Tag Archives: infections after chemo

Doctors as Detectives

During my prolonged treatment and recovery from acute myeloid leukemia, I spent many weeks in the hospital with a severely suppressed immune system as a side effect of chemotherapy. This condition is an open invitation to any infectious agents who happen to be in the neighborhood, and I had my share of them.  They included colitis, E-coli, the cytomegalovirus, and several others that were never definitively identified.

I was also on numerous medications, including prophylactic antibiotic, anti-viral, anti-fungal, and anti-rejection drugs as well as other drugs to blunt the side effects of these initial medications.  These drugs nonetheless produced some nasty side effects on their own or in interaction with each other.

The upshot was that on any given day, I would experience symptoms that included fevers, headaches, intestinal indignities, rashes, blurred vision, light-headedness, muscle aches, bone pain, and even persistent hiccups. It was on these occasions that I became acquainted with one of my now-favorite medical specialties known as infectious disease doctors.

I’d only known them as heroic figures in melodramatic movies about plagues threatening all humanity.  But on a more mundane and realistic level, they were also everyday heroes who often provided me relief from a myriad of infections and side-effects.

Their visits would be prompted by my report of unpleasant symptoms or obvious signs like spiking fevers. They would then begin looking for clues like detectives on the trail of a suspect.  They would consider all the medications I was taking as well as their doses and scheduling.  They would listen carefully to my recitation of symptoms. They would prioritize which medications were necessary and which could be eliminated or replaced with others. And they would order blood work, stool samples and other tests to nail down the culprits.

It would often take several days to grow and identify infectious critters in the lab, and sometimes a definitive diagnosis remained elusive.  Even so, their experience, their listening skills, and their hunches often led to solutions that relieved not only my symptoms but their underlying causes.

While it was unpleasant to weather so many infections and side-effects, I came to welcome visits from these doctor/detectives who so often cracked the case, identified the villain, and brought me relief so I could focus on healing and recovery.

Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.

Facing Chemotherapy 3: Your Own Worst Enemy

Chemotherapy kills fast growing cells and hence can be effective against cancer.  But it does not discriminate between healthy and malignant cells.  Hence, the trade-off for killing cancer cells is killing fast-growing, healthy cells as well.

The most serious side effect may be chemotherapy’s impact on the immune system. It drives down white and red blood cell counts as well as platelets. Low platelets can lead to unusual bleeding and low red blood cell counts can bring fatigue. Perhaps most important, low white blood cell counts leave us vulnerable to infectious agents we might normally resist and never even notice.

To counter this heightened susceptibility to infection, patients receiving chemotherapy must take various precautions to minimize their exposure to infection. Wearing masks, washing hands, limiting contacts, and even isolation rooms are just some of the precautions that patients routinely take.

As important as these practices are, they rest on the premise that infections arise from external sources.  This was how I interpreted an E-coli infection I acquired several weeks after receiving induction chemotherapy for my leukemia. I blamed the hospital environment for my misfortune until my doctors offered an even more plausible explanation.

Much to my surprise, most of us have E-coli bacteria peacefully residing in our gut throughout our lifetimes.  With a healthy immune system, these bacteria are well controlled and produce no troublesome symptoms. It is only when we are immunosuppressed that these bacteria can morph into major infections requiring aggressive, antibiotic treatment.

The same dynamic played out after my transplant.  I was given anti-rejection medication to allow my transplanted stem cells to take root and construct a new immune system.  This also caused immunosuppression and opened the door to another critter known as the cytomegalovirus. It is a common virus that resides in many of us but is usually well controlled by a healthy immune system.  When that system is compromised by anti-rejection medication, the virus can break out and require proactive treatment with anti-viral medication.

My encounter with E-coli taught me to never scoff at adult diapers again.  But more importantly, I learned that for all our well-intentioned efforts to minimize exposure to external agents of infection, sometimes we turn out to be our own worst enemy as “auto-infections” arise from deep within us.

 

Steve Buechler is a recently retired sociology professor and cancer survivor.  In 2016, he was diagnosed with acute myeloid leukemia and successfully treated with chemotherapy, radiation, and a stem cell transplant. He has since become a big advocate of writing stories as a survival strategy in the face of life-threatening illness.  His own story is available in “How Steve Became Ralph: A Cancer/Stem Cell Odyssey (with Jokes),” his memoir from Written Dream Publishing.