Wed Sep. 13. had second round of BCG. We still don't have any idea what happened last Tues. CT Scan done but negative. Decided to proceed at the 1/3 dosage to see if I can get a reaction that can be interpreted as positive. Will keep all informed.
I was good until Tues morning this week. I woke to severe nauseau and this progressed to vomiting. Scared, my wife called 911 and I was hospitalized and monitored thru Wed afternoon, then released. My scheduled BCG treatment for Wednesday was "postponed" by my doctor . He is mystified and cautious. I will report as events unfold.
I finally began BCG treatments this morning, starting with 1/3 dose, and am happy to report that aside from the discomfort of the catheter insertion, and the inconvenience of having to employ super clean techniques, I had had NO adverse reaction yet. I am expecting some reaction, but I now think its going to be OK. I will definitely report here for the record, but only adverse or noteworthy events in the next 6 weeks.
I have received a reply from Dr Lamm:
Dear Mr. P:
BCG has been given to many patients with a hypersensitive response to PPD.
PPD is the skin test for exposure to tuberculosis. More than 60% of
patients who receive intravesical BCG will convert to a positive PPD skin
test. There is some evidence that those who have a positive PPD or
convert to positive PPD have a lower risk of tumor recurrence when treated
with BCG. 90% of patients who receive percutaneous (through the skin) BCG
will convert to positive PPD, so I often add percutaneous administration
to increase the immune response.
Surprisingly, people who have had severe reactions to PPD generally
tolerate BCG. Nonetheless, there is an increased risk of side effects.
These effects can be reduced, if needed, be dose reduction of BCG.
Good luck and thanks for asking,
Don Lamm, MD
I find this reply to be helpful in overcoming my reservations. Now if I can get the attention of my doc for adjusting or attenuating the dosage.
I wrote you a long reply, but the steam died out as I wrote it.
Whatever, I will try to be responsible and caring,
just like those that are helping on this forum. I do appreciate your input.
And I want to thank again, and again.
P.S. I found the answer to your initial question, would BCG be contra-indicated in your case, having tested postive 34 yrs ago? From Michael O'Donnell at U of Iowa:
"This question has come up many times before. The answer is there is no reason not to get BCG therapy in the bladder. The patient should be aware, however, that the likelihood of getting reactions (side effects) sooner and more intense is greater. The way to deal with this is simply to dose reduce the BCG by one thirds (i.e from full dose to 1/3 to 1/10th to 1/30th etc) to maintain a tolerant side effect profile. Note: dose reduction may not be necessary at all in the majority of patients but is an option if side effects become problematic.