Friday, November 8, 2013

Was Sprycel Keeping My Peripheral Neuropathy at Bay?

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In April of 2010, a little more than three and a half years ago, I suffered extreme side effects from an antibiotic called Cipro, also known as Ciproflaxin. This antibiotic is in a class of antibiotics called floroquinolones; Levaquinn and Avelox are also in this class of antibiotic. Apparently in 2010 there were over 20 million prescriptions written for Cipro, and its’ popularity has increased.

Cipro was designed as a powerful, last drug of choice, antibiotic to be used in extreme bacterial infections that did not respond to prior treatment; it has become a first choice antibiotic for many, many physicians and dentists, despite its’ Black Box Warning status.

So, what’s the big deal? It’s an antibiotic, right? All antibiotics come with some risk and side effects, right? If you’re sick, you need an antibiotic, right? While all of these answers may be “yes” I will tell you what three doses of this antibiotic have done to me; they have apparently caused a permanent, peripheral neuropathy; with my feet being the hardest hit.

I suppose that I probably take in excess of 10,000 steps each and every day; imagine excruciating pain every time that you put weight on your foot; that is 10,000 jolts a day. And imagine that after you experience the jolt, your feet just throb in between each jolt. That is what Cipro did to my feet. I had/have many other issues as well, but my feet are my greatest challenge.

Fast forward eleven months from my second floxing; I was diagnosed with chronic myelogenous leukemia. During my initial treatment I received a chemotherapy drug called Cytarabine. Within days of receiving these chemo treatments, my foot pain began to subside; eventually it became almost non-existent. I began to be able to walk normally and I began to be able to use and bend my toes, my knees and my hips without pain. I was ecstatic! I had found a golden lining to having leukemia; my daily pain was much improved; I began to move, and dance like my old self. To me it was miraculous; to the doctors, they simply shrugged and said that they often heard that people’s RA and other peripheral neuropathy improved after chemotherapy.

I cannot tell you how happy and excited I have been without this daily pain. I was released from the hospital and began a daily medication called Sprycel. Sprycel is a drug used to treat CML. Apparently it also has kept my peripheral neuropathy at bay, because for two and a half years, my pain level has remained stable.

That is until I developed pleural effusion, a side effect of Sprycel, and had to stop my treatment for three weeks until the PE resolved. During this time, the pain in my feet has returned. It began slowly but has continued to progress; it is depressing and I swear I would go in and have a round of chemo if I knew that it would help. I am hoping and praying that by resuming my Sprycel treatment the pain will begin to subside once more, but I also wonder if the Sprycel was strong enough to hold the peripheral neuropathy at bay, but not strong enough to stop it. 

Something to ask at my next doctor's appointment....

Monday, September 30, 2013

Sprycel Vacation: The Good, the Bad and the Ugly!!

Interestingly enough, I have noticed many different things that Sprycel does, and doesn’t do, to my body. After a nearly three week vacation, it has been difficult in some ways to return to my CML treatment, but comforting and even helpful, in others.

The major disappointment in returning to treatment is my missing “spark”; Sprycel seems to have a way of diminishing my inner “happy” glow! I know that sounds silly, and I am still an extreme optimist, but the bursting-over joy, that I have when I am not on Sprycel, just is not the same. This coupled with the fact that when I am not on Sprycel, the leukemia has an opportunity to kick start its engine.

That being said, there is a comfort to returning to the battlefield. The most difficult part being the return of the side effects; I have suffered greatly from muscle spasms in my back, am extremely tired, and once again, my hair is starting to fall out! Ugh, it was finally beginning to grow again. The afternoon, flu-ish, fever-y feeling has returned, along with the headaches.

The Good news is that the peripheral neuropathy, from the Cipro damage, is beginning to subside again. I still cannot believe how taking Sprycel keeps the pain in my feet, and joints in my legs, at bay. I suppose this really is the golden lining to living with a chronic cancer; totally strange!

My belief and hope is that it will not take as much time, as it did when I first began taking Sprycel to adapt to the medication and for the side effects to seem less severe. I often wonder whether the side effects actually lessen, or if we just learn to better adapt to them.

What do you think?

Wednesday, September 18, 2013

Peripheral Neuropathy, from Cipro, Returned; Not Good!

As many of you may already know, four and a half years ago, I suffered severe side effects from an antibiotic, in the floroquinolone family, called Cipro. The first time it happened, I suffered a ruptured tendon. I did not correlate the ruptured tendon to the antibiotic, Cipro.

Eleven months later, I was nearly crippled by the drug. I was given it a second time for a urinary tract infection; I took five pills and my body was destroyed. I mean literally destroyed; I suffered from the worst pain I have ever felt, in my entire life. It was mostly located in my hips, legs and feet. The pain was constant, excruciating, and never subsided. This time I DID realized that it was caused by Cipro.

I also suffered from light sensitivity and total brain fog. This is not something that you would wish upon any one, not even your worst enemy. There is no way to reverse these side effects and doctors simply shrug their shoulders when presented with a floxed patient.

Oddly enough, I suffered with this destruction and peripheral neuropathy, right up until I received chemotherapy treatments, after being diagnosed with CML. Oddly enough, there is something in the chemotherapy that can reduce symptoms in RA patients, and now I have experienced the same thing; pain relief. I was ecstatic and figured that this pain relief was the golden lining, in having leukemia.

Fast forward two and a half years; the peripheral neuropathy and the light sensitivity have improved drastically, although I cannot say the same thing about the brain fog. All was well until I developed pleural effusion and bronchitis last month; I had to go off of my Sprycel treatment, until my lungs were functioning properly, again.

 Within ten days of ceasing the Sprycel, the peripheral neuropathy began to return. I started getting extreme pain in the balls of my feet and toes, (my hardest hit area), skin sensitivity and the feeling that my Achilles and other tendons could rupture if I was not careful. I was horrified and angry. It really makes me ponder the correlation between the peripheral neuropathy and the TKI’s, as well as the chemotherapy; AND just how damaging this class of antibiotics, really are.

Moral to the story; I am actually blessed to have CML because living with that sort of pain is truly unbearable. It literally made me wish I would die; I would rather have cancer than the pain associated with the damage from those drugs. How sad it that?

In my opinion, unless it is an absolute, last resort, life or death situation, the floroquiolone, antibiotics Cipro, Levaquinn and Avelox, should be avoided like the plague!

Tuesday, September 10, 2013

Living in Chronic Pain? Create Your Own Brief History

Recently I was talking to another CML buddy about my pleural effusion. He has also suffered from pleural effusion as well as many other side effects, which many of us deal with, too. I thought that I was pretty darn good at keeping tabs of my medical issues and records, but when I saw his “Brief History” I was very impressed.
He actually encouraged me to start my own brief history quite some time ago, and I am not really sure why I never got around to it. Now, I have to go back through my “thick” medical records that I DO have, and create a wonderful “Brief History”, like his!
I would encourage each and every one of you to do the same; even if you don’t go back to your diagnosis, you can begin documenting your important data now, as we all will be managing and living with CML, for the rest of our lives.
My friend has kindly allowed me to share his Brief History, with you, as an example.

DX CML 12-23-2008
MDA Protocol: Tasigna-400mg; 2xday-1/09
On Flecainide for AF...still had frequent episodes
Q PCR bone@ MDA…0.17 on 7/09
Acute Pancreatitis-7/5/09
Stopped Tasigna-7/13/09
Q PCRU blood @ Baptist…undetected-7-29-09 !
Started Gleevec-400mg/day-7/31/09
Developed rash ~ 8/19/09
Rash treated with Steroids..improvement
Rash worsens~9/22/09
Stopped Gleevec-9/28/09
Restarted Gleevec @300mg/day-10/8/09
Stopped Gleevec-10/13/09-toxic rash\
AF returned infrequently
Q PCR bone-0.05
Started Sprycel @ 100mg/day-10/20/09
Some AF...increased FLecainde..1, 2x/day
Q PCR bone @ MDA..0.07
Stopped Alcohol…no AF, ½ Flecainide 2x/day
Q PCR Blood @ Baptist…Non Detectible-12-13-10
Q PCR Bone @ MDA..0.01--2-25-11
Q PCR Blood @ Baptist…Undetectible-5-19-11
Reduced Flecainide to 1/2 per day
Pleural and pericardial Effusion: stopped Sprycel-12-6-'11
Prednisone 50mg /day to combat PE; 12/14/'11 gradual reduction
Pleural Effusion clear 12-21-11
Started Sprycel 70mg/day..12-23-11
QPR bone @ MDA.. <0 .01...2-16-12="" span="">
Started Sprycel 50mg/day..3-10-12
Chest pains...slightly more PL Eff 4-19-12
Steroid Dose pack to alleviate:.still on 50mgs
Change to 20 mgs/day Sprycel..4-26-12
Chest clear, effusion gone-5-14-12
Q-PCR Blood @ Baptist-Undetectible-6-13-12
Neuropathy moving up legs, some weakness noted--12
Q-PCR Blood @ MDA..<0 .01="" span="">
Q-PCR Bone @ MDA…<0 .01="" span="">
Q-PCR Blood @ Baptist….Undetectible..6-19-13

Wednesday, September 4, 2013

FDA Announces New Black Box Warning!

Apparently there has been a change to the Black Box Warning for Floroquinolones. The FDA announced on August 15, 2013, that fluoroquinolone drugs such as Levaquin, Cipro and Avelox will be required to change packaging inserts to contain a warning for severe, permanent and disabling peripheral neuropathy. The FDA states that the damage may occur very soon into the administration of the drugs and the damage may be permanent.

If you are wondering what peripheral neuropathy is, this is the description from the FDA: Peripheral neuropathy is a nerve disorder occurring in the arms or legs. Symptoms include pain, burning, tingling, numbness, weakness, or a change in sensation to light touch, pain or temperature, or the sense of body position. It can occur at any time during treatment with fluoroquinolones and can last for months to years after the drug is stopped, or even be permanent.

Permanent: I cannot even imagine the pain that I suffered during the first two years, after being floxed, lasting forever. I swear that I would have jumped in front of the bus, if I had not begun to see a slight decrease in pain, during the first six months. This pain relief was minuscule, yet gave me hope.

I am telling you that the pain was the absolute worst pain, I have ever experienced. It is not like a cut or a bruise, it is not like a broken bone or a migraine; it is like you are walking on burning glass. It is constant and never subsides; even the air hurts the affected parts of your body.

I was unable to touch my feet or toes; I could not wear socks or shoes and could bear absolutely no weight, on the front part of my feet: for years. My hips, knees and Achilles felt as though they would burst at any moment. This pain is indescribable. Not only did I have pain in my legs and feet, I was unable to open my eyes in the morning, because of the light, for hours, and even then I had to keep the house dim. I couldn't remember things, I was easily confused and literally just wanted to sit in a dark corner and cry. The skin on my body hurt to the touch and wearing anything other than really, really soft material, was excruciating. This is not something I would wish on anyone!

There was not a doctor, or pharmacist that had any advice on how to control the pain, or if it would ever go away. The only person that gave me any sort of advice on how to try and detoxify my body, and rebuild the damage was Dr. Leland Carroll; a chiropractor. I believe that it is with his help, my persistence and a round of chemotherapy, (due to my leukemia diagnosis) that I am much improved. It absolutely floors me, that once you have suffered the toxicity of these drugs, that there is absolutely no protocol on how to stop, or reverse the damage. No one can tell you that someday, you MAY get better.

I will bet you that the orthopedic surgeons that are repairing torn tendons and the Fibromyalgia doctors that are treating tons of patients with chronic, unexplained pain, are thanking these drugs; all the way to the bank. You can bet that they never even ask their patients if they have taken a floroquinolone. This is disturbing and unconscionable.

I am certain that many physicians are completely unaware of the Black Box warning placed on fluoroquinolones in 2008; and I am certain that most have never seen the outcome of those of us that have suffered these side effects. Probably the biggest reason for this, is simply the lack of correlation, to the pain and the antibiotic; not many figure out what has caused their pain, therefore, it goes unreported. 

Fortunately, the internet is bringing these issues to light, and hopefully our voices are being heard. We need to report these side effects to the FDA and the drug companies, and once made aware of the risks, we must refuse this class of antibiotics, unless there is no other choice. Trust me, you do not what to take the chance, that you will become the next victim.

I do not believe that any doctor or dentist would knowingly prescribe an antibiotic that is so dangerous; unless they were completely unaware of the consequences, or there was no other option. I also understand that all drugs come with their own list of precautions and warnings, risks and side effects. These must be carefully weighed; and you must decide if the result, outweighs the risk. Believe you, me; if I had had a choice of diarrhea or a rash, over being crippled and in chronic, extreme pain, I would chosen the diarrhea or rash; every time. Usually, there are alternative antibiotics, but you must ask.

I believe that it is the pharmacist's responsibility to inform a patient of the Black Box Warning, prior to filling the prescription; I know that this was not the case on the two prescriptions that I filled. What good is a Black Box Warning if no one knows about it? Education is key here, for physicians and pharmacists, not to mention the patient, We, as patients need to take these warnings seriously.

Thanks to the internet, the dangers of Cipro, Levaquinn and Avelox are finally getting the wide spread attention they deserve.There are petitions and lawsuits, and there was even a march on the capital lawn, in Washington, bringing awareness and looking for retribution for victims. Victims are tired of being victims and they are realizing that they really are not just one in a million, but one of many. 

Do not fall prey to the antibiotics Cipro, Levaquinn or Avelox; it is not worth the risk. If you have suffered peripheral neuropathy you may wish to contact the Floroquinolone Victims Advocacy Network. 
New class action suits are being prepared.