Wednesday Night
Dec. 3
Hi Everyone,
I don’t know how to start describing everything we learned today, so I’ll just plunge in and see where this goes.
The Palliative Care team visited Bob late this afternoon. I was still driving back to Emory when Bob called to tell me the doctors were in his room. He kept them busy until I arrived 15 minutes later. Stephanie, the Director, and Sandra, the Chaplain, were seated in Bob’s room when I walked in and joined the group.
Stephanie told us she spoke with Dr. Kauh about Bob’s situation. Basically, Bob has beaten all odds. Dr. Kauh expected Bob to die six months ago. That would be around May/June, a couple months after the “lymph node” had been spotted on the CAT scans after surgery. No wonder the nurses and physician assistants all looked so sad!
Dr. Kauh told Stephanie he believes Bob has a tumor (although it cannot be confirmed), but it is a slow-growing tumor. What is more of concern are the recurrent infections. It’s been the #%*?!@# infections that have been the problem ever since surgery back in November 2007. I keep thinking “if only an infection had not happened, Bob could have recovered quickly and gained weight and then if/when a tumor began to grow it could be treated with chemo.” But, the infection did happen and everything else followed.
For now, our plan of action is to find the best way to treat the infection(s). We are now waiting for the cultures to finish growing from the abscess area. The initial cultures are Graham Positive and if they continue to grow a certain way then they may show that old VRE from before. One of the antibiotics he is taking is Vancomycin. Yesterday’s white blood count had dropped to 11.5, so the antibiotics appear to be effective. But 11.5 is a little above normal so the doctors think something else is going on.
If the cultures show Vancomycin can be effective, then a PICC line will be inserted and we will go home to administer with I.V. drugs. If the bug IS the old VRE (see definition):
vancomycin-resistant enterococcus : any of various bacterial strains of the genus Enterococcus (as E. faecium and E. faecalis) that are resistant to the antibiotic vancomycin, occur as part of the normal flora especially of the gastrointestinal tract, and may cause serious infections (as of the urinary tract, blood, or surgical wounds) typically in immunocompromised individuals in a hospital setting.
…then we will probably use Zyvox as before. The Zyvox can be taken orally. But as I recall, the doctors don’t want Bob to take it more than one or two weeks due to potential side effects. Our biggest enemy right now is infections. The cancer is secondary.
Tomorrow we will meet with a Care Coordinator and another member of the Palliative Care team. We expect to have a final report on the type of bug(s) we are dealing with. So we will have more news to absorb and plan our next steps.
Bob is feeling better and stronger each day. The Physical Therapist came by this afternoon and worked him hard. He is in much better condition than the last time we were discharged from Emory. And Bob’s appetite is greatly improved. When I went home today I returned with a packet of brown sugar and some raisins for his morning oatmeal (or porridge, if you’re name is Kees). I looked at his tummy tonight and it seemed rather rounded to me. Hmmmm…. Maybe the boy is actually gaining a little weight.
I stopped by and visited with Dad and Fran today. Fran is walking much better with her walker. She has all her paintings hung and her apartment is looking very homey. I think she’s happy with it. She wanted to join me as I walked over to visit with Dad. I managed to get us through the alarmed doors without setting them off. (I’ve done it twice now.) We found Dad sitting in the living room with a few other residents. They were waiting for an activity to begin. He seems to be doing a bit better. The girls asked me what his favorite foods are and that has helped coax him into eating more.
MARTA is allowing me to take more personal time away from work. (Thank you Jennifer.) Bob has asked me to stay for a couple weeks once we get home. I stopped by the office today for a quick visit and we agreed I will return after Christmas. (Another thank you to Chris, Lisa, and everybody else who is covering for me.)
Meanwhile, I feel as if I’ve moved in here at Chez Emory. Maybe tomorrow I’ll bring in a potted plant or a braided rug.
Love,
Deb and Bob
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