Tuesday, May 27, 2014

My Belly Button Sent Me to the Hospital: A Story In Media Res

It only makes sense that a monkey would begin a blog in media res and out of order. Don’t worry, an exposition post is on its way explaining how I got diagnosed and all that jazz.
My Facebook peeps already know I was hospitalized for a few days for one of the most ridiculous of reasons: a belly button piercing infection.
Now why would a chemo patient even think of getting a navel piercing? In my defense, I got the piercing before I got diagnosed. 
Navel piercings can take up to a year to completely heal, and I recently reached my three-month anniversary. My routine of washing my piercing everyday with an antibacterial soap was working just dandy, and under normal circumstances should have continued to work. Except…
My first chemo treatment diminished my blood cell count, which meant my still-healing piercing from February was more susceptible to infection. I’m guessing when the site became infected, my body fought back and depleted its minimal stores of neutrophils, a very important type of white blood cell (WBC). It’s like stonemasons were in the process of fixing a tiny hole in a castle wall, and then most of the knights died in the crossfire of a magic spell meant to protect the structure, so trolls took advantage of the weak point and killed off the remaining knights. Which of course puts the castle in a very precarious situation. 

Here’s a timeline of my adventure; pictures are included near the end:
Note: I realize everyone has a different threshold for gore, so I tried to be sensitive towards that. On a scale of 0-10, with 8 being of Red Wedding caliber and 10 being the lawnmower scene from Dead Alive!, I'd say my details are within the 1-3 range.

Thursday, May 8: First chemotherapy treatment. Two weeks of navigating various side effects, overall feeling better and better as time nears my second treatment, scheduled for Thursday, May 22.

Sunday, May 18: I notice a pinching pain at my belly button. When I first got the piercing, the piercer told me that if I developed an infection I could cover my navel with a cup of warm water mixed with sea salt and that should help. I try this home remedy first, as well as continue to wash with antibacterial soap.

Monday, May 19: Pain increases. The site becomes pink and swollen (click here for picture). Yikes! I continue home remedies. I debate whether to call my piercer or primary care physician (PCP) or my oncologist about the issue. It’s not specifically cancer-related, yet I know getting antibiotics would be better given my status as a chemotherapy patient.

Tuesday, May 20: After getting blood drawn in preparation for Thursday, I discuss my piercing infection with the nurses at the infusion center where I get my treatments. I joke about how silly it would be to end up hospitalized for this and they confirm it could happen. They recommend calling my PCP about antibiotics, so I call and schedule an appointment for the next morning.
Later, I develop a headache and monitor my temperature throughout the day. If my temp raises to 100.5 °F or higher, I’m supposed to call my oncologist. Luckily, my temp stays below this point, although I do have a slight fever. My throat also feels sore, yet it’s been sore off and on for several weeks, so I mostly ignore this symptom.

Wednesday, May 21: 
Morning: I learn my PCP isn’t available that day, so I decide to see another doctor at her clinic. The nurse records my temperature at 100 °F. The new doctor prescribes antibiotics and suggests I remove the piercing, which I refuse to do in hopes that all will get better. He also examines my sore throat and says the antibiotics will take care of any issues.
Noon: The infusion center calls and says something is amiss with my blood work and they need me to retest. A few minutes later my oncologist calls to tell me not to worry about retesting, my WBC count is low, and she wants to postpone chemo until Tuesday to give my body a chance to fight the infection. She reminds me to call if my temperature gets too high.
Throughout Day: Temperature fluctuates above and below 100 °F, still never reaching 100.5 °F. The right side of my throat stings.
6:00pm: A couple hours after talking with an artist at the parlor where I got my piercing, I decide to remove the navel ring. Although I weep over my loss, I know it is for the best. While this should have been a no brainer (jewelry or constant threat of life-threatening infection?), the ring had become an important symbol to me, which I will discuss in another post. As soon as I remove the ring, the pain in my tummy and throat decrease. Sweet relief!
6:45pm: While a friend and I are hanging out, I notice I don’t feel so great, so I take my temperature. 100.8 °F. Oh dear. Maybe it’s a mistake? Five minutes later, retake temp: 101.3 °F. Uh oh. Really not good. I call the after hours line and speak with the oncologist on call. She tells me I need to report to the ER as soon as possible and that she’d notify them I would be coming so they can admit me faster. She also tells me to wear a protective face mask when I arrive because I have zero white blood cells and I’m highly susceptible to infection. 
8:00pm: My mom and I arrive at ER. My dad meets us there. I suck up my pride and put on a mask. We finally get to the front of the line to check in. Temperature: approx. 101.8 °F The nurse tells us to take a seat. I barely rest my head on my dad’s shoulder for ten seconds before my name is called. That was fast.
From here, time muddles together.
I am taken to rest on a hallway bed until a room became available in the ER. A catheter is inserted into my vein and blood is drawn; the uncomfortable catheter remains in case more blood needs to be taken. A receptionist comes by and has me fill out paperwork. I am officially admitted due to a “neutropenic fever” and wheeled into an ER room.

Don't Panic!
The ER doc sees me pretty much right away and assesses my situation. He tells me I’ll need IV antibiotics and that I most likely will have to stay two or three days. He also will need to drain the abscess that has developed at my infected piercing site.
The nurse takes more blood, then takes out the catheter (thank goodness) and hooks up an IV to the port I had surgically implanted two weeks earlier. X-rays are taken. The doc performs an ultrasound of my wound (Phew! It's not an alien).
11:25pm: The ER doc numbs my tummy and at 11:35pm, begins the procedure to drain the abscess. Mom holds my hand and a few minutes minutes later, we're done. Highlight if you want slightly grosser details: The lidocaine injection stings; a small price to pay considering the doc is going to cut me open in a few minutes.  (I groaned when he came to give me the lidocaine shot. I liked his response: “I’m happy to see you too.”) The doctor described the procedure as basically popping a giant zit and expelling the pus. The 1 cm long, 1 cm deep wound has to stay open to allow drainage. No stitches. The doc put a special gauze in the opening to help the healing process. A portion of the gauze strip sticks out, kind of like the little paper that sticks out of a Hershey's Kiss. Over the upcoming weeks, my mom and sister will have to help me change and replace the fabric every few days. This is not the worst wound in the world by any means, yet I hate pain so I request meds. I get my first ever dose of morphine (after this I got a second, smaller dose, and then was switched to oxycodone for the rest of my hospital stay).
"When a problem comes along, You must whip it...Whip it good!"
12:00am: My dad returns home because he has work in the morning. I have a little bit of time to myself because my mom needs to re-park the car. I rest, but can’t sleep.
Mom returns. More waiting. Another doctor sees me. It’s officially determined they will transfer me upstairs. Just have to wait for another room to become available.
2:45am: Finally wheeled to my own private room. Since I’m neutropenic (low neutrophil count), I have to be semi-isolated. This means no roommate for me. Visitors are welcome. My mom spends the night with me.

After that I spent two and a half days sitting around in a hospital bed, getting antibiotics through an IV, feeling physically fine with the exception of sharp abdominal pain at my wound site. Oh yeah, and my temperature remained within normal ranges the entire time. Woot! Under normal circumstances, I would have healed at home, watched TV, and gulped down antibiotics every couple of hours. 
My mom stayed with me the most, with the exception of Friday because she had to work. My youngest sister took over watching me and I’m grateful she did. I’m also grateful my dad, other sisters, and bro-in-law could visit me. We were even able to sneak in my two-year-old nephew for a few minutes. Tee hee!
Two of the worst parts of my hospitalization were 1) When the wound experts changed my wound dressing on Thursday. No lidocaine for that experience. Yeaouch! and 2) Constantly needing to pee because I was on a constant saline drip. By the time I returned from the restroom and settled into bed, I would need to pee again. At least my kidneys are working fine.
Of course, it wasn’t all sitting around:
Pole Dancing

Oo La La!
General Silliness

Away from Home
 My goal is to dress up for each chemo treatment. Steampunk Dorothy was going to be first because Dorothy looks better in braids. While I was hospitalized the hair loss process began, so I decided to get pictures while I could.
Dorothy gets a scarecrow, tin woodman, and lion; I get these fabulous goofballs!

Steampunky Flyin' Monkey!

Click here if you want to see me with my piercing wound.
You can barely see it. ’Tis But A Scratch!

Nurse Sunny was awesome! She took care for me for two days. Always friendly and helpful. At one point I was crying because the wound experts had just finished cleaning my injury, and I was super exhausted because I hadn’t slept at all the night before, and I was losing my hair,  and the whole situation sucked…so Sunny gave me chocolate ice cream. =)
Nurse Andrea was also great!
She gave us lots of information to help me manage future chemo side effects and whatnot.
Patients should always have effective communication with their medical team.

Each day my doctors monitored my blood cell counts, since they couldn’t send me home unless I had enough knights to defend my castle. When the on-call doctor told me over the phone that I had zero white blood cells, I thought she was exaggerating. I have since checked my patient record online and what she meant was I had zero neutrophils. There are five types of WBC, and my counts for each were low, but most were within normal ranges. Neutrophils are the main type of WBC and the one that fights infection.
Obviously, having zero is bad. A normal, healthy person should have a minimum of 1500 neutrophils. The oncology resident told me I might go home if my counts reached 500, although some doctors like to wait until a patient reaches 1000. Here were my neutrophil counts, as far as I recall:
Tuesday: zero
Wednesday: 130
Thursday: 430
Friday: 530 
Saturday: 1000+
Thus, on Saturday I was disconnected from my IV and sent home with a fresh prescription of antibiotics and instructions on how to take care of my wound.
My chemotherapy treatments have been postponed until my tummy heals and/or my oncologist determines that I'm ready. Don’t want to kill the newly recruited knights before the stonemasons have had a chance to fix the castle walls.
There you have it. My belly button piercing sent me to the hospital. I still haven’t decided whether or not I’ll get it re-pierced after I finish chemo in six months. I probably will. And I might get a tattoo to go with it.


Tuesday, May 20, 2014

My First Post

A few weeks ago, on April 30, 2014 I was officially diagnosed with cancer. Nodular sclerosis Hodgkin lymphoma to be exact. And after some more testing, Stage 2. Since I won’t be going to Disneyland anytime soon, I guess the next best thing is to start a blog and document my adventure.
I make no promises to post consistently. I’ll try for once a week, or twice a month, or something. Whatever tickles my fancy.