The Next Battle

My body is fighting a war, good cells against bad cells. It is being fought on multiple fronts.

There is the cancer. We learned that when I had my second surgery in July (to repair the anastomosis that was bleeding) they removed another microscopic tumor. Too small for the surgeons to see. Too small for the pathologists to see. Only under the microscope, going through cell by cell, did they discover it. This confirms what we and the medical team suspected and assumed: We will be fighting this war for the rest of my life, as tiny tumors sneakily grow. This doesn’t change our management plan; we will still wait and watch, carefully. There is no chemotherapy for my situation. No remission for this kind of cancer. So we will be always at the ready, vigilant and aware, to do what we can to keep it at bay.

There are other battles in this war. Surgery means incisions and scars. Countless blood draws and dozens of IVs have left craters in my elbows, bruises up and down my arms and a blocked vein in one hand.

But the next fight we face is one doctors and patients fear: infection. After my surgeries I developed an abscess, a collection of infected fluid in my pelvis. A catheter drain was inserted to remove the fluid over the next two weeks.

What we suspect happened is that at some point, the abscess split in two, with a wall forming between. The drain emptied one pocket, but the infected fluid from the other spread. Now, I have multiple collections in both fallopian tubes, touching my ovaries, and another pocket centered in my pelvis. Unlike my first abscess, these ones are not in positions where a catheter could be easily inserted; they are surrounded by blood vessels, organs, bone.

At this point, the team feels that they can safely be treated with antibiotics.  After five days in hospital, this morning the team gave us the option of trying to go home. The plan is two weeks of intense oral antibiotics with home care nurses coming several times a week, a check up at the hospital in one week followed by repeat imaging (scans) at the hospital a week after that.

This is just an attempt at being home. This kind of infection usually requires narcotics for pain. I can’t take narcotics and so we are managing the pain with acetaminophen and ibuprofen. I have quite a bit of nausea and there are some concerns about our ability to manage my pain, nausea and hydration. The antibiotics cause nausea and diarrhea with a potential for c. diff, and so I might not be able to stay home if we can’t keep me hydrated.

The hope is that I will sleep better and eat better at home and that those things will help. The team was very willing to let us try to come home – they offered it to us as an option – but it is definitely a trial basis, with the very real chance I will need to return either to be treated with fluids as an outpatient, or to be readmitted. We have a long list of things to watch for that will send us back to hospital, and quite honestly expect to be back before the week is out, even while we remain hopeful we can get this under control.

It is possible that in two weeks’ time, imaging will show significant change and all will be well and I’ll come off antibiotics then. More likely though, is that this is going to be either a drawn-out fight (the doctor spoke of months). If I am clinically stable (no fever, no vomiting, pain under control, vitals good) and show signs of improvement but the images don’t show changes in the abscesses, then we continue with antibiotics; however, if my condition doesn’t improve or deteriorates, then the team will reassess whether or not they can access the abscesses to drain them, and surgery becomes a very real possibility.

We don’t know what the next days and weeks hold, which way things will go. For tonight, I’m grateful to be sleeping in my own bed.