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Acute monoblastic leukemia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hi, My Sister in Law is suffering from Acute Monoblastic Leukemia. The Dadar based doctor,, started chemotherapy for her. it was 60 % Complete. During this procedure she is infected with pnuemonia. Her condition his getting worse day by day. She has been shifted to and still being treated for pnuemonia. Her condition is not at all improving and we are getting really worried. It appears her condition has worsened due to chemotheraphy? We urgently some advice as well as hope? What are the chances of her surviving? Is the doctor following correct procedure?
Doctor :   Hi, I am Dr. AAAAAAA
Let me read your query for few minutes to
be able to have a good discussion here.
User :   ok no worries
Doctor :   OK
Doctor :   I guess you have been informed by the treating doctor about the
User :   Her WBC count is really low
Doctor :   adverse effects posed by
Doctor :   chemotherapy
Doctor :   the benefits it offers
User :   no he never metioned it to us
User :   but we do know it is used to cure cancer
User :   but the adverse effects was never mentioned by the doctor
Doctor :   Did they not get an informed consent signed from the patient/ guardians?
Doctor :   before starting chemo
Doctor :   ?
User :   probably not
User :   but I will confirm it by brother
Doctor :   Ok, now what you need to know is
User :   as I was not present at the hospital
Doctor :   that chemo in this case is given
Doctor :   to attack the cells in the bone marrow
User :   you mean the name of the medicine?
Doctor :   Sorry- from the bone marrow
User :   do you need to know it now?
Doctor :   Bone marrow is present in the bone & is responsibl e for production of
Doctor :   white blood cells
Doctor :   which are protective cells
Doctor :   Acute Monoblastic Leukemia is a disease of theses cells
User :   ok
Doctor :   The chemo kills these diseased cells & some normal cells also
Doctor :   So the person becomes more prone to infections
User :   ok
Doctor :   Pneumonia is one such infection
User :   this means her WBC count will be very low
Doctor :   & is quiet common
User :   the doctor has been trying since last three days
Doctor :   Acute Monoblastic Leukemia. is not a simple disease, needs a superspecialist to handle it
User :   but the situation has not improved at all
User :   we were referred to by our local doctor
Doctor :   Pneumonia in such a case, where the body has been rendered weak by chemo & Acute Monoblastic Leukemia is indeed very difficult to handle
User :   Does it mean her chances of surviving is very low?
Doctor :   It is low compared to other patients who do not have the other conditions that she has
Doctor :   i cannot as such say how low it is
User :   the condition of pnuemonia is not improving at all
Doctor :   It all depends on the level of infection, the level of her immune system
User :   what should be given to improve her protection to pnuemonia
User :   or what should be done?
User :   or what can be done now?
Doctor :   Ok, now she needs very strong antibiotics
Doctor :   & a life support system if she not already on one
User :   she is already on life support system
Doctor :   I am sure she is already on the strongest antibiotic
Doctor :   OK
User :   as she was having difficulty in breathing
Doctor :   Is she on a ventillator?
User :   yes
User :   thats correct
Doctor :   Then the only thing left is to give her body the time it takes to heal
Doctor :   If the infection is not that severe
User :   what sort of time frame should we be looking at?
User :   and what is the infection is really severe
Doctor :   & the antibiotic is able to clear the infection then she will start breathing herself
Doctor :   THe time as I said depends on many tthings- the level/severity of infection, her body strenght, the nature of the infecting organism
User :   ok
Doctor :   it could take 2days to a week
User :   aok
Doctor :   for her to come out of the ventillator
User :   during this stage pnemonia should not increase, correct?
Doctor :   No, pneumonia can go either ways
Doctor :   but most of the times it improves
User :   So what if it worsens
User :   are there still some chances of improvement?
Doctor :   Then it becomes more difficult to handle, will need change of antibiotics,
User :   or survival
User :   ok
User :   it is not getting worse but it is also not improving
Doctor :   They will check if the organisms are susceptible to particular antibiotics & put that antibiotic
User :   i guess, it is matter of time then
Doctor :   Then may be the pneumonia is reducing but her body has not yet
Doctor :   become strong enough
User :   they have been conducting some test every couple of hours
Doctor :   to sustain breathing life by itself
User :   ok
Doctor :   Yes in an ICU they will conduct tests even every hour
User :   yeah thats correct
Doctor :   Its all for her good
Doctor :   kindly cooperate with them
User :   yep we are not at all figthing with them
Doctor :   as her life is now in their hands
User :   but they also dont provide any information as such
Doctor :   Critical care docs are the most dedicated
Doctor :   They must
User :   and this is why we get really worried
Doctor :   please demand it
User :   they only say we are providing antibotics
User :   but dont say what and if they are changing it?
Doctor :   They will usually communicate it to one of the guardians & it is his duty to inform others or else others will think that they say nothing
Doctor :   They think that it is enough if they say antibiotics
Doctor :   but if you want to know which, its your right, please ask
User :   yeah they should atleast be telling it to my brother
User :   and he is the primary guardian in this case
Doctor :   They should & will
User :   Her condition was better yesterday
User :   but it has worsen again
User :   is this normal with pnuemonia
User :   ?
Doctor :   Yes, with any disease in leukemia/cancer & AIDS patients
User :   ok thanks
Doctor :   In these patients as I said- immunity is low
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