[KKronowski1]

Severe bloating during RVD treatment

by KKronowski1 on Thu Aug 08, 2013 11:06 am

My mom is a recently diagnosed multiple myeloma patient. She is currently on her second cycle of Revlimid, Velcade, and dexamethasone (RVD), taking 25 mg of Revlimid for 14 days, and Day 1, 4, 8, 11 Velcade with 40 mg of dex. She has been experiencing pretty significant bloating in her stomach, particularly her upper abdomen, and bloating / swelling in the face and under her chin. We are assuming this is from the dex, but the doctor is not inclined to lower the dose at this time in treatment.

I was wondering if anyone had any suggestions that may help alleviate some of her discomfort.

Thank you!

[Russ]

Re: Severe bloating during RVD treatment

by Russ on Thu Aug 08, 2013 2:10 pm

Dex tended to cause me to retain water and therefore experience a little swelling, but the gastro-related issues were caused by the Velcade (and probably aggravated by the dex). Velcade can cause some gastroparesis, which effectively means that your stomach is emptying slower than normal, hence the bloating. For me, things start moving properly again by about the third day post-Velcade, but if your mom is doing a twice weekly cycle, she is getting dosed again about the time the gastroparesis would be wearing off, and not getting any relief. I tend to watch what I eat for those days, and that seems to help me, but I believe there are meds available (to be taken before and with meals) that overcomes this effect.

Talk with your doctor about the symptoms, and it might be worth talking with a gastro-specialist. It seems to me that effective side-effect management betters the results of overall treatment (i.e., you are less likely to discontinue or modify an effective treatment if you can tolerate it well).

All the best to your mother.

Regards,

Russ

[Kevin J]

Re: Severe bloating during RVD treatment

by Kevin J on Fri Aug 09, 2013 4:07 pm

I had both gastrointestinal issues and fluid retention while receiving carfilzomib (Kyprolis), Revlimid, and dexamethasone treatment for two years. Similar to Russ, the fluid retention seemed to be due to the dexamethasone, which makes sense since it is a common side effect of steroids, and it usually lasted about 2-4 days. I attributed the gastrointestinal issues to the Revlimid, since they were fairly constant and I only received the dex and carfilzomib weekly and biweekly.

I was prescribed Lasix for the water retention and would take one or two daily as needed, the second and third days after infusion, which helped a lot. I basically just lived with the gastrointestinal issues, though I could lessen them if I made sure to include plenty of fiber, prunes, or other foods the tend to flush the system, in my diet..