Vidaza IM? instead of subq?

[token nurse in the family]

The doctor appears to be giving my brother-in-law Vidaza IM instead of subq like the literature instructs. My brother-in-law did tell the dr the nurse gave it in the back of the arm and even on one occassion offered the dr his stomach. The dr still gave two shots in the deltoid. I called the drug company and they had no information on IM injections being less or more effective or any information on the drugs action when given IM vs SQ. I wonder if anyone out there has any experience with this altered route. I would question his doctor but I think he’s starting to think I ask too many questions and I don’t want to worry my brother-in-law. My brother in law is this office’s first recipient of Vidaza. The nurses are not available 4 out of the 7 day series and told me they did instruct the dr on how to give (or mix it??). He just finished his first series of shots-did fine, a little redness at sites, mild nausea, tired. He’s getting CBC every week til next series – bumped his WBC and HGB a little so far, platelets went down. Dr sez he doesn’t expect his counts to go down (also a little different than what I read in Vidaza info site)and doesn’t expect to see it work or not until he’s had 4 series. My brother-in-law knew he had “something wrong” with his WBC being really low but I guess didn’t understand the “doctor-speak” two years ago after his first bone marrow. A repeat bone marrow was done in October after pancytopenia turned up in a yearly check-up. They asked me to go with them for results ( i.e. the”token nurse”) and sounds like doctor told him two years ago he would ultimately reach this point (he is 64 with Type II diabetes and officially RAEB-t without chromosome problems). He had a sister die of some form of MDS 2 1/2 years ago at age 63-so this has been very scarey for him and the rest of the family. At any rate I am learning ALOT about MDS these days and trying to educate and advocate for my brother-in-law and the family without harming his patient-dr relationship. We all feel robbed of the last two years when he seemed well but was clueless it would come to this. But also very thankful there are several drugs available and on the horizon that he may benifit from. Anyone have any personal insights to the shot route and anything else about his course? Thanks, Token Nurse

[Caroline]

I cannot help you with the Vidaza question but I think I know a bit about how you feel.

My Dad is 79. When I first found out that my Dad has had MDS for about 3 years and they didn’t do anything except test his blood every 3 months and give him Vitamin B-6, I was kind of upset and felt robbed as well. Dad was oblivious to the fact that MDS would eventually transition into Leukemia and there was a period of time that I thought he should be researching it and ‘preventing’ it from happening. But now when I see how sick and weak his is with CMML which the doctors ARE actively treating and which I have studied the life out of, I am glad that we didn’t really know what was wrong with him before. He lived normally and didn’t see an end in sight. We had 3 reasonably healthy years. Sure, he was tired alot and felt sick once in awhile but otherwise he still participated in his grandchildrens’ lives and took care of his house and property, etc. Now…he sleeps and barely communicates at all. When he does eat, it is usually a few spoons of soup because everything else makes him feel sick to his stomach. Now, all any of us can see is an end and it is a horrible feeling.

I don’t think that there is any easy way of approaching or living through this. We all wake up feeling like hell and we all go to bed feeling like hell and when we wake up half-way through the night and reality once again sets in, again we feel like hell.

Your brother-in-law is a lucky man to have you as his ‘token nurse’. I took on that responsibility in our family for my Dad and it is an awful job and yet it is a very rewarding job for me. I read and research and ask a million questions and then I make assumptions and always see the worst case scenario before I see that…OH YEAH, maybe it isn’t as bad as what I thought. I went over to give Dad his Eprex shot thismorning and he was so sick in bed that I thought he was going to die. He has the flu and I spent from 10 till 2 with him so that my Mom could go to her appointments. My husband left work to take her. I spent over an hour on the phone calling the doctor and asking questions regarding whether I could give him his needle when he has diarreah so badly and a fever and the chills/sweats, etc. At one point, the dear nurse chuckled and said, “Caroline…he has the flu. Give him the shot, baby him, make him tea and if he still has these symptoms in the morning, phone us again and we’ll probably hospitalize him for dehydration.” By the time I left Dad and Mom’s to come back home, he was up out of bed, drinking tea and watching TV in front of his fireplace. My Dad has the flu…. I overreact like a brand new mother does. In fact, I did that with my newborns too.

Good luck to you with your brother-in-law and if you have any questions, the people in this forum will certainly share their wisdom with you. This place is fantastic. I don’t know what I would do without them.

Blessings,
Caroline

[Terri]

Token Nurse, I will ask our Nurses tomorrow when Bob goes in for his SHots if they have any info on it. Maybe it gets into the body quicker subq.
Anyhow I will let you know if they have any info.
I know that if the nurses do Subq on an angle Bob Bruises like hell but if they do subz strait in then It is less bruising and just some redness after the shots. His platelets are low so we try doing anything to avoid all the bruising.

[Caroline]

Token Nurse,

I tried to email you back but I cannot use Outlook Express on this computer for some reason. I tried to email you from my personal account but I can’t find your email address anywhere. If you don’t want to be written to that is alright, but if you do, would you please email me one more time and add your email address? I am new to using computers and I don’t really know anything except the basics.

Have a nice day,
Caroline

[Terri]

Got the answer well what our nurses said anyway, IM it will not absorb properly the Mfg def says it has to be Subq. Also make sure the SUBQ they give the Shot not at an angle but they pinch the area between the fingers lifting the skin area and put it Strait in not slowly. When they go in on an angle it is too close to the top of the skin and their is more brusing/ redness etc.

[Author]

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