sudden onset of pneumonia

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Cabisbee
Posts: 16
Joined: Tue Aug 27, 2013 4:20 pm
Facebook Username: Chantelle Bisbee

sudden onset of pneumonia

Postby Cabisbee » Mon Mar 24, 2014 7:55 pm

We have had a pretty crazy weekend. My husband was finally able to get round 9 of Folfox after several delays. It went pretty much as usual, discontinued the pump on Saturday after chemo was done and saline bolus was finished. He puked once Sunday morning, swears he didn't aspirate, and then noticed his breathing sounded weird. I'm a nurse, so I grabbed my stethoscope and his lungs sounded awful with crackles. I took him to the ER on Sunday, not sure if he was developing pulmonary edema or infection. They decided his xray showed pneumonia in his right lung. He stayed in the hospital overnight getting 2 antibiotics and fluids and his lungs sounded much better today so they sent him home on oral antibiotics. He was not neutropenic, so I don't know why he didn't have much of an immune response. His WBC was only 7 and he never ran any fever. He really had not even had a cough. He said he had a little clear drainage the 2 days before that if he felt like he needed to clear his throat he was able to cough a little out, but no real cough until the day the crackles developed. He said it sounded like coke fizz to him. They were concerned about his blood pressure, it was a little low but he had not really drank anything the day before and that one liter of saline just didn't go far enough. It just all happened so fast it was weird. To top things off, our oncologist partner who was on call said for them to admit him under our PCP since it was pneumonia and he was out of town. He rarely ever takes off, but it's spring break here. We ended up under the hospitalist group and we did NOT like the doctor. Glad he is back home now, but praying for no more of that. We've managed to make it since August with him on chemo without him catching any funk from any of our kids so I guess we have done good overall.
Cabisbee, husband dx 7/22/13 at age 42
Stage 3B, 2 out of 27 lymph nodes positive
Lynch gene positive
LAR 7/23/13, 8cm mass, bowel wall perforation, peritoneal adhesion
8/14/13 PET/CT NED
12/5/13 8th round of Folfox
2/10/14 radiation x 28
3/2014 9th round of Folfox, Oxaliplatin discontinued
5/2014 12th round of 5FU completed
7/2014 CT NED, colonoscopy 3 adenoma's
7/2015 CT NED, colonoscopy 2 adenoma's
7/2016 CT NED, colonoscopy 1 adenoma

Val*pal
Posts: 860
Joined: Sun Feb 10, 2013 1:24 pm
Facebook Username: Valerie Barkus Kantner
Location: Metro Detroit, Michigan

Re: sudden onset of pneumonia

Postby Val*pal » Wed Mar 26, 2014 6:47 pm

I'm so sorry your husband came down with pneumonia. If it isn't one thing, it's another, right?

I guess it's no surprise that so many of our spouses who have colon cancer suddenly develop "extra" health issues. I know my husband's white cell counts have been pretty bad lately, but he's managed to escape some of the viruses going around, thank goodness. But he did get extremely dehydrated (and very quickly) when he developed diarrhea in January. That put him in the hospital for a week. He must get tired of me asking him how he is, but I'm always afraid he'll get a cold or other virus. A year ago he had a mild head cold that kicked his butt big time, so I appreciate how difficult it is when our loved ones get sick.
DH dx'ed May '11, age 62
Jul '11: resection Stage IV
10/11: 6 mo Folfox
8/12:thyr canc, surg/tx
2/13: peri mets
2/13: Firi/Avas
6/13: Ok
8/13: break
10/13: Lung, peri, mets
10/13: Firi/Erb
1/14: Erb Fail; spread
5/14: Tx stopped
6/20/14: At rest

dianne052506
Posts: 1651
Joined: Sun Nov 02, 2008 11:57 pm
Location: North Carolina

Re: sudden onset of pneumonia

Postby dianne052506 » Wed Mar 26, 2014 7:47 pm

Cabisbee,
By any chance is your DH on Avastin with the FOLFOX?
Over the years, I've had lots of Avastin - first with FOLFOX, then with XELIRI (irinotecan + Xeloda), and since August 2012, with a study drug as part of a phase I clinical trial. Over the last 4 years, I've had a number of episodes of proteinuria from the Avastin. Apparently once you have proteinuria, you are more susceptible to dehydration. I only found out recently when the research onc told the nephrologist who was treating me for acute kidney failure.
I've had 3 episodes of dehydration since Christmas. Once after a reaction to IV contrast for a CT, once with 105 fever and pneumonia (caused by one of the lung tumors) and this most recent time probably because the first two times were not handled well. Every time I was at the research clinic after Christmas, I commented on my unusually low blood pressure and got the "what are you complaining about" look. Now I know that low BP is also a sign of dehydration.
Your DH is lucky to have you watching out for him. When I was feeling lousy these last few months, all I wanted to do was sleep, and my family didn't know any better so they let me. Now we know that I should have been pushing fluids. The nephrologist wants me to have 1.5 liters/day, but with my low appetite and frequent nausea, that's impossible, so I'm going in for IV fluids 3 times a week. Quite a pain, but if it keeps me out of the hospital, it's worth it.
Sorry about the pneumonia. Hope that gets resolved soon as well. Just wanted you to be aware of the higher dehydration risk if he is on Avastin.
Best wishes to you both,
Dianne
May 06 Stage IV CC: liver,ovarian mets
Oct 07 inoperable lung mets
Feb 08 - Apr'12 chemo
allergic to oxaliplatin, irinotecan
Aug '12-Feb'14 Genentech PD-L1/Avastin trial
Mar '14 -radiation to largest lung nodule
still recovering; looking at trials again

Cabisbee
Posts: 16
Joined: Tue Aug 27, 2013 4:20 pm
Facebook Username: Chantelle Bisbee

Re: sudden onset of pneumonia

Postby Cabisbee » Wed Mar 26, 2014 10:42 pm

Nope, no Avastin. He's just on Folfox with Leucovorin. On the day his pump comes off, he's always the sickest. That's the day he gets a saline bolus from me before I unhook him. We have found the right combination of meds ( Sancuso patch, Scopolamine patch, oral Ativan and Compazine) so that he's not puking all day, but he still tends to get a little dry because he can't make himself drink that day. Sometimes he does get sick one last time on the morning of day 4, but not always. He's really done pretty well overall. They took a break after round 8 due to fingertip neuropathy and did his radiation. Unfortunately, radiation caused some pretty significant colitis, so now that's contributing to losing fluids when it kicks in. He was delayed another 3 weeks from restarting with round 9 due to foot neuropathy kicking in. We think it was triggered because the colitis flushed out his b12. He's done better with b12 shots now. All in all, we have felt blessed that his side effects have not been any worse, but this whole pneumonia episode threw us for a loop.
Cabisbee, husband dx 7/22/13 at age 42
Stage 3B, 2 out of 27 lymph nodes positive
Lynch gene positive
LAR 7/23/13, 8cm mass, bowel wall perforation, peritoneal adhesion
8/14/13 PET/CT NED
12/5/13 8th round of Folfox
2/10/14 radiation x 28
3/2014 9th round of Folfox, Oxaliplatin discontinued
5/2014 12th round of 5FU completed
7/2014 CT NED, colonoscopy 3 adenoma's
7/2015 CT NED, colonoscopy 2 adenoma's
7/2016 CT NED, colonoscopy 1 adenoma


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