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Friday, October 23, 2009

Cellulitis

Well I meant to post an update about the acupuncture next, but...... before I got to it something else happened.

For about 2 weeks I'd been feeling a new band of tightness along the inside of my right arm. It was a lot like the post radiation roping and tightness -- kind of like my tendon was trying to turn into a rubber band. I didn't really get why I'd be feeling that kind of thing again now, but what do I know? I figured I'd pull back against it, swim it out. That worked before. SO last Fri and Sat I swam a mile each day. The tightness stopped pulling after a few minutes of swimming, but there was a redness that didn't seem to be going away. Then on Sunday there was a hard red spot on my arm in the middle of the band, just above the inside of my elbow.


So I emailed the PT I'd had a few sessions with in Jan/Feb (before we figured out that our insurance didn't cover her & I had to stop) and I emailed my radiation onc, even though it's been 7 months since I finished radiation, and described the red protrusion on my arm. He answered promptly and predictably: "Can you come in and show me your arm?" That was Monday afternoon. On Tuesday I had 3 jobs planned, and thought I'd swim in between job #2 and #3, and see the doc after the last one, at about 2:15-2:30. I warned Em I might not make it to pick her up at 3:30, after her after-school activity. Oh boy, was that an understatement!

By Tuesday morning I had decided I didn't like the look of the thing on my arm. YOu know how sometimes in the middle of the night problems that seem small and insignificant during the day feel big and ominous? Often they quiet down by day again, but sometimes for me the nighttime questions are real questions that perhaps the chaos of my daily life had been keeping away. ANyway Monday night I was massaging my red spot, thinking it was probably something the PT could rub out, when a little voice in my head said "Hmmm, it's red, swollen and hard. What could it be?" I used to interpret for my nurse friends at the clinic, when I worked as an AIDS educator, often enough that I knew what they were going to say before they said it. This thing had all the hallmarks of an infection.

So the next morning when the PT called me back, I said, "Thanks, but I think this is one for the doctor." I also called my doctor's office, and asked if I could come earlier than 2:30. A voice in my head said "If I were a doctor and someone brought me an arm that looked like this, I'd want them in the hospital on IV antibiotics." I almost packed a small overnight bag in my car, with at least my eyedrops, but then I thought, Nah, I'm not a doctor, what do I know?

I scooted in to see my doctor after job #1, at about 9:45. He came right out and met me in a room. He took one look at my arm and said "Okay, this is serious. YOu need to go to the ER." I was not happy to hear this.... I've only ever been to the ER for my kids, and always had to wait, and wait, and waaaaitttt -- the better the patient looks, the longer they wait. And I always look fine. Even when I was in labor they didn't believe me..... When I went to the hospital to have Matthew I arrived pretty sure it was time, but got delayed by the woman taking insurance info, who said, "Yeah, this is your first, right? They all think it's urgent -- but it could be two weeks!" So.... I had always been thinking I'd like to try having a natural birth, but when I got to the midwife, I said, "YOu know, I might be interested in some pain meds, actually, if it really might be awhile." And she checked me and said "Too late, just push."

So this is where my dismay about going to the ER was coming from..... but this time was different, because my doctor walked me over to the ER. (This is a great doctor -- too bad he's my radiation onc and that's over with.....you want a doctor like that all the time, you know?)

When we got to the ER the doc said to the guy on duty "She looks good, but this is an emergency." THey took me in right away. My doctor also went in and talked to someone -- gave them my history or something. What a guy!

That was Tuesday morning. I was in the hospital until yesterday at about 3pm. (Yeah, I know -- I shoulda listened to that inner voice and packed that bag....) It's cellulitis, which sounds deceptively like cellulite, but is not, as Matthew guessed, butt fat on my arm. It's an infection. It's dangerous! It might have been caused by my picking my cuticles. Yikes! On my right hand, that is, because I have no lymph nodes in my right armpit. (Holy shit, I am going to have to figure out how not to do that!) You can't have manicures on the hand attached to the no-lymph-node arm. I didn't know that, but I might have been told; I am not tempted by manicures, so I wouldn't have paid attention. However, the picking is similar, if you think about it.....

So I spent Tuesday in the ER and Tuesday night through Thurs in a hospital room. I got 250 mg vancomycin by IV every 12 hours, 5 times. Then they sent me home with a prescription for 2 weeks of keflex. I can't imagine how one little red pill a day is going to do the job of 6 hours* of IV antibiotics...... The infection doesn't look any better to me, just different -- more contained, and taking up a smaller area, but harder and firmer, so that it burns when I extend my arm all the way. (I can still do that, though -- no restrictions. I am allowed to ignore the pain -- however, I was also told that pushing through the pain wouldn't speed up the healing. Yeah, that's my usual strategy...*In all fairness I have to admit that the antibiotics are usually given in an hour each dose, so that would be 2 hrs a day. I was starting to get a reaction, though, and needed it administered more slowly, with a benadryl. Reminded me of how I had to get cytoxan. Just my body on drugs I guess -- but of a lightweight that way.

Em had a hard time with my being in the hospital, and Alan and Matthew gave up some stuff -- Alan had to cut his workday a lot, and Matthew missed a ball game because he didn't have a ride. Thank goodness he has a friend who drives; that's how he got home from his after school stuff every day! And I was not pleased initially -- I had to call work and explain that I was bailing on jobs #2 and 3 at the last minute! But then it got interesting.

They did an ultrasound of my vein to make sure there were no clots. The guy doing it was learning and the more experienced guy was right there with him directing him so I got to learn too -- and as soon as they got past my clavicle I got to turn my head and watch the ultrasound too. And then when I got to my room I had a roommate who was an elderly Spanish-only speaker. And there I was, a Spanish interpreter who felt fine and hadn't gotten to do her last 2 hours of work for the day! I worried that it would be a problem, confidentiality-wise, for me to interpret for her, but when the doctors came in and used the phone service instead of me, the only thing they had for privacy was a curtain, so I heard everything, in two languages. So I interpreted for the nurses, technicians, nutritionist, etc. (I assumed that the docs have to follow protocol.) The nurses told the next shift of nurses about my offer, in their report about the patients on the floor. It was fun.


After I got home I found an interesting thing: I had been on a bike ride on Monday, and I went on another bike ride today. (I asked, no restrictions on activity.) I had been slow and struggling to keep up with the group on Monday, and my knee had started giving me trouble on uphills. I'd had to cut the ride short -- to 30 miles, when I'd been planning to ride 40. (I'd been riding more slowly the previous 2 weeks, losing ground, but I didn't expect to find a specific cause....) I went to the chiropractor in the evening and was surprised to hear that there wasn't anything seriously wrong with my knee...... he adjusted me and gave me exercises though. But then today I rode great, no problem riding with the group for like 30 miles. (I mean it didn't even feel like keeping up!) Today's ride was a 50, but I decided to skip one of the extra loops, so my ride was 43m. That was about where I had been at with my riding until a few weeks ago, when I started getting tired and slowing down for no apparent reason.

Well who knew? Apparently an infection DOES slow you down! I think I was also waking up more tired and sometimes nauseous in the month or two or three before my cancer was diagnosed. All those blood vessels diverted...... my body missed them! I feel like these things would have had to work harder to slow me down in the past, when I was younger. (Is it harder to detect cancer in kids, I wonder, because of that? Or maybe just high energy kids?)

Anyway that was my hospital adventure. It was fun because I kind of like medical stuff -- but I would have preferred to go the week before when we had 4 days straight of cold rain; it was NICE out the 3 days I was in the hospital! (I got out for walks -- but just once a day, for less than an hour.)

I came home with 2 weeks' worth of keflex. They tell me it won't shrink down for 2 weeks, and will hurt for a month. It only hurts when I touch it or extend my arm all the way out, though.