peacefully at 2:55 pm.

the morphine worked beautifully and God just ever so gently took her home.

leslie xo

BeenThereDoneThat74, MSN, RN · Dec 23, 2004

I'm sorry for your loss. You sound like you were (somewhat) comfortable with the decision you made. We have no idea what it is like to be on the other side of the situation until it happens to us. She's not suffering anymore.

chemoqueen, BSN, RN · Dec 23, 2004

I've been offline for a while. I'm so sorry about your mom, but as I read, you sounded like you were comfortable with the decision. Hope you are doing well. I'm thinking about you.

my mom, who was dx'd with aml was admitted to the hospital a few days ago and has been receivng chemo qd x10 days.
i've spoken with her a few times each day and even though she sounds tired,
we've been able to converse.
i spoke with her this a.m. and she sounded so tired but still, sounded like my mom.
around 1/2 hr ago i called her again and didn't recognize the voice that answered the phone. i had to ask for diane......
when she told me it was her, i couldn't believe the acute deterioration....
she told me she felt like death warmed over and couldn't even stay on the phone more than 1 minute.
now she's 75 and her prognosis is very poor, especially with the subtype of aml that she has; it's the hardest type to treat...
can chemo act that quickly where you're alert then hours later you can hardly talk?
it's well known the elderly are distinct in the treatment of this cancer but i was so shocked that i didn't even recognize her voice.
is this a common scenario?
my sister who is finally done with her chemo, NEVER sounded like this and at best, she c/o fatigue and all her meds worked re: nausea, anemias, etc.
what's going on with my mom?
a couple of doctors have already told us that chemo is futile for her type but this is what mom wants...
i just don't know what to think....
any onc nurses know of sudden deterioration?
any input, please.
with peace and gratitude.
leslie

gaulkari · Dec 26, 2004

Leslie,

I am so sorry to hear about your mother...it must have been a very difficult decision for you and your family. I am happy to hear that she passed so comfortably. You have my deepest sympathies.

Karin

leslie :-D · Dec 26, 2004

Leslie,
I am so sorry to hear about your mother...it must have been a very difficult decision for you and your family. I am happy to hear that she passed so comfortably. You have my deepest sympathies.
Karin

ironically karin, it was one of the easiest decisions i've ever made.

the thought of my mother continuing with invasive and dangerous treatments, just to wake up and die again....well to me, there was no decision.

all mds agreed that should she recover from the leukopenia/sepsis, it would only be a matter of days to weeks tops.

and knowing her fear of death, it was my goal to ensure that she never regained consciousness.

when i prayed to God about my decision, i was at total peace.

there was no conflict whatsoever.

and just for the fact that it took her less than an hour to die showed how close to death she was.

i will forever be comfortable with my decision.

my siblings now agree with my decision, even though they were much more ambivalent beforehand.

if there's anything such as a perfect death (which would be unique to each person and situation), my mom's was as perfect as they come.

and for me to be able to hold her that closely was just another gift.

thank you God, for your compassion and mercy.

leslie xo