A Little Bit of Progress!

Another two weeks have gone by since my previous post, so let's catch up again!  David had the recheck CT on May 7th, but it was a bit of a fiasco!  David's infectious disease doctor had ordered an abdominal CT to recheck the liver abscesses & his oncologist had added on a thoracic CT as part of his routine (every two to three month) screening for metastatic progression of his cancer.  Now you have to know that anal retentive Janet had checked two weeks ahead of the procedure to make sure that the radiology department saw both orders & could do both studies at the same time, & I was reassured that both would be done on May 7th.  But, of course, when we checked in that morning with the reception staff, we were told that only the abdominal CT was on the schedule & we would have to come back at another time to have the thoracic study done.  After some back & forth with the receptionist, it was deemed that both studies could be performed together (it honestly doesn't take more than five minutes to perform a thoracic CT).  Since David had his IV antibiotics running into his chemo port, I went back with him into the CT prep area so I could disconnect him from the antibiotics & they could then use that port to administer the IV contrast for the CT study.  Not long after they had taken David back for the study, the IV nurse came out to chastise me because the IV needle in David's port was not one that would allow the fast injection of IV contrast.  She showed me exactly what needle is needed & told me it is my responsibility to make sure that the infusion nursing staff that changes David's needle weekly uses only that particular needle.  Okay, so one more thing that I need to keep track of & make sure that someone else on their staff is doing their job correctly (can you tell that this really pissed me off!).  Unfortunately, as is usually the case, David had to pay the price for this error as they had to place a peripheral IV & his veins are pretty shot from all of his recent hospitalizations.  So, they got a peripheral IV placed & injected the contrast, but then the machine broke!!!!  The gantry table that moves David into the scanner wouldn't move!  So, they hustled him over to another CT machine, but by the time they did the study, the contrast had already moved through his vascular system.  And, they can't inject more contrast because it is very hard on the kidneys.  What we got was a subpar study for all of our frustrations!  They were able to make a determination that David has no new abscesses in his liver & the ones present are slightly smaller ... so, we'll take that good news & try to shake off the frustrations!

Based on the information of no new abscesses & a slight decrease in the size of the abscesses present, David's infectious disease doctor decided to switch David to a different antibiotic.  She was concerned that the offending bacteria causing the abscesses could become resistant to the Zosyn he had been on for eight weeks.  So, last Friday, we switched to an IV antibiotic called Ertapenem.  The delivery system is so much easier -- a daily infusion that takes 30 minutes to administer.  Let's just hope that this antibiotic kicks the fanny of the remaining bacteria!!

On Monday, David had a recheck of his cholecystostomy tube.  The cystic duct that drains bile from the gallbladder into the common bile duct remains patent (open), so the interventional radiologist & David decided to do a trial capping of the tube (they put a cap on a very short section of the tube hanging out of David's side & took away the bag that the tube had previously been draining into, although David had really not been having any drainage into the tube for nearly a week).  They will recheck his gallbladder in another week & if the cystic duct remains patent & the gallbladder has not become distended, they could potentially remove the tube all together as they could then assume that David's gallbladder is functioning more normally.  Fingers crossed on this one!  In the meantime, David says it surely feels good not to have a long tube & bag hanging from his side & not to be hooked up to an IV pump 20 hours a day!  We are grateful for what appears to be some progress!!

Since my last post, David had to go back for another paracentesis as his abdomen was once again filling up with fluids.  Again, no one is really sure why this is happening, but it appears that David is going to need to have this done on a kinda regular basis.  They again tapped out two-&-a-half liters of fluids, which is about when he clinically feels like he needs to have a paracentesis as that amount of fluid interferes with his appetite, makes his abdomen feel tight & uncomfortable, & pushes up on his diaphragm, which makes it harder to take a deep breath.

We saw David's oncologist (Dr. Fanta) on Monday & he encouraged us to go spend some time in Colorado while things are looking pretty stable.  So, we are working on getting everything in place to do just that -- no easy task since it involves traveling with his IV antibiotic supplies, his cholecystostomy tube supplies, his twice daily injections of blood thinners, & all of his daily & as needed medications.  It is both an exciting & scary prospect to consider spending time in our beloved mountain cabin!  We are hoping to get there next week after getting the cholecystostomy tube rechecked, having another paracentesis done to empty out as many extra fluids as possible, & getting the weekly IV needle changed out.  Wish us luck!!

Hoping this finds all of you well & getting geared up for the upcoming Memorial Day weekend & the kick off to summer!!  Hugs, Janet