The Good, the Bad, and the Ugly

That’s the title of one of Tim’s favorite movies, the classic Clint Eastwood western.  It seemed appropriate to describe what’s happened in the last 24 hours, but not necessarily in that order.

First, the bad:  As I blogged previously my doctor has advised me to stay at home and limited visitors because my white count had dropped, as often happens with chemotherapy patients.  I was also ordered to monitor my temperature closely, and to call the oncology clinic if my temperature reached 101 degrees.  On Sunday, and again yesterday, my body flirted dangerously close to the magic 101 degrees.  Just when I thought it was under control, shortly after 9:30 last night, the mercury jumped above 101.  The doctor’s instructions were to get to UAMS Emergency Room pronto.  Within the hour, my temp had peaked at 102 degrees. 

Oh, and along with the fever, over the last 24 hours the soreness in my mouth had migrated south, to the point where even drinking water became a painful experience.  Not even the magic mouthwash was helping anymore.

Fortunately, I didn’t have to wait long for attention at the ER.  For good or ill, patients like me with compromised immune systems get near the top of the triage ladder; they don’t want us hanging around in the waiting room very long, where we might be exposed to some really nasty microbes that our bodies cannot fight. 

More bad:  Once in the treatment room at the ER, the usual collection of blood was drawn, and x-rays were taken.  It was obvious to medical personnel that I was not successfully fighting some kind of infection, the assumption being that it was probably due to a very low white count.  The initial meeting with the doctor:  “I’m going to transfer you to a hospital room where we can successfully monitor you for the next week.” 

A WEEK??!!  Yes, that was my reaction too.  But the doctor tried to reassure me that this kind of reaction sometimes happens with chemo patients and to not be alarmed.  Think of it as a “medical vacation,” my brother added.  Like going on a cruise.  You can imagine - the thought of being held captive in a hospital room for a week wasn’t in my plans.  But I’m learning that when it comes to fighting cancer, plans often change.  This is just one of those times.

Here’s the GOOD news – and lots of it! 

• Not only do I have a healthy white count, my doctor is quite impressed with my ability to reproduce white blood cells on my own in such a short time.  The third bar represents Saturday’s count while the fourth bar represents last night’s count.  Yeah Me!!  Hip Hip Hooray!  Woo hoo! 

• My final diagnosis is actually a systemic yeast infection, or Candida.  Candida albicans is a fungal organism that is present in everyone’s intestinal tract. It is normally kept under control by the immune system and by beneficial intestinal bacteria.  This balance is upset when these bacteria are destroyed (antibiotics) or when our immune function is impaired (i.e. chemotherapy).  Once that balance is upset, Candida begins to proliferate and invade and colonize our body tissues. In my case it presented itself as oral thrush. But Candida albicans can also spread inside the body and become a systemic problem.  That is what has happened to me. As my colleague Jordan described it, "There's a fungus among us."  
• All of this is quite curable with rounds of good meds by smart doctors. 
• I should be home by Wednesday or Thursday, just in time to help Anna-Lee get ready for her spring break cruise. 
• Abbey has gone to live with my brother Mike for the next few days.
• I’m enjoying my very nice brand-spanking new room at the new UAMS Hospital, listening to old songs on my iPod and getting much rest. 

Another hurdle, but not one I can’t climb.  These medical wizards over here have already made me feel so much better.  Okay, maybe not Mexican food tonight, but a grilled cheese sandwich and some soup are much better than a pear- and Popsicle-only diet.  Thank you UAMS!!