Pneumonitis

Monday, July 3, 2017 around 3:00 pm I started to experience de jevu. The overwhelming fatigue caused me to lay down for a nap. I woke up around 5:30 pm with a cough and low grade 99.5 temperature. I felt like you do when you first start to get the flu--I call it lousy. The coughing was getting worse and the temperature crossed the 100.5 threshold to call the oncology office at UM. I was told to head for UMER and be evaluated. By the time I arrived, the cough was so steady Mary asked if I had coughed out a lung and my temperature was at 101. The triage nurse had my name and she got me right into an isolation room with those cute little masks on. I needed to settle in for a night of IV fluids, chest x-ray and multiple blood pokes for a variety of tests. By now, I was sweating enough to have soaked the sheets on my gurney and needed them to be changed. Calls were made to  my on call oncologist as my regular one is on vacation for the holidays which I was glad to hear he was taking time off to enjoy himself. The call was to again admit me and observe what was happening. Since this was only a couple of weeks away from my last episode they were now getting concerned it was a possible side effect of the immunotherapy.

At 10:00 pm I was moved to a single room on the 6th floor for observation. The cough and temperature came and went often. I was told that all of my tests were negative and that the chest x-ray was clear. Tonight I would again soak my sheets in sweat and feel my chest tighten as I coughed. My pulse ox level was hanging n the 90-91 range and they wanted it to be at least 95 so I was put on 2 liters of ox. 

The next day was the holiday and I was struck by how quiet it was around the hospital. Around midday the Resident came and said the oncologist was concerned about a condition called Pneumonitis which had been identified as a possible side effect for 3% on immunotherapy patients. So an IV drip of 80 mg of prednisone was started and an antibiotic regime to hit and prevent any further infection. I have since read several articles on this side effect and it fits my symptoms to a T. Within 3 hours of the IV starting I stopped coughing and began to feel better. My fever broke by morning. I then spent two more days being observed and working with a breathing device to clear my lungs to get my pulse ox levels up, I finally passed the tests on Thursday morning and was sent home on my birthday to celebrate with my family. It was so nice that the kitchen staff sent me birthday cards signed by them all on my birthday. The doctors and nurses all came in and congratulated me and wished me a happy birthday.

I came home and got cleaned up so that Mary. Michelle and Christopher could drive me to Grand Rapids to celebrate a birthday dinner with Megan and Brian. I had a wonderful Polish sausage and a single Tupelo draft beer for dinner and then road home. In the car on the way home I had a chance to read all the wonderful comments so many of you sent me for my birthday from all over the world. I am such a blessed man!!!!

The plan going forward is to meet with my oncologist next week to discuss the Pneumonitis treatment plan and how it will affect the immunotherapy schedules in the future. I understand the Prednisone should not interfere with the TACE procedure set for July 21, 217. Hopefully after a cooling down period we can restart the immunotherapy.