After all the focus on cellulitis, the doctors have determined that this was not the problem with Cheryl's right leg. The area that had us all concerned turns out to be inflammation. The doctor discontinued the antibiotic and it appears that things are under control with an anti-inflammatory and Lovenox blood thinner.
On that note, they have decided that Cheryl is a Coumadin failure, meaning that it is not controlling her clotting correctly so she will be going on theraputic Lovenox where she will have to give herself two injections a day.
Her leg pain has cleared up and they are making arrangements to have her discharged today. The vascular surgeon said that she does not want to put in the inferior vena cava filter since it usually ineffective in cancer patients but she does want to do a follow up with Cheryl in a couple of weeks. Cheryl will also have a follow up with the general oncologist.
Afternoon update
Cheryl's discharge paperwork was finished and we were out of the hospital before noon. We stopped at Red Lobster and had a nice leisurely lunch before coming home. We stopped at Wal-Mart and picked up a few flowers to complete the project she started before she had to go to the hospital. If the weather is nice tomorrow, she expects to finish up the patio and front porch planters.
Thursday, March 31, 2011
Tuesday, March 29, 2011
Another Hospital Stay
Cheryl has been having some pain and redness on the side of her right calf since mid-March. When she saw Dr. Burke on March 16th, the area was about 2X3 inches and slightly red. He had a deep ultrasound done to rule out a deep vein thrombosis and the scan came back okay. He referred her back to our family practice. By the time she got in to their office, the area of pain and swelling was several inches long and substantially wider. They made a preliminary diagnosis of superficial thrombophlebitis and put her on Keflex (antibiotic) for several days which did nothing to slow the spread of the effected area.
On her return visit to Dr. Tomus' office, they changed her diagnosis to cellulitis and discontinued the Keflex and put her on Cipro and Cleocin (antobiotics) and gave her Vicodin for pain. Over the next several days, the pain increased and the area grew larger extending about three inches past where the NP (nurse practitioner) had marked on her last visit.
Which get us to this afternoon. The NP and doctor reviewed Cheryl's blood work and did not see an increased white count. Her hemoglobin is at 11 vs 12 but overall, the rest of her panel was in normal range. Dr. Tomus determined that the next course of action has to be hospitalization for IV antibiotics and additional pain meds to get this under control. He called in to Memorial Health in Savannah and coordinated a direct admit so we didn't have to go through the usual ER hassles.
After Cheryl was processed and was waiting to be sent to a room, we had a chance to meet with Dr. Ignacio who will be managing her care. He said that the course of treatment could take as long as five days to get the infection under control.
Before I left the hospital this evening, the had already given Cheryl her first IV bag of antibiotic and also gave her a shot of morphine to help ease her pain. The good news is, cellulitis is not normally life-threatening but it is extremely painful and can advance to other problems if it is not taken care of adequately.
Please pray that the antibiotics will be effective and that Cheryl will be released as soon as possible.
Wednesday Morning Update
Just got off the phone with Cheryl. She is feeling less pain in her right leg this morning. They did an ultrasound of her left calf since she was also having some pain there as well and they've discovered a new deep vein thrombosis. Her meds have been adjusted and they will now be monitoring the DVT on the left leg along with the cellulitis on the right leg.
Wednesday Afternoon Update
The vascular doctors have decided that Cheryl has DVT in both legs. They are going over her information to determine what else needs to be done. As of now, she will be adding Lovenox injections to her daily routine and it looks as if they will insert a filter in the inferior vena cava to prevent these clots and any future clots from migrating to the lungs (pulmonary embolism),heart or brain. We should know more by this evening.
On her return visit to Dr. Tomus' office, they changed her diagnosis to cellulitis and discontinued the Keflex and put her on Cipro and Cleocin (antobiotics) and gave her Vicodin for pain. Over the next several days, the pain increased and the area grew larger extending about three inches past where the NP (nurse practitioner) had marked on her last visit.
Which get us to this afternoon. The NP and doctor reviewed Cheryl's blood work and did not see an increased white count. Her hemoglobin is at 11 vs 12 but overall, the rest of her panel was in normal range. Dr. Tomus determined that the next course of action has to be hospitalization for IV antibiotics and additional pain meds to get this under control. He called in to Memorial Health in Savannah and coordinated a direct admit so we didn't have to go through the usual ER hassles.
After Cheryl was processed and was waiting to be sent to a room, we had a chance to meet with Dr. Ignacio who will be managing her care. He said that the course of treatment could take as long as five days to get the infection under control.
Before I left the hospital this evening, the had already given Cheryl her first IV bag of antibiotic and also gave her a shot of morphine to help ease her pain. The good news is, cellulitis is not normally life-threatening but it is extremely painful and can advance to other problems if it is not taken care of adequately.
Please pray that the antibiotics will be effective and that Cheryl will be released as soon as possible.
Wednesday Morning Update
Just got off the phone with Cheryl. She is feeling less pain in her right leg this morning. They did an ultrasound of her left calf since she was also having some pain there as well and they've discovered a new deep vein thrombosis. Her meds have been adjusted and they will now be monitoring the DVT on the left leg along with the cellulitis on the right leg.
Wednesday Afternoon Update
The vascular doctors have decided that Cheryl has DVT in both legs. They are going over her information to determine what else needs to be done. As of now, she will be adding Lovenox injections to her daily routine and it looks as if they will insert a filter in the inferior vena cava to prevent these clots and any future clots from migrating to the lungs (pulmonary embolism),heart or brain. We should know more by this evening.
Thursday, March 17, 2011
Good News and Not So Good News
Cheryl had her first full follow-up with Dr. Burke Wednesday morning (3/16/11). Her physical exam went well and she appears to be making good progress. Dr. Burke said that all of her abdominal and pelvic CAT scans looked good and discussed that the lung CAT scan does still show some loculated fluid (trapped pockets between the lung and pleural lining).
As we were wrapping up the appointment, he told the nurse that Cheryl needs to have a CA 125 check since the last one was performed back in January, shortly after she completed chemo. He told us that the result of this test would likely be lower than the 19 she had on the previous one.
After the appointment, I dropped Cheryl off at home and went on in to work for a few hours and then headed over to the church to get ready for the mid-week prayer service. Shortly after 5 PM, Cheryl received a called from the Dr. Burke's nurse telling her that she needs to come back in for another CA 125 next month since this test was elevated.
By elevated, she meant that it had gone from 19 to 97.9. Dr. Burke had the nurse tell Cheryl that the elevated level may be due to the fluid that remains in her pleural cavity. There can also be other causes for an elevated CA 125 which is part of why they want to wait the 30 days to do a recheck.
With this bit of information, we are not panicked but we are most definitely praying for this level to come back down to normal range. We thank you for all of your prayers along the way and ask that you continue to lift us up to the Throne of Grace.
As we were wrapping up the appointment, he told the nurse that Cheryl needs to have a CA 125 check since the last one was performed back in January, shortly after she completed chemo. He told us that the result of this test would likely be lower than the 19 she had on the previous one.
After the appointment, I dropped Cheryl off at home and went on in to work for a few hours and then headed over to the church to get ready for the mid-week prayer service. Shortly after 5 PM, Cheryl received a called from the Dr. Burke's nurse telling her that she needs to come back in for another CA 125 next month since this test was elevated.
By elevated, she meant that it had gone from 19 to 97.9. Dr. Burke had the nurse tell Cheryl that the elevated level may be due to the fluid that remains in her pleural cavity. There can also be other causes for an elevated CA 125 which is part of why they want to wait the 30 days to do a recheck.
With this bit of information, we are not panicked but we are most definitely praying for this level to come back down to normal range. We thank you for all of your prayers along the way and ask that you continue to lift us up to the Throne of Grace.
Monday, March 14, 2011
A Reason to Celebrate (through Cheryl's eyes)
Cheryl's Remission Party was a real hit. With over 100 people in attendance, it was quite a time of celebration.
I took the floor to say thank you to everyone and was overwhelmed as I looked out at all the faces of family, neighbors and friends who were so helpful in getting us to this point.
Not only was the food good, the news of remission good, but our daughter Michelle also had some good news of her own to share. She announced that she is pregnant and is due on September 14th which was Granddaddy Leo Maxwell's birthday.
This news makes me all the more thankful o be through with chemo and feeling better. It gives me one more thing to look forward to.
This Wednesday, I will go see Dr. Burke who will have the results of my recent CAT scans. Since the CA125 numbers were good, we are expecting good news. We will update the blog with new of how the CAT scans turn out.
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