Wednesday, 1 August 2012

Treating an infection

About a week after having the second IVE chemotherapy I started to feel a bit ill, but as coincidence would have it I had a hospital appointment for a lung function test that day, so I thought I'd go along to that and whilst I was there mention to a nurse in the haematology clinic that I wasn't feeling so great.  I left home a bit early for the lung function test, as I thought I'd try to see a nurse in the haematology clinic first (just in case they decided it wasn't worth doing the lung function test at that time), but it took a while to get a parking space, so in the end I just went straight to the lung function test.

The lung function test is pretty straight-forward, as you're really just asked to breath in and out of a tube using a mouthpiece (what is essentially a glorified peg is put on your nose too); A computer is connected to the other end of the tube so that it can analyse the air content, flow and volume.  It probably takes around thirty minutes in total, as there are a few different types of breathing tests to be done, and you do most of the tests at least twice to ensure that the results are consistent/representative.  You're guided through each test with instructions like: "breath normally", "take a deep breath and hold it" and "breath out as fast as you can"; The only thing that varies from one test to the next is the sequence of and exact breathing instructions given.  Personally, I find the hardest part of the tests is being asked to breath out every last bit of air from your lungs, as it's not something that we ever really do in real-life; To a lesser extent, holding your breath can be similar.

After the lung function test, I mentioned to a nurse in the haematology clinic that I wasn't feeling so great, so a blood test was arranged and my temperature was taken.  My temperature was above 38°C, so at that point I pretty much knew I'd be admitted for a course of antibiotics.  I did also suspect that I'd need a platelets transfusion, as that morning I'd noticed a small black (ish) spot had appeared on my tongue and I had some bruises from where my weight had been concentrated when sleeping.  Both the need for being admitted and a platelets transfusion were later confirmed by one of the doctors, after receiving the blood test results and a quick chat, followed by an examination of my breathing (after walking for a bit, I found myself a little out-of-breath and with some discomfort/pain just below my right shoulder blade).

After being admitted to the haematology ward:
in order to determine the source and type of infection some more blood samples were taken (one through the hickman line and one through a cannula), I had a chest x-ray (just in case it showed anything), I was started on a course of antibiotics, and I was given a platelets transfusion.  A further platelets transfusion and a couple of red blood cell transfusions were prescribed over the next day or so, due to my platelets still being low, and my hemoglobin level dropping a bit further.  I was also started on a second antibiotic after a couple of days, as the preliminary results for identifying the infection suggested it might be worthwhile, but that antibiotic was stopped a few days later when the exact infection was identified, as that infection is known to respond fine to just the first antibiotic.

After a couple of days or so on the antibiotics I felt fine again really (diarrhea aside), but the full course for the first antibiotic is five to seven days, hence I needed to stay in hospital for a while longer.  I had that antibiotic for seven days in the end, and during that time I also went for another heart scan (the results of which were fine) and a PET scan (the results for which I'm still waiting).  Even after the antibiotics finished, I still had to stay in hospital, as my blood counts hadn't recovered enough for me to go home; They were on their way up, but were taking it steady.  One of the doctors explained that the delay in my blood counts returning to normal is likely just a sign that my bone marrow needs a rest after all of the treatment that I've had, hence my third (and hopefully final) IVE chemotherapy will be delayed until I've had time to recover.

Note: I'm actually in hospital now, which makes it nine days and nights so far, and I'm still waiting to find out when I will be discharged.  As you can probably imagine, hospital is not the most fun place to be, even though I can make use of the gadgets etc in the teenagers and young adults ward, but I did manage to pass a bit of time in the last few days by decorating my room a little with some drawings of a handful of cartoon characters (there are a few whiteboards scattered around for that kind of thing).  There are some pictures below (click on one to view it full size):

Mickey Mouse
Mike (Monsters Inc)

Bugs Bunny
Boo (Monsters Inc)

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