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My son has provided a reasonably accurate account of events so I won't duplicate activities leading up to this morning. My wife is currently in the Cardiac Intensive Care unit. When I left it sounded like they were debating about intubating her. I laid out the Alimta toxicity argument lock, stock and barrel. All fallen on deaf ears. EXTREME fatigue, EXTREME SOB, EXTREME uncontrollable anxiety / episodic RAGE, mild delirium. Initial CXR is inconclusive but my son has updated me and states that a pocket of pneumonia or pneumonitis is possibility evident. This dramatic deterioration commenced ~ 36 hours after my wife received Alimta. Bottom line is that unless you are in a cancer facility / hospital that is knowledgeable about newer cancer drugs don't expect cooperation in pursuing the drug angle, IMO w/o successful intervention I can't see my wife living more than a few days. She seems to be suffering terribly. The above-mentioned anxiety /rage is particularly striking if you knew my wife. So out of character for her. Given the symptoms and progression, this is either a clear cut case of severe Alimta toxicity or one heck of a medical coincidence.

Thanks to all for the kind words of support.


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According to what I have read about Alimta. The recommended dosage is 500mg (clinical trials) not 780mg. Maybe you can ask the onc. why her dosage was increased. This may have been the cause of Etsuko's cardiac problem. Is she sensitive to meds? I know I am very very sensitive and would rather start with a lower dose and if needed increase. Harder to eliminate higher dose from ones system, causes toxicity... I have friends who experienced toxicity, could not eliminate from their system...

Wish I were closer too, in my prayers every day!!!

Please keep us posted...


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There have been few cases of ALIMTA overdose. Reported toxicities included neutropenia, anemia, thrombocytopenia, mucositis, and rash. Anticipated complications of overdose include bone marrow suppression as manifested by neutropenia, thrombocytopenia, and anemia. In addition, infection with or without fever, diarrhea, and mucositis may be seen. If an overdose occurs, general supportive measures should be instituted as deemed necessary by the treating physician.

In clinical trials, leucovorin was permitted for CTC Grade 4 leukopenia lasting ³3 days, CTC Grade 4 neutropenia lasting ³3 days, and immediately for CTC Grade 4 thrombocytopenia, bleeding associated with Grade 3 thrombocytopenia, or Grade 3 or 4 mucositis. The following intravenous doses and schedules of leucovorin were recommended for intravenous use: 100 mg/m2, intravenously once, followed by leucovorin, 50 mg/m2, intravenously every 6 hours for 8 days.

The ability of ALIMTA to be dialyzed is unknown.


ALIMTA is contraindicated in patients who have a history of severe hypersensitivity reaction to pemetrexed or to any other ingredient used in the formulation.


This is some of info that I think May help you But not sure specifically.

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I am so sorry you are going through all this. Alimta had a very bad effect on Mike. He developed pneumonitis, was put on high doses of prednisone and it's wasn't an overnight cure, but it did gradually help him. Your wife's case sounds much more complicated, but I keep bringing this experience up on these boards, because there seems to be a huge connection between Alimta and severe SOB and fatigue. You and your family continue to be in my prayers.


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I am so sorry you are going through all this. Alimta had a very bad effect on Mike. He developed pneumonitis, was put on high doses of prednisone and it's wasn't an overnight cure, but it did gradually help him. Your wife's case sounds much more complicated, but I keep bringing this experience up on these boards, because there seems to be a huge connection between Alimta and severe SOB and fatigue. You and your family continue to be in my prayers.


I wont report anything definjtive until I and my father hear it from a critical care pulmonologuist or some other treating dr / explanations coming out of cardiac icu arent jiving. my father says that some of this sounds more like spin and butt covering. pneumonitis was mentioned early then a completely diffrent cause is pushed by the oncologist. steroids and antibiotics for something like pneumonitis or pneumonia makes some sense but for tumors in lymph channels ? I dont know. still waiting to hear if any body has heard of this/


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Reviewer Info: Monica Gandhi, MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. ; ADAM Health Illustrated Encyclopedia, 6/15/2005

What do you think of this article?

Page: 1 2 Next >


Lymphadenitis and lymphangitis are infection of the lymph nodes (also called lymph glands) and lymph channels, respectively.

Alternative Names

Lymph node infection; Lymph gland infection; Localized lymphadenopathy

Causes, incidence, and risk factors

The lymphatic system is a network of vessels (channels), nodes (glands) and organs. It functions as part of the immune system to protect against and fight infection, inflammation, and cancers. It also functions in the transport of fluids, fats, proteins, and other substances within the body.

The lymph glands, or nodes, are small structures that filter the lymph fluid. There are many white blood cells in the lymph nodes to help fight infection.

Lymphadenitis and lymphangitis are common complications of bacterial infections.

Lymphadenitis involves inflammation of the lymph glands. It may occur if the glands are overwhelmed by bacteria, virus, fungi, or other organisms and infection develops within the glands. It may also occur as a result of circulating cancer cells or other inflammatory conditions.

The location of the affected gland(s) is usually associated with the site of the underlying infection, tumor, or inflammation. Lymph node infections is commonly a result of a cellulitis or other bacterial infections (usually infection by streptococci or staphylococci), but can also be caused by rare infections, such as tuberculosis or cat scratch disease (Bartonella).

Lymphangitis involves the lymph vessels/channels, with inflammation of the channel and resultant pain and systemic and localized symptoms. It commonly results from an acute streptococcal or staphylococcal infection of the skin (cellulitis), or from an abscess in the skin or soft tissues.

Lymphangitis may suggest that an infection is progressing, and should raise concerns of spread of bacteria to the bloodstream, which can cause life-threatening infections. Lymphangitis may be confused with a clot in a vein (thrombophlebitis ).



lymph nodes may be swollen, tender, and hard

lymph nodes feel smooth or irregular to touch, or soft and "rubbery" if an abscess has formed

the skin over a node may be reddened and hot


red streaks from infected area to the armpit or groin

may be faint or obvious

throbbing pain along the affected area (common)

may involve the lymph nodes (see above)

fever of 100 to 104 degrees Fahrenheit and/or chills

individuals may have a general ill feeling (malaise), with loss of appetite, headache, and muscle aches

Signs and tests

An examination shows affected lymph nodes and/or lymph vessels and may indicate the cause. The health care provider may look for evidence of trauma around enlarged or swollen nodes.

A biopsy and culture of the affected area or node may reveal the cause of the inflammation. Blood cultures may reveal spread of infection to the bloodstream.


Lymphadenitis and lymphangitis may spread within hours. Treatment should begin promptly.

Specific antibiotics are used to control infection, when this is diagnosed as the underlying cause of lymphadenitis. Analgesics may be needed to control pain with lymphangitis.

Anti-inflammatory medications may help reduce inflammation and swelling. Aspirin may be recommended as an analgesic, anti-inflammatory, and fever reducer. (Consult the health care provider before giving aspirin to children!)

An abscess may require surgical drainage. Hot moist compresses may help to reduce inflammation and pain.

Expectations (prognosis)

Prompt treatment with antibiotics may result in complete recovery, though it may take weeks, or even months, for swelling to disappear. The amount of time until recovery occurs will vary depending on the underlying cause.


abscess formation


sepsis (generalized or bloodstream infection)

fistula formation (seen with lymphadenitis due to tuberculosis)

Also This is from ACS on hoe cancer spreads.

Researchers have discovered one of the ways cancer cells metastasize, or spread, to the lymph nodes and lungs, according to a study conducted in mice, published in the February issue of Nature Medicine. This finding points the way for future research on methods to stop cancer from spreading.

The study authors, led by Michael Detmar, MD, a dermatologist at Massachusetts General Hospital's Cutaneous Biology Research Center (CBRC) used a new technique to show "that a system of lymphatic vessels grows within cancers." Doctors have long known that the first place most types of cancer cells spread to is the lymph nodes, bean-sized collections of immune system cells. They also knew that cancer cells spread to these lymph nodes through small vein-like channels called lymphatic vessels. Until now, scientists could recognize lymphatic channels at the edges of cancerous tumors, but they could not prove that the channels also were present inside the tumors.

This is some more info I found in researching what info you gaveMyasthenia gravis






Selected links


Although there is no cure for MG, there are a range of treatments available that can control the symptoms for most people.

Some people with very mild symptoms find that rest and a good night’s sleep is all that is needed to relieve their symptoms, without any additional treatment.

Medicines known as cholinesterase inhibitors (such as pyridostigmine) can block the action of the chemical that normally makes the muscles relax once they have contracted. They work best with mild MG, but can improve muscle contractions and muscle strength in the muscles affected.

Surgical removal of the thymus gland (thymectomy) improves the symptoms of MG for more than 70% of those who have it, and for about 30% their symptoms disappear completely. However, the improvement may take some time to appear - it is usually seen within the first year, but may take up to three years. A thymectomy is generally only recommended for those under the age of 60.

Steroids (such as prednisolone) or immunosuppressant drugs (such as azathioprine) can alter the body’s immune system and reduce the production of the antibodies that cause MG. Although it may take several months, they can reduce or even completely relieve MG symptoms. They are often prescribed to those who cannot have a thymectomy, or those whose symptoms have not been improved by one.

If MG muscle weakness becomes so severe that it causes life-threatening breathing or swallowing problems, two treatments can be given - plasmaphoresis or intravenous immunoglobulin therapy. In plasmaphoresis, your blood is routed through a machine that removes the plasma containing the harmful antibodies, replacing it with antibody-free plasma before returning it to your body. In intravenous immunoglobulin therapy, you are injected with normal antibodies which change the way your immune system acts. Both of these treatments can produce a rapid improvement in MG symptoms, but the benefits only last for a few weeks, so they are not suitable as long-term treatments and are usually used only if you are seriously ill.

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Bill and family: I am very sorry that your wife has to suffer this. My first instinct says yes... it is definitely an alimta reaction. I hope she pulls through it. I have read of others having pronounced sob on taking alimta. You and your family have my prayers.

Don M

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Bill and Rob,

I'm just so very sorry all this is occurring. Your family is certainly living a nightmare. Hope knowing that we are all here to listen will somehow help. Sure wish there was something I could do.........just isn't. I'm just really at a total loss for words. Sorry is about all I can say.


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Thinking of you at this trying time. I hope that they can get to the core of this quickly and give her the treatment she needs to recover and get back to the main job of fighting the wretched cancer. Will be sending major vibes over the airways to you and her and all of yours,



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