dilaudid, aka hydromorphone.
Tuesday started with the usual round of junior doctors waking us up at 6:00 am. Of course, they can't offer anything useful, so they're just practicing. Overall, it was a quiet day. Marye has been enjoying the effects of the aforementioned pain medication. Apparently, this stuff is several times stronger than morphine, and is considered the Egg McMuffin of pain meds. Within five minutes of getting the shot, her eyes start to glaze over and she becomes less coherent, spouting nonsensical sentences to the nurses. Eventually, she drifts off to sleep, awaking momentarily only to holler out some out-of-context non-sequiter. Funny stuff.
In other news, her white blood cell (WBC) count, which had come down after the first few doses of antibiotics, actually shot up again. As of Monday night and Tuesday morning, they were hovering around 39- way too high. The doctor theorized that after the procedure to install the drain, the gall bladder might have become more inflammed, temporarily, prompting that reaction. By Tuesday night, the WBC was slowly falling and stood at 35. At least it's moving in the right direction.
The other good news was when Dr. Riley came in and sat with us for about an hour. She explained that the lesions that were visible on the CT scan were likely abcesses, not cancer, and there is not much reason to worry about them now. The latest tumor marker number was down to about 300, and there is no clinical indication that the cancer is growing. Anyway, with the infection in her gall bladder, she can't take chemo- possibly for as long as two months. It would be very dangerous to attack her immune system until the infection is taken care of. Still, it's scary to stop the treatment, as the cancer could start to rebound. If they decide to take out her gall bladder, they could then go in and biopsy the lesions. Until then, she's just going to continue with the same chemo drug (taxol) when she restarts her therapy.
Also, on Wednesday, they plan on doing a cholesystogram, which is a scan of the gall bladder. They'll inject a dye into the tube that's draining the infected bile, then look at the gall bladder under a flouroscope. That will give them a good picture of what it looks like. For the near-term, it looks like she'll be in the hospital until the infection gets under control. Eventually, I anticipate that she'll go home with home infusion of antibiotics. Again, they may or may not decide to take out the gall bladder. She may also have the drain tube in place for some time. There is still a pretty ugly looking bile/blood/pus mixture draining. We don't have a lot of answers, as far as timeline goes. It's just depends on how she responds to the antibiotics.
Overall, it was good to hear that the cancer doesn't seem to be playing a part (or growing), even though she is still pretty sick. As long as she can fight this infection, I think she'll be ok. Thanks to everyone for their concern. She's a fighter. I'll post again on Wednesday after I know something.
-Chris
