Today I had a therapeutic/dignostic thoracenteses and I can breathe again! (Diagnostic just in case it could be caused by something other than Sprycel)
I saw the doctor at 9:40 and had the procedure at 12:30. You can find out how it's done by googling it so I won't bore you with the procedure but it was pretty cool. My lung looked like a shriveled raisin on the ultrasound before the procedure and like a real lung on the x-ray afterwards. The radiologist removed 1.25 L but was unable to get a little sliver of fluid down around the diaphram so I hope it will be reabsorbed soon and I hope that it doesn't just fill right back up again. Only time will tell, but I've been off Sprycel now for almost a week so maybe I'll luck out.
www.ncbi.nlm.nih.gov/pmc/articles/PMC2785832/pdf/1756-8722-2-46.pdf
There is some good information in the article above about the possible immune relation between dasatinib and pleural effusions. One thing that caught my eye was that the history of a rash
during therapy (with either imatinib or dasatinib) may be a factor in the development of pleural effusions. Last March I posted about a weird rash I had developed just on my toes. It was purpuric in nature and on occasion was itchy and could be painful. It came again in October and about every 3-4 weeks after and then I had the pleural effusion.
The other foot looked like this but not as bad for some reason. The thing on top of my foot is nothing, every time I cut myself or otherwise break the skin now it leaves a brownish red spot when it heals.
If you are on dasatinib (Sprycel) or any of the other TKIs, nilotinib least of the three, familiarize yourself with signs of pleural effusion. In retrospect, I think mine was coming on for awhile before I recognized it for what it was. After the first of the year I noticed when ever I had a good hard laugh I would end off with a cough, I noticed it as out of the ordinary but did not make the connection. Also, I might not have had to go through this if I were more proactive with my onc. When we first saw the PE it was very tiny. I should have insisted that I go off Sprycel at the time but he didn't suggest it and I really didn't want to, so nothing was said. My second opportunity to avoid the painful, scary PE that developed. I should have remembered that I was his first patient on Sprycel - now he has three.
Chest pain, can be pleuritic in nature, like mine (ask someone who has had pleurisy, they can describe it in detail or google it), shortness of breath and dry cough or anything else you may think that is out of the ordinary.
Our lights just flickered and we're having a thunderstorm so I'd better hit send.
Pat