Dang!

I'm starting to get a temperature. I just checked it: it's 99.4 to 99.6, up from 97.6 to 98.4 earlier today. Then again, I had an Ibuprofen (one pill) last night because of aches and pains, one Tylenol at 5:30 when I woke up with a headache and then another Tylenol about 9:00 when the headache wouldn't go away. So, that artificially depressed my temperature.

If it goes up to 100.5 then I'm calling.

Thank you, Joanna, for your advice and for telling me your experience. I haven't been on Herceptin for two months as it exacerbated the pain in the armpit.

Now I am Confused!

I saw the surgeon today and in the end, hem palpated the lesion and then decided to lance it and drain what fluid was there. He only got about 5-10 cc's of fluid and it was a bit creamy (I will take his word for it as I didn't want to look.) It wasn't pus. Then, he rooted around under his cut (about 4 inches around) and didn't feel any more pockets of fluid, only what he feels is a necrotic tumor. His diagnosis: a layer of bacterial infection ocher the dead tumor.

Now I am confused. One doc says one thing and the other says another thing.

He did take a sample to send to the lab. Not sure when I will hear those results.

He packed the hole with gauze in order to keep it from getting infected. I may or may not see the wound care nurse on Monday, depending on how things are going.

I need to keep an eye on my temp and if it rises again, I need to contact the on-call docs because that means the antibiotics aren't working.

He also felt that the armpit needs radiation sooner rather than later and wondered if I could do Abraxane and radiation at the same time. But that will be something to ask Dr. K about.

So, it's wait and see again. I got a bit confused with the "if-then" scenarios because there were several of them and they dependedmon each other. In other words, if this happened, then this is what we would do -then if something happened with that, then this was the next step. But if it didn't happen, then this was the course of action. Trying to keep the order of it all was a bit overwhelming. Will I get chemo on Tuesday? Or not?

Which just made me realize, as I typed thus, something I advise my grad students: don't worry about what's going to happen next year for the moment. Just focus on the task at hand.

That means, stay the course this weekend. Take both the Flagyl and Levaquin, watch for a fever, change the dressing when I need to, and rest. Next week will take care of itself.

I am such a planner and now that the plan, such as it was, is in the air, I have become discombobulated.

Live in the moment, right, P? (A friend who just emailed me today to offer encouragement and to remind me to live in the moment. Thank you, P!

P.S. Struggling with the living in the moment attitude. Truth is, I am feeling a bit like I have been abandoned by my medical team. All offices are closed for the weekend, but there are things I am worried about and want to know tomorrow. Like, is it an anaerobic infection? After I changed my dressing tonight, I am not sure the surgeon today is right. He thought that I wouldn't drain as much and it turned out I drained more and then used a lot of wound care dressings to try to keep it contained for the night. He was wrong about drainage and so could be wrong about the type of infection. I would like to know the lab results of the sample TOMORROW. On the other hand, I just remembered that bacterial cultures usually take a couple of days. I am also worried about running out of dressings. Then I worry about having to be hospitalized and thinking about coverage for my class. But I need to let go of that -hard to do when it is a class you care about- and let my colleagues deal with that if that happens.

The good news is that I have only had Tylenol since the morning and no temperature. I will cling to that.

Mom and dad and Rena, please don't worry. I don't really want to talk about it. It would help me tons if we didn't discuss too much in person. I want to save my energy to talk about other things and to take care of Eddie. Just continue to read my blog. I just think you understand it better if I write it all down rather than talk about it because sometimes I feel like you don't get the right message and it takes energy to correct you. Also, mom, I know you like to know my schedule - always a mom, right? LOL - so I will write it down. It will be easier than trying to say it in person. Just known that I love all of you very much. So really, let's talk about something else for a change? : ) I will try to get out of my own head enough to interact more. Love you!

Glad I pay attention!

So, last night, so as not to mess up with my sleep, I didn't do any research on anaerobic infections. I was also way too tired.

This morning, I got curious enough, so here's the first site enlisted on Google: http://www.faqs.org/health/topics/37/Anaerobic-infections.html

Good thing I waited until today when I don't have a fever and am rested! Words like gangrene, pus, infections in deep cavities, tissue destruction, etc., are all in the description. If not treated, it could result in even bone destruction.

Lovely.

So, treatment is to take Flagyl and the fine needle aspiration to remove any pockets of pus. I see the surgeon at 3:30pm so we can more.

Based upon what I read, Mount Herminator is probably pus, or maybe it is a pocket of gas production.

So my metaphor of a volcano was pretty much on target.

Imagine if I didn't ask for appointments yesterday when the wound changed?

Anaerobic infection, oh boy!

I saw the wound care nurse this morning and she confirmed that Mount Herminator had indeed changed significantly since Tuesday. I asked her about the smell, but she felt there it wasn't cancerous and it didn't seem like a bacterial infection.

Then Eddie had two appointments and then I saw Dr. K's colleague, Dr. O., who is new to the practice. First, I should say that I like this guy, too, and felt very comfortable with him.

Dr. O took a look at the wound, smelled the smell that I have smelt since I got the fever. His diagnosis? An anaerobic infection. So, I will take Flagil in addition to Levaquin in order to get rid of the infection.

Now, my day was busy and I was running on about 1.5 hours sleep. Damn insomnia! I forgot to take Tylenol/Ibuprofen on schedule, so by the time I saw Dr. O, my temp was 99.8 (using the forehead thermometer which runs about 1.0 below the in mouth models). And my pulse, blood pressure, and heart rate were up. So he felt that my immune system probably couldn't handle Abraxane tomorrow.

Instead, he wants me to see Dr. F, the surgeon, so he could ultrasound the lesion to see if there are pockets of pus, which would not be good in terms of fighting the infection. If so, then I think they could take out the pus through fine needle aspiration? Anywa, a lovely thought, that, "pockets of pus".

However, he wants me to start Abraxane on Tues, which would be one full week after starting Levaquin and five days after starting Flagil. I will start it after I see the wound care nurse, my counselor, and my acupuncturist.

I teach on Mon and Wed so I might need to find someone to take over my class on Wed. I have already asked someone . . .

So, now I am back on schedule with all my meds. I started out feeling okay today and slowly deteriorated. Still have a bit of a fever. And exhausted. So off to bed for me in a few minutes.