Tag Archives: cancer sucks

D Is for Done

Published / by Kim / 4 Comments on D Is for Done

Done, done, done! As in finished. Complete. No more!

Yesterday I got official word from my doctor that I can stop using the wound vac. It’s impossible to say how happy this makes me. Over the last 9 weeks, I have grown to despise this machine.

There’s still a small hole, but it’s not deep or long, so I just have a wet-to-dry dressing on now. I have to change it myself twice a day until the skin grows over it, which should take a couple of weeks.

I’m just going to consider this another tool in my kit for the end times or the zombie apocalypse: wound care knowledge. Between the knitting, soapmaking, and now this, I’ll have several skills to fall back on when society collapses, be it from rogue computers or zombies.

But I think I digressed a little…

D is for Done! And I couldn’t be happier.

The Saga of the Wound Vac, Part 2 (and a pathology update)

Published / by Kim / 3 Comments on The Saga of the Wound Vac, Part 2 (and a pathology update)

I know, I know. I’ve been a bag blogger. And a bad ABC-alonger. I fell behind at B this year. That has to be a record. I plan to catch up this weekend.

For now, I have more about the wound vac to talk about. I talk about the wound vac a lot, unfortunately, because my life is pretty much consumed by this thing these days. The wound is much, much smaller now. It’s only (only, ha!) about 2 inches long, an inch wide, and a little under an inch deep. With its smaller size, however, have come a raft of problems.

The most pressing problem – to me, anyway – is that the foam has begun to smell. A really horrible smell. My nurse thinks it smells like cigarette smoke, which I think is crazy because it clearly smells like shit. Literally. When I first began smelling it, I was constantly checking the litterbox to see if it needed cleaning and it was usually fine.

The first time it happened, the nurse and I were really worried that there was an infection. But when she took the dressing off and cleaned the wound, the wound didn’t smell. We eventually deduced that it was the foam that had the smell, not the wound. The nurse from the wound vac company (KCI) was here today and the first thing I brought up was the smell. She told me that it’s normal. Normal! She said that when the foam touches the drainage, it smells. So basically, live with it. Which is diffcult, because it makes me nauseous. I started piling on more tape to hold the smell in,which she says is fine, but it always seems to break through.

Now I’m even more reluctant to leave the house. As if having a tube attached to my body, coming out of my pants no less, with blood flowing through it wasn’t bad enough, now I’m constantly wreathed with the smell of shit. Attractive, right?

The second problem is that the pressure on the machine has been constantly fluctuating. This was a problem in the beginning, but we tracked it down to the nurse not making the hole in the plastic large enough before putting on the tube, so it was fine for a while. It’s possible that this new fluctuation problem has been due to too much foam being put in. With the KCI nurse looking on today and giving direction, my nurse used half the foam she normally does. So hopefully that will solve that.

Today we also changed the pressure from 125 to 150. (I’m not sure what units those are.) Also, we changed it from continues pressure to intermittant pressure. That means it goes on for 2 minutes, then off for a while, then back on for 2 minutes. This sucks – ha ha! I’m so funny! You get it? Sucks? Sucks? You get it? – because every time it turns on, it hurts. So I was shown how to change it back to continuous if I can’t take the intermittant anymore.

Hopefully, it’s only 2 more weeks with the wound vac. If it’s more than that, I may go insane.

There’s good news on the pathology report, though. It turns out that the pathologist was just being super descriptive. The tumors didn’t change into a form more likely to turn invasive. So hurray for that. Treatment remains the same, which is basically no treatment. Just vigilance and more surgery if they come back again.

Final Pathology Report

Published / by Kim / 6 Comments on Final Pathology Report

First, let me say thanks for all your comments and good wishes. I usually reply to some comments by email, but something seems to have happened somewhere and I’m not getting comments sent to me by email*. But I’m reading all your comments and really appreciate them.

On Thursday, I went back to the doctor so he could check the wound.  While we were there, he discussed the final pathology report with us. Surprisingly to him, the cysts were not cysts and not benign. They were, in fact, a recurrence of the borderline tumors. No one was more shocked than my oncologist, because the growths he removed didn’t look like the previous tumors and the frozen section biopsied in the OR came back benign.

This is actually the second time the frozen section came back benign only to have the complete biopsy show a different story. That’s a fluke, of course, because the frozen section is taken at random, and it just happened that each time they took a section that contained benign tissue. The implications of this are dire for me if I have another recurrence, though, because next time, he clearly can’t trust the frozen section and has to just proceed as if it’s a return of the cancer. That means this was my last shot at preserving my ovary. Next time, it comes out, no questions asked.

And the thing is, since this is the second time this has come back, there’s a very high risk of it coming back again. To complicate matters, there was some ambiguity in the wording of the report. My original tumor – removed in March 2003 – was a serous papillary tumor, which is a borderline malignant tumor with a practically nil chance of turning into invasive cancer. The second time around – September 2004 – was the same type of tumor. This time, however, the pathologist wrote “focal micropapillary tumor.” (I may not have that exactly right, but it’s what I recall.) Apparently one of those words – focal or micro – means it would be the same type of tumor as the others, more or less, with an extremely low chance of becoming invasive cancer. The other word is a problem, though. (And I can’t remember which word he said meant which, and Scott and I each say the opposite.) The doctor said that recent studies have shown that borderline tumors with the other word have a much higher risk of recurrence and a higher risk of turning into invasive cancer.

So the fact that both words were used confuses the issue. He was presenting my case to his board yesterday and will be discussing it with the pathologist to get more information. He thinks the pathologist was just being extra descriptive, but is trying to get it cleared up so we know what’s what. Obviously, one type of tumor would require a lot more monitoring for me than the other.

He’s pleased with how the wound is healing, though, so that was a bright spot. He and the nurse seem to believe that it will be completely healed in just a couple of weeks. I find that difficult to believe, since it’s still so big, but I’m sure they know what they’re talking about.

*One of these days, I’ll get around to looking into that.

How about an update?

Published / by Kim / 8 Comments on How about an update?

This has been a really diffcult recovery, which is why I haven’t really posted since the surgery. Today, I’m feeling well enough to sit at my desk long enough to post, though, so it’s time for an update.

The surgery was on December 17 and it went really well. It only took about 2 hours, which is fantastic. (First surgery, 6 years ago, was 7 hours and the second, 4 years ago, was 4 or 5 hours, so 2 is awesome.) The really terrific news is that the cysts really were cysts, not a return of the tumors! Dr. Holcomb talked to Scott while I was in recovery and said the biopsies came back clean, he saved the ovary, and we’re clear to do more IVF if we choose. I couldn’t have asked for a better result.

I had a hard time with the IV pain meds the next day and couldn’t keep any of the liquid diet down, but that eased up as soon as they took me off the IV and I started the percocet. Everything seemed to be going great until Thursday night, when I developed a fever. It wasn’t too high, so they gave me some Tylenol and took a urine sample to check for a UTI. That fever went away very quickly. That was a miserable night, though, because I was still on the IV pain meds and feeling so nauseous on top of being hot from the fever.

Unfortunately, that day they took the bandage off and a few hours later I looked at the incision and noticed that it was red and the skin around it was hot, which meant the incision was infected. They started me on IV antibiotics to control the infection, but the red area around the incision kept getting bigger. So on Saturday, my doctor started opening the incision to look for pus, which he unfortunately found. He had to open half the incision to clean out the infection and irrigate the wound. That sucked. Hard. That was followed with several more rounds of IV antibiotics, but I had another fever overnight that night. So on Sunday, my doctor ended up opening up the entire incision and found more infection. At this point, my nice, neat surgical incision had become a 10cm long, 5cm wide, 5cm deep wound. This wound has to heal from the inside, so they put in a wet-to-dry dressing to keep it open and prevent it from closing over and healing with an abscess.

Finally, on Monday, they set me up with a visiting nurse service for home and released me from the hospital. All told, I spent 6 days in the hospital, when I was expecting to spend 3. My doctor also ordered a wound vac, which came a few days later and has been on for 10 or 11 days, though we’ve had some problems with the nurses not setting it up right. (A topic for another post.)

As a result of the huge wound, this recovery has been the worst of the 3 surgeries. Ironic, because the surgery itself was the simplest. I’m still taking percocet for the pain, which is considerable. At this point after the previous surgeries, I was off pain meds. So healing is slow and my mobility is limited and I spend a lot of time reclined, but I’m getting a little better every day. The wound is down to 9.5cm long, 4cm wide, and 2.8cm deep, as of this morning, so it’s healing well. It looks absolutely HORRIBLE to me, but I’m assured by the nurses that it looks excellent. Beefy red is good, they tell me.

Scott’s staying home one more week to take care of me, which is really good, because I still need him. He goes back to work next Monday.

So that’s where I am. How’s your world?