oxygen use to combat anemia from riba

[pocomilk]

Hi,
A dear friend is suffering severe fatigue from anemia while leading a very hectic work schedule. I have urged him to talk to his doc about possibly starting procrit. Does anyone have experience with the use of oxygen to help in the meantime? Where would he get oxygen to use at home? Portable ones? What brands are good? Thanks for your help.
tv

[nygirl7]

I have never heard of anyone using oxygen personally.  Procrit should fix your friend up but it takes a few weeks to work and they will only let them have it usually once they get under 10. Do you know what their hemo number currently is? I would assume you would need a prescription to get oxygen bottles....honestly don't know about it. Some of the members have had anemia quite drastically and I didn't remember them doing this - however transfusions help temporarily.

[newleaf09]

Very interesting idea, but I doubt that the addition of extra oxygen to the lungs would alter anything.  The fatigue is caused by circulating much fewer of the hemoglobin cells that carry oxygen to cells throughout the body.  Hemoglobin is, unfortunately, destroyed by ribavirin, one of the anti-virals in the treatment.  The addition of extra oxygen to the lungs would not change the fact tthat fewer oxygen carrying cells (hemoglobin) are now available to carry the oxygen where it needs to go.  Procrit is currently the best method for stimulating the bone marrow to increase production of new oxygen carrying cells.  It does take 3 weeks or so (a shot per week) to become effective You are a good freind.  Please keep thinking creatively to assist your buddy.

[jdwithhcv]

I had very low hgb and the week I started procrit I passed out at home from hypoxia.  The EMTs who responded to my home put me on oxygen immediately and it helped a lot, it kept me conscious and the hospital kept me on oxygen until the transfusions were finished.  That is the only time I used oxygen during my tx.

Procrit takes a while to help.  Be patient.

jd

[nygirl7]

It does sound like at least it would get rid of the "I can't breathe.....I"m gonna pass out...wow the world is going away....BAM!" portion.  While it surely isn't a cure I guess it makes sense that it would alleviate the symptoms. I wish I knew that when I kept fainting - I would have tried it for sure.

[pocomilk]

Thank you for all your immediate comments. I think the oxygen could only help. That, and a portable oxymeter. I am wondering if anyone know where to get portable oxygen. Thanks.

[pocomilk]

I only found out today that my friend's latest hemoglobin is near 10 but not quite below 10 yet so the PCP refused to prescribe Procrit as I believe he needs given his severe symptoms and status of living alone and leading a demanding work life. The other thing is this Hb is from 3 weeks ago.  And  he only found out the result today!  If you have anemia and experience bad symptoms, do your docs call you with the result sooner? Do they check your blood more frequently? My friend only found out because he finally called the PCP for an appointment because of severe symptoms, including low grade fever. I urged him to ask for a blood test to check on the anemia and infection but that was not done!

[merryBe]

two conditions may exist, regular hemolytic anemia where you lose red blood cells...but the cells remaining are carrying at full capacity. this is most common, and only procrit can correct it as adding oxyggen does no good unless there are cells to carry it. Since the cells you have are carrying at full capacity in this cae adding oygen is dangerous..it cannot be of benefit, but can cause great oxidative stress.

the second condition is when the number of cells left are NOT carrying at full capacity, and it this case oxygen may be used, but it has to be a 10% or more loss of carrying capacity. Even then, one must regulate carefully so an not to over oxygenate the body.

If you have the first condition best to use procrit, get weekly CBCs to see if levels comes up, and if not go to a higher dose.
There is no way to tell if you have the second condition without getting an oxygen test done by your doctor. Many GP's can measure this in their office, if not you would need a respiratoy specialist to measure it.

Most of the people treating will only get the first condition, this is because red cells are being killed off more quickly, but their actual shape or oxygen carrying capacity while alive is not altered.

mb

[pocomilk]

Thank you both for your very helpful comments.  MerryBe, your points make total sense. Thanks for your taking the time.

[merryBe]

you are most welcome.

the temptation, if one is really suffering is to ask for a transfusion, I would make sure they have upped the procrit to 60,000 per week if they haven't already. More than that has no effect.

I would also ask for an iron panel and make sure there is enough free transferrin (available iron) in the blood for the procrit to work...no available iron means no red cells can form even with procrit present, but you need the test...if one just starts eating iron without knowing ones numbers, you could easily get into iron overload which is common in HCVers, and you do NOT want iron overload as it greatly harms the liver and is a main cause of hepatic cancer (HCC).

Last choice of all would be transfusion, not because of chance of reinfection with more HCV, that chance is very low now with testing...1 in 600,000 if memory serves...but because each transfusion causes a storm of antibodies to form, causing immune confusion, and every transfusion is said to lower a persons chances of a success liver transplant. (rejection rates much higher for transfused people).

Of course if your friend would not qualify for a transplant anyway, then a transfusion could help him.