The Infection

The day after liver surgery I had a blood clot and right lung collapse. No chest tube. They sent me to ICU, gave me high flow oxygen, and let it "reinflate" itself. This meant when I left the hospital, I still had fluid around the lung. 

Two weeks later I returned for a follow up MRI. The fluid was still there, but Dr. S's thought was it would clear itself naturally. And natural is always better than shoving a catheter into someone's back to drain and risk infection...hahaha. Ha. Infection. Funny story. 

Another two weeks pass, I'm cleared for chemo and knock out round #7. The following week the pain is worse. It's painful to breathe. I cannot hold my breath more than 10 seconds. Just getting to my doctor is a feat. Fatigue is one thing. I can push through the loss of breath...because I can breathe. When you're working with one and one third lung, walk 15 feet without stopping and you're a darn hero!

I had mentioned the pain was a little worse during my pre-chemo chat with Dr. H, but this appointment I complained more and was sent for a chest x-ray. I was also anemic, so while waiting for x-ray results the plan was to get some iron through IV. That didn't happen. The finding was an abscess, and I was immediately admitted to the hospital. 

And then the talking heads got together. Dr. H was generally uncomfortable making decisions about the abscess. (It's another doctors work, they know the area, what they did, blah, blah, blah.) So he calls Dr. S (liver surgeon), who explains only 10% of his patients need draining and he still thinks natural is best. And the infectious disease doctor (Dr. V, aka The Russian) says no temp, no infection. So while I'm still in pain, and after two days of waiting in the hospital, they decide to release me. If I run a temp, I go to the ER. 

Fun fact. It seems every time a doctor throws out a percentage, I am that stupid fun percentage. Hours after I get home I start running a low grade temp. And by that night we're minutes from going to the ER, and then the temp drops. I was taking Loratab with Tylenol and didn't realize it was causing the temp drop. The next morning another fever, so I call Dr. H's office and we're off to the ER. 

I'm admitted around 9:30 AM, and by 2:30 PM we finally get rolling and the abscess is finally drained. Up until this point I thought the abscess was in the lung area, but I find out it's actually located where the liver surgery was performed. Upper liver. Hard to get to..remembering the first biopsy. 

Thankfully they kept me pretty sedated for the drainage, but it was still painful. The catheter was inserted right under my boob, practically going through breast tissue. Yeah, pain! And then I see the syringe of fluid they are pulling. It's not fluid. It's blood tainted white gunk. Like "light chocolate milk" according to one of the nurses. And these are not small syringes that are being used. The doc instructs the nurse to admit me into ICU. 

Five gigantic syringes later, I'm moved to my side, and they start to drain the fluid in my lung. There was a problem with the catheter so they only remove 100cc, but it's all clear. Basically the abscess was causing the fluid build up in my lung, it was unrelated to the lung collapse, and would naturally clear now that it had been removed. 

The drain tube is left inside. It's about 2 feet of tubing that is shoved under my boob & ribs. This thing is painful. I learn as long as I don't move the pain isn't bad. Bathroom visits required a shot of morphine to manage to pain of moving. 

Dr. H stops by for a visit during his evening rounds. He's shocked that I was walking around with all that gunk, and not really complaining when I had every right to complain. "Oh, here's Heather with a football of abscess fluid...it kinda hurts here Dr. H." Before he leaves we ask when I'd be released, he said Monday. 

MRI Check Up

Most people tend to get nervous before their MRI check ups, but because I had a CT that showed clear shrinkage I was feeling pretty good. At least until we started driving, and then nerves kicked in anyway. 

Dr. S (Surgeon 2) scheduled a consultation immediately following the MRI. I was expecting good news. What I got was the exact opposite. 

I have one lesion on the liver that measures 1.5 cm. What I was told is now I had four lesions. Four! (Somehow I remained fairly calm, fairly certain it was shock.) We were told I have one lesion in the middle, three surrounding. 

Then Fred asked about the markers he had placed during the MRI assisted biopsy. Blank face. "You had markers placed? How many?" (Um, yeah...three and YOU ordered them!) "Well, the radiologist is having a hard time reading the MRI." (Well, how about you & the radiologist read my damn chart before you unnecessarily scare a patient to death!) "I want to see you again after the radiologist has more time, I prefer in-person consultations." 

And then he started asking me questions about my ostomy surgery. He couldn't read the surgeon's handwriting. Totally get that, but maybe call the surgeon and ask him. (The questions were far too technical for a patient to answer, and others I simply didn't know.) 

Surgeon 2 questioning me about the ostomy and not Surgeon 1. The fact that he clearly hadn't read my chart and refreshed himself on my case before the consultation. I was left with a bad feeling about this surgeon, and if there is one thing I've learned it's trust my instincts! I went home that night and started searching for a second opinion. If he didn't straighten himself out by the next appointment, I was moving on!

The next appointment. He immediately starts talking surgery. We had to ask him for the MRI results. "It's shrunk 50%." (Okay, what about the other "lesions".) "They were reading the markers as lesions." (Thank you Jesus! ...MORONS! Next time read the chart!)

That's it. Very matter of fact. No excitement or fist-bump like Dr. H (my oncologist). But at least he had a conversation with Surgeon 1 and could clearly talk surgery and recommendations. 

Going Forward:  [TMI'ish Warning]

Liver resection surgery is planned for August 18th. Because of the location it will NOT be laparoscopic. I had already assumed that based the difficult biopsies. Recovery time is 4 weeks (I'll be in the hospital at least 5-days). 

The original colonoscopy didn't get past the bowel blockage. As a precaution, he wants to close the gap and get the other half checked. (I already had a consultation scheduled with Dr. T, a GI doctor.)

CT MRI Biopsy, Oh My!

Five weeks after surgery I was finally healed enough to lay flat for thirty minutes, and able to get a new MRI. The previous MRI showed a possible spot on the liver, but it wasn't a good scan because it was post-surgery. This was a big one. The one that would confirm stage III or IV. 

•I have a tiny 1.5 cm lesion on the liver.

•I'm officially diagnosed as stage IV.

A biopsy followed to confirm colon cancer. 

Enter the most painful thing I've experienced to date. Biopsy #1. Going in I knew there was a 50/50 chance it would be painful, and because of the location they didn't allow much sedation. I felt the crunch as the needle passed through my tissues. I was crying on the table. Crying! I am not a crier. I breathe or moan through pain. When I cry, it's bad. And the pain didn't go away after the procedure. Two rounds of morphine did nothing. Dilaudid finally got the pain under control. And then I spent the next five days drugged, attached to a heating pad. 

When you label something #1, there has to be a #2. Yep. All that pain and it wasn't a good sample. Just the thought of having go through that all over again had me in tears. But the second would be done at Emory, and I made them well aware of the pain I experienced during the first biopsy. The first was CT guided, but the Emory biopsy team came in and based on the location they wanted to do MRI guided. It meant I would have to reschedule, but if there was even a slight chance it would make the procedure less painful I jumped!

By the time the MRI assisted biopsy was scheduled, I had completed my first round of chemo. This time I was under twilight sedation. You can listen and complete tasks, but typically don't remember. Oh, I remember. I let out a good moan as the needle pushed through, the doctor was surprised that I was awoken by the pain and quickly increased the sedation meds. I was given a script for Percocet to manage any post procedure pain (I wasn't prescribed anything after the first biopsy). The team at Emory did a fantastic job, and I only had minor pain. Hallelujah! 

If your lesion is high, on the "top" of the liver, ask for a MRI guided biopsy. Seriously. No one needs to experience the level of pain I went through with the CT guided biopsy.