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Taking Care of Yourself: Preventing Infection With Myeloma

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Published on September 23, 2016

What do myeloma patients in various stages of treatment need to know about preventing and dealing with infections? Watch now to hear advice from experts Dr. Frits van Rhee and Nadine Baxter from UAMS Myeloma Institute—especially for patients with low blood counts and recovering from transplants. 

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Transcript | Taking Care of Yourself: Preventing Infection With Myeloma

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

I’ve got another question for you about infection. So if you go to the primary care doctor, and you have a cold, they’re not rushing to give you an antibiotic. But if we’ve had some of these heavy-duty therapies, our immune system is not so perfect. We have to be very wary of infections, right? So what would you say to people? And what do you do here to help people not develop pneumonia or some other terrible infection either because of weaknesses in their immune system or effects of the treatments they’ve had?

Dr. van Rhee:      

I think one of the answers is close monitoring of the patient. Patients get seen here during active therapy every single day.

They get checked for fever, blood pressure. We do a number of blood tests. And then, there is also a great emphasis on prophylaxis hereagainst bacterial infection, shingles, yeast infections. So prophylaxis is important. And patient education is important as well, particularly when their blood counts are low, they’re at home or here in an apartment or in a guest house. They need to know when to seek advice and call and come to our center and receive antibiotic therapy. 

Andrew Schorr:                  

So Nadine, if somebody develops a fever, you want to know about it.

Nadine Baxter: 

Immediately.

Andrew Schorr:                  

Let’s talk about that about when to call. 

Nadine Baxter: 

If you’re in this area, certainly, we would appreciate, and we emphasize the fact that any fever, you need to immediately either be seen in our Infusion 4 area or in the Emergency Room setting.

But that applies to the patient who has gone home, too, who has had treatment. Every day, I hear Dr. Morgan and Dr. Davies talking to the patient about the importance of going to their closest facility if they develop any type of fever. A cold in a myeloma patient is not a cold in me or anyone on this panel. A cold is to be taken very seriously in an individual and to be treated appropriately. 

Andrew Schorr:                  

Okay. So a lot of people, especially if you’ve been to the doctor a lot, you’ve been to the clinic and, like you said, it’s just a cold, but remember cancer patients are a little different category. And we may be continuing to take even an oral medicine, very powerful medicines. So if this stuff comes up for you, you’ve got to deal with it. And you’ve got to deal with it aggressively. Now, who has got a grandchild in this room?

A bunch of kids, they get colds and infections. So one of the questions I have for you, Nadine, is should we—if our grandchild is sniffling from whatever they picked up at the preschool or elementary school, should we be standing back from them? I mean, just in interpersonal relations, should we feel we’re sort of damaged goods? We’ve been talking about our immune system. We’ve got to wear a mask on a plane or don’t hug the grandkid, what? 

Nadine Baxter: 

They’re precious. They are so precious, but you do need to be very careful around them. Unfortunately, little children are little bug carriers. And oftentimes, we have patients go home for a holiday, and they’ve been around their grandchild. And they come back, and they have pneumonia. So you need to just be very, very careful staying away from them. I think about that you can stay away for that visit, but you’re going to have at least 10 more years of good visits with them in the future staying healthy.

Andrew Schorr:                  

But it may have to do with where your blood counts are.

Nadine Baxter: 

Absolutely. It does impact it.

Andrew Schorr:                  

So in other words, if you’re restored, if you will, Sean is way out of treatment now, so he’s in deep remission. He’s in a different—than somebody who has just had a transplant.

Nadine Baxter: 

That is correct. Someone who has just had a transplant needs to be very careful. Sean, and Stephanie has children of her own. So those that are away from a transplant for a period of time, their immune system will reconstitute itself. Therefore, they are more able to handle that exposure to that child with the cold. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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