Month: August 2023

10 August 2023

Yesterday I received the lab report from the surgery on Monday. First, the good news. Everything was negative for malignancy. They sampled all the tissue removed that was causing the inflammation of my left breast – all 83 grams of yellow fatty tissue within a “cystic hemorrhagic cavity” measuring 12x9x4 cm or 432 ml. To speak unscientific, that’s 14.6 ounces of fat and blood or almost 2 cups. As you might guess, when you look up cystic hemorrhagic cavity, most references point to it occurring on ovaries.

You have to laugh at it. What else can go wrong? At 1:30 am this morning I shot upright in bed because I felt a wetness under my left arm. Not only my tee shirt but my top sheet was stained with, not much blood, but mostly sera. Apparently my drain developed a clot in the line and the blood/sera had no where to go but leak out the incision onto my tee shirt and top sheet. Yes, I checked the line before I went to bed and it was clear so it happened sometime during the night.

After clearing the blood clot, I decided to put the compression bandage back on to perhaps keep the leakage around the incision to a minimum but the bandage was so uncomfortable, I had to take it back off. I decided to hell with it and simply put on a clean tee shirt and went back to a bloody bed. When I got up at 5 am, I had a second bloody tee shirt. I started the wash before I made my first cup of coffee. After my second cup of coffee I remade my bed with clean sheets – for now.

I arrived for my 11:45 am appointment with Dr. Burgers and the receptionist was a little surprised. They had forgotten to tell her my appointment had been switched from tomorrow.

Dr. Burgers inspected the drain, did an ultrasound, and said things were looking much better since the surgery. What was removed during the surgery was mostly necrotic fat tissue and some blood clots. She took a sample of blood from the drain and sent it off for analysis.

The area around the surgery is very sensitive and if clothing touches it, it’s like a burning sensation. She decided to write me a script for Gabapentin (Neurontin) which is often used to prevent or control seizures but can also be used to neuropathic pain. She thinks this will take care of the burning sensation. The one side effect she mentioned was drowsiness. I’m not sure I’ll take it after reading some of the other side effects.

It’s not recommended to take Gabapentin if you take anti-depressants or anti-anxiety (I’m on this) medications or antihistamines (I take Allegra for itching).

That now makes 11 scripted drugs I’m on with all but 4 coming with the cancer diagnosis. Fortunately, I don’t have to take most of them daily because they are for infusions which start on the 21st – if Dr. Burgers clears me for infusions.

Sadly, she wanted me to keep the drain. I’ll go back Monday for another post op meeting with her. I’m going to try to catch up on my interrupted sleep this afternoon. I’ll probably wake in time for the afternoon electrical storm and downpour. We’re still under a heat emergency.

Stay tuned.

9 August 2023

I started the morning like gangbusters! I felt good, the coffee tasted right, and I was looking forward to starting my walks back again. After reading newspapers online, I got this strange gurgling sound coming from my belly and I knew that meant there wasn’t going to be a morning walk except to the bathroom and back. After 4 trips, I finally made it back to bed and found out I was in pain no matter what position I placed myself.

What was really strange is that when I took a breath, my left side hurt from the front of my chest to the back of my torso. Being the hypochondriac I am, I immediately figured I was developing pneumonia since Klebsiella pneumoniae is known to cause bacterial pneumonia. I put a call into the Nurse Navigator and left a voice mail about my problems and wanted to know options. I knew if it got worse I would take myself to the emergency room but I also knew that Dr. Burgers said she could work me in tomorrow if needed.

The Nurse Navigator called me back and said I could remove the compression bandage that was wrapped around my chest. That immediately alleviated a lot of the pain I was experiencing. When I finally unwrapped my mummified body, I had a huge wad of gauze sticking out of one of the incisions made on Monday. It had to be most of a whole roll. There was no sense in letting it dangle so I found some scissors and cut off the excess. Hopefully Dr. Burgers will unpack it tomorrow.

The drain is working overtime. This morning I had 50 ml of pinkish blood. Thank goodness it has turned pink and is not blood red any more. That’s what the first drain was supposed to do but did not ever accomplish.

Monday, the day the drain went in, I got 60 ml of red. Tuesday, it was emptied three times and it was 100 ml, the first 30 red and the next 70 was pink.

This morning is was 50 ml and still pink. I still will probably empty the drain one or two more times before the day is over.

Holley and I just figured I’ve had four doses of antibiotic. That leaves 10 doses (5 days) more on that.

Of course, after setting the appointment for tomorrow with Dr. Burgers, I immediately forgot the time. I had to email the Nurse Navigator to find out it was 11:45 so I need to be there around 11:30 am.

It seems every step forward I take, I step two backwards. Better end this now. I hear gurgling again.

Stay tuned!

8 August 2023

Apologies for the lack of a post yesterday but I was a little under the anesthesia. As a matter of fact, I’m still feeling the influence so this blog may (1) not make any sense (2) have a lot of misspellings (3) not get the syntax correct.

Holley was spot on time of arrival at my house and then I proceeded to get her to exit the wrong place. Regardless, we made it to Holy Cross Healthplex before my noon required presence. As you might guess, there were forms to check the accuracy even though I had done that the previous day online. By 12:30 pm I was taken back for surgical prep. After putting on my gown, booties, and hair net, they allowed Holley to come back and keep me company. We had a good time talking and giggling until we realized it was 1:30. A receptionist appeared in my cubicle and asked if we were expecting anyone else. We both said Tom at the same time.

With the three of us, we probably came very close to being asked to leave. We could take our comedy routine on the road and make a mint. Tom is the person I helped through his stay at Broward Health a few months ago. I think he finally left around 5:30 (everything is still hazy) and soon after the anesthesiologist showed up and I was wheeled back to the operating room. It certainly was pristine and well managed. I shifted to the operating table, they place my arms at right angles to my body and covered my arms to keep them from getting cold. Then the anesthesiologist said you are going to get very sleepy and that’s the last thing I remembered until waking up in recovery. Later, I think they had to put me deeper under anesthesia and they must have intubated me for some reason.

What was supposed to be a quick 30 minute procedure took 1 1/2 hours on the operating table. What I write next is second hand from Holley but apparently Dr. Burgers had to make a larger incision than she thought – to the point that the incision was larger than the one for breast removal. Dr. Burgers apparently ran into some unexpected complications. I’ll know more when I get my report from her posted on the Holy Cross app.

In recovery I got chills and they kept running back and forth to provide me with warm blankets, even to the point of putting them back on my arms, around my head, and, of course, my torso and legs and toes. They then hooked up a heater hose to blow warm air on my torso. I was extremely emotional and when the nurse said I must have someone at my house with me after discharge, I broke into tears because I knew Holley couldn’t do it because she had to take her husband to surgery today and she had just spent 7 1/2 hours with me in the Healthplex. If I had known the surgery turned out more serious than anticipated, I could have lined up some help with staying overnight. Of course, Holley said she would stay and I said NO! She had already gone above and beyond.

Dr. Burgers, after the surgery, found Holley in the reception area and went over everything in detail with her. Again, Dr. Burgers goes the extra mile for me and my friends. I now have a drain again. The good news this morning is that it isn’t blood red any more but more pinkish. In addition the swelling has gone down considerably and I’m not in any pain.

After Holley gets me home around 7:30, I start thinking who I can call. Chris lives the closest so I started with her but my call went to voice mail. Next I called Barbara and she immediately volunteered. I felt badly asking with so little lead time but Barb dropped everything, packed a bag, and came over.

As you might also guess, there were prescriptions to be picked up and Jim, Holley’s husband picked them up for me at CVS. I only know this because the medicines appeared and I was told Jim brought them. He even came back to see me in the bedroom but I have no recollection.

Holley spent 7 1/2 hours in the Healthplex and when Barb showed up at the door stayed and went through all the procedures, medications, etc. Holley didn’t leave my house until 11:30 pm. I think she and Barb hit it off and I suspect Jim and I were much the topic for most of the night. I wouldn’t know, I was out of it.

Holley and Barb gave me a Tramadol for pain. Holley convinced Dr. Burgers that even though I had Tramadol at the house, she wouldn’t know where to look for it so got Dr. Burgers to write me a prescription for it. I never took it for the mastectomy but I did for this procedure. Honestly, the mastectomy was a breeze compare to yesterday’s procedure. I was an emotional wreck, weak and trembly, and not to stable when upright.

Somewhere during the last two procedures (Dr. Burger’s office and Healthplex) they determined my bacterial infection to be Klebsiella pneumoniae var.pneumoniae. This is a facultative anaerobic, Gram negative bacterium usually found in the intestines. It’s most often spread through person-to-person contact, particularly when someone infected with it doesn’t wash their hands. The bacterium may cause pneumonia, bloodstream infections, meningitis, and urinary tract infections. It is also considered a nosocomial bacterium which means it was transmitted to me either from my last hospital stay from the first chemo infusion at at Dr. Burger’s examination room. My money is on the first hospital stay or the next one for the mastectomy. I think it also explains why I was not getting any better nor feeling well at all.

The antibiotic Dr. Burgers prescribed is sulfamethoxazole-tmp (also known as Bactrim). It’s like the last antibiotic which I will now discontinue, twice a day, evenly spaced. Dr. Burgers explained Bactrim was a better antibiotic than Cephalexin for Klebsiella.

Before I left the Healthplex yesterday, Dr. Burgers had already scheduled me an appointment on Friday at 10:15 am. Again, this information is all through Holley. If I get worse, go to the emergency room or she could see me on Thursday. I was seriously threatened with bodily harm if (1) I took a shower or (2) changed the bandage or (3) removed the compression wrap around my torso. You do not want to piss off Dr. Burgers, Holley, or Barbara – not if you want to live to tell about it.

I’m a little trembly this morning. I made coffee for Barb and me and I ate my usual fruit and yogurt breakfast. Barb kept washing dishes (Hello! Dishwasher!) and helped organize the kitchen table to look more like a kitchen table than a medical clinic. I have been promised dire consequences if I need her and don’t call her. I feel 100% better than before the surgery. I’m not as swollen and I actually feel good for the first time since my emergency room/hospital stay after the first chemo. I’m still weak and unsteady on my feet. I’ve been told by Drs. H & B to keep my ass in bed.

I don’t know how I deserve good friends. Saints and Sinner and I’m the Sinner. Everyone else has been a Saint!

Stay tuned!

5 August 2023

It was an interesting night. At least the Xanax let me get a good night’s sleep. Unfortunately, it gives me a slight hangover.

The interesting part of last night was when I was getting ready to turn out the light and go to sleep and realized my bandage from the morning session with Dr. Burgers was wet and soaked through. I knew I needed to change it or I would wake up to soaked sheets.

Off came the bloody tee shirt and then I pulled away the bandage. My poor skin has had more tape on it in the last few weeks than ever before and is getting a little sensitive. I’ve always subscribed to the theory to remove it quickly and get the smarting over with. Even that theory is wearing thin. It hurts like hell to take the tape off.

What I had forgotten about was Dr. Burgers said she had packed some sterile gauze into the wound over the breast and as I removed the outer bandage I saw a long piece of gauze dangling from the opening of the incision. I didn’t think. I just decided to pull it out. Big mistake. First it was a lot of packing in the wound and as I pulled, the gauze kept coming.

It reminded me when I used to have nose bleeds as a kid and Dr. Clark packed my nose one time. I pulled that out and wondered how he got that much gauze up my nasal cavity. He had put a whole roll of gauze up my nose. This was kinda the same experience.

The minute I pulled the last of the gauze out, blood gushed all over the place. It was on me, my pajamas, the sink, the bathroom mat, my feet, and it kept coming. You forget how sticky blood is until it gets between your toes. I finally got a piece of gauze up against the incision and applied pressure. The incision was a lot larger than I anticipated. I never get to see what Dr. Burgers is doing when she’s doing it so I had no idea. You can’t really tell what she’s doing since you are numb from the lidocaine.

It kept bleeding and bleeding. Finally, I slowed it down enough to put another piece of gauze and tape over the incision and then I used the ace bandage to wrap around my chest to apply more pressure. I put another tee shirt on top of that and placed a towel on the bed.

Next was pouring hydrogen peroxide over my tee shirt and the bath mat. I really splattered blood all over the mat. After the treatment, I finally got back into bed and slept until 8:30 am.

Today I again need to change the bandage (more bloody tee shirts) and wash all the hydrogen peroxided clothes and bath mat. That’s in addition to regular laundry, cleaning house, and since I didn’t clean the pool filter yesterday, try to get that done. I’ll probably get some washing done but I figure everything else can wait.

The wound area is certainly sore but the real problem is the tightness of the skin in that area. The good news is the swelling over the left breast is down somewhat but I still have the knot of the hematoma under the arm pit.

I think when this is over I’ll write about what they don’t tell you about breast cancer surgery and treatment. They throw so much information at you that you are overwhelmed and forget to tell you little things like the hair of your nose disappears. As a bald person, I tend to grow more hair on my ears than on my head but since the first chemo treatment, I haven’t had to worry about that little issue. There are lots of other little things that you begin to notice that are not in the info sheets they give you.

I think my biggest problem (after bleeding) is diet. I’m pretty much on a junk food diet these days. I’m usually just OK with ice cream. I’m not really a big eater of it but I’ll have two scoops every so often. A gallon (they are not really gallon containers these days) will last months at my place. I’m now up to four scoops a night. I crave Tootsie Rolls. As far as real food goes, I can force it down but I almost never complete a meal.

I know why Tootsie Rolls. My cousin Jimmie’s parents owned a fruit stand they leased out a half a block away when we were kids. Jimmie and I lived on Cokes, potato chips, and, for me, Tootsie Rolls and Milk Duds. When we started going across the street to the fruit stand (we had to cross the very busy Highway 80) the original Coke machine was the type you had to put your money in and move the coke through a sliding track to get it to come out.

Back then Cokes were 5 cents, potato chips were 5 cents and Tootsie Rolls were 5 cents. We were, of course, outraged when Cokes went to 6 cents.

I haven’t walked in almost a week. I either sleep too late because of the Xanax or I have doctors’ appointments and haven’t time. Of course, I can always use the excuse of it being too hot. I could walk late in the afternoons but then I would be dodging lightning bolts. Let’s face it, it’s hard to keep a routine when going through cancer protocols and I am, if nothing, a creature of habit. That’s the biggest problem for me.

With the Xanax hangover, washing clothes, and no appetite, I think I’ll take it easy this afternoon and wait for the thunderstorms and rain downpours. There’s always a book on my iPad to read.

Stay tuned!

4 August 2023

It’s been a day, starting with a restless night’s sleep. I probably should have taken a Xanax. I will tonight. It seems the pressure builds up in the swelling over what was my left breast and under the arm pit and I kept tossing and turning. Also, every time I got up last night to go to the bathroom it felt like my vertigo was trying to make a come back.

I was early to Dr. Burger’s appointment but didn’t mind waiting. I kept hearing the receptionist handle phone calls. That woman has the patience of Job. No matter how upset the caller, she never raised her voice, always tried to soothe the person on the phone and she handled it with such professionalism. I get the feeling that all their staff undergo empathy training but I think it comes naturally to most of them.

Lorraine, the nurse, took me back for a vitals check and it wasn’t but a minute or two before Dr. Burgers walked in. She first did an ultrasound of the area and offered me two options. She could give me a local in the examining room and try to free up the congealed blood and express it through a small incision or see me in surgery on Monday where she would have more equipment at her disposal.

After thinking it over, she said, let’s try it today. My skin was so tight with the swelling I didn’t even feel the injection of the lidocaine. I did feel the scalpel’s incision but it was so quick it didn’t matter. Then for the next 30-40 minutes she worked on getting the blood out. It was a little like popping a pimple. She pushed and shoved and tried to work what congealed blood she could through the incision.

The knot under my arm pit did not cooperate and did not seem to be connected to the other swelling so she shot that area with lidocaine and did another incision right at that location. Again, pop the pimple time.

She was successful somewhat. Lorraine, who assisted, said she got a lot of semi-solid blood out. Dr. Burgers, at one point, was using forceps to pull some of the stuff out. She really dug in and around those two incisions. Of course, all during this time I was dripping all over the examination table.

She took a swab to send off to the lab to make sure there are no surprises. Unless it comes back positive for bacteria, she doesn’t plan to put me on antibiotics because of my diarrhea issue.

In the end, she decided to go ahead with surgery on Monday. She thinks she can suction all the material out in one go and instead of waiting on my body to absorb the blood over three or four months, cut down the time to a week or two.

She’ll give me a light dose of anesthesia – somewhat like for a colonoscopy. That way I won’t feel anything but won’t be in deep sleep.

I’m now scheduled to go in on August 7th at 12:30 pm at the Holy Cross Healthplex. That’s where they did my bicep surgery. I like the place and they treat you well there. Dr. Burgers said she would try not to put another drain in me but that was a possibility.

She and Lorraine bandaged me up, supplied me with changes in dressings and sent me home. Lorraine told me to use hydrogen peroxide on the blood stains on my shirt. I wore a red shirt just in case. The lidocaine was wearing off (they use a short acting one) and I was in a good bit of pain by the time I got home. I slept for about two hours. I did try the hydrogen peroxide and it took the blood stain out without any scrubbing.

I now have three holes on my left side, all seeping fluids, mostly blood. I’m back to bath wipes since I can’t shower with open wounds. I’m sure where she worked on me will be tender and sore. She was not gentle in trying to get the goo out. However, I can tell that the pressure that was under the skin is not as great as it once was.

I send out a friend request for transport to and from surgery. Holley, again, immediately volunteered to take me, wait for me and bring me home from surgery. No one is faster at answering a group text when I ask for help. I’ll have to buy her another adult coloring book. The ten hours she spent the last surgery probably gave her enough time to completely color her other adult coloring book.

You know how little things get you upset? I was a little miffed as I drove to the doctor this morning. My next door neighbor is having impact windows installed (I’m pleased for her since she’s alone and can’t lower her hurricane shutters). Today was yard trash and garbage pick up. The two guys installing the windows took all the cardboard surrounding the windows and put it in my yard waste bin.

I don’t care they used my bins but they needed to use the recycle bin, not yard waste. The city once issued me a warning when someone put their doggy poop bag in my yard waste bin. I called the city and complained and explained I couldn’t be held responsible for someone putting their dog waste in a bin that on the street to be picked up. I had no control over that. Deaf ears.

I fully expected a warning on my yard waste bin when I returned but apparently their either didn’t care or notice that it was full of yard waste and cardboard. It’s a silly thing to get upset over but with everything that been happening lately, it was one more thing I didn’t need to worry about.

Stay tuned!