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Swollen leg, pain, weakness and nausea.

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Hello

I’m currently looking after a friend with several years of CML. He is currently on a generic Gleevec 400mg. He had a fall from a dog knocking him down. Three days later he fainted and hit his head on the floor resulting in a bump and bruise and a small broken blood vessel in his eye. He told me it was vagal shock due to his stomach pain.

 

He has now doubled his dose to 800mg because his right thigh has swollen hard and painful. He had done this before under doctor’s supervision  

 

It’s now day 6 and swelling is slightly down. He feels weaker.  He had another controlled collapse while on his walker this morning after coming from the washroom. No fainting.

 

We think his WBC increased dramatically due to the injuries causing the thigh swelling and bruised head. Also, I wasn’t aware of his diet and he ate more cholesterol than usual which he’s now stopped. He has ordered hydroxyurea pills to assist his healing (this is not doctor prescribed) but he has taken it in the past in the hospital when a similar more serious incident happened in where his calf and foot was severely swollen and not due to any accidental injury. This was about 2 years ago  

 

I’m concerned because he is going to self-medicate with hydroxyurea plus he has doubled his medication. He is not from this country and he does not want to go to a doctor or hospital due to exhorbitant costs. Will he be doing more harm?

I'm not a medical professional, just a professing CML patient.  Yes, I think taking 800mg Gleevec with hydroxyurea is a very harmful idea.  As I understand it, neither of these medications increase healing of contusions or edema.  Gleevec actually causes edema as a side effect, it can also cause hemorrhaging at higher doses.  In my experience, it's more likely the Gleevec caused the eye bleed than the fall.  I've never taken hydrea, but it's not meant to be used as a healing medication, it's meant to indiscriminately depress blood counts when they are dangerously high.

My recommendation would be to get CBC and PCR tests to check his current level of CML control.

Hope this helps,

Kirk

I am also not a medical professional but feel that this does not stack up. I can't see the trauma of the fall leading to a WBC that made hydroxurea a good idea, and I'm not at all sure what the doubling the imatinib is for. If I had a swollen leg like you describe I would want the DVT risk checked out asap. I agree with RC that the eye bleed could well be an imatinib side effect.

Hope this helps.

I cannot see any connection between oedema and possible rise of WBC. Yes, there is a little physiological rise after trauma but not so high to cause this. It has to be really high to develop leukostazis and it is typically on acral areas of the body, often priapism. 

This self medication of hydroxyurea and doubling imatinib is real hazard without knowing exact results. It could do more harm than good very likely. 

Many of the symptoms described could be side effect of medication. I strongly recommend to visit a doctor and take at least blood test, event. imaging - USG, brain CT . It depends. It could not be done online without seeing real patient and having lab. 

I understand your financial concern, but each of us live just once. Do not forget it. 

Eva

 My friend has started one day with his normal dosage of 400mg of Gleevic  (reduced from 800mg) the lightening pain in his legs has significantly subsided. He did take 500mg of hydroxyurea as well with no ill effects. This was what the hospital gave him 2 years ago for a similar incident. 

At present I’m trying to find if there is any way of having him see a doctor in Canada as he still holds a Canadian passport. To not have insurance here would be extremely expensive to get the same treatment he had in Hong Kong. 

I told him he’s playing Russian Roullette with his health.   All the comments have been valuable and passed onto him.   Thank you

 

Has he even Googled hydroxyurea?  He needs to see a doctor.  Period.  Glad his Gleevec dosage has been put right, but the hydroxyurea is just nuts.  Also, a guy who falls, faints, knocks his head, has unexplained swelling of an extremity?  Hello?  Get him to a real doctor!