Wednesday, September 02, 2009

Can't fight the fever


Home at last!!

Well, only about two weeks later than I was expecting, I'm finally back home. I'm still having some low-grade fevers, most likely due to the post-embolization syndrome (that's a great catch-all, isn't it? "Oh doctor I'm having major headaches and bloody noses after my ankle sprain." "Oh that? That's just post-ankle-sprain syndrome. It's very common, nothing to worry about."). It turned out that I was having some slightly worrisome symptoms, as my fevers were mostly low grade until two nights ago, when I had one that spiked past 102F. Given everything that was happening, the doctors wanted to be conservative, so they kept me on antibiotics and watched me for another day. I had another CT scan yesterday to see if there were any other possible reasons for the fevers. The scan showed a couple things: my gall bladder is inflamed, and there were a couple of little bubbles inside of the liver mass. The theory is that the gel foam got into the arteries supplying the gall bladder, so it's not able to compress as much as it normally does. The liver bubbles are probably also from cells dying and releasing gas or from the gel foam itself, which has gas inside it. There's a minor possibility of infection, but it's not likely since my white counts weren't elevated.

Oh, the gall

Yesterday the docs laid out the options for dealing with the gall bladder issue:
  1. Watch and wait - it's very likely the inflammation will go away on its own; apparently it's very rare for people to get CT scans this soon after an embolization, so it's entirely possible that this happens in most people and they just don't detect it;
  2. Insert a catheter into the gall bladder to drain the fluid and allow it to be less "stressed" for a while (this would require carrying around a little pouch that I would occasionally drain for 4-6 weeks); and
  3. Have surgery to remove the gall bladder.
Luckily, we've decided to go with number one, given my good response the past couple of days. On Friday I'll talk to the oncology surgeons about possible options for the liver mass (I will eventually talk to the radiation therapy team as well), and next Wednesday if all goes well I'll start that new chemo regimen we've been waiting for. . .

Until then, I'm trying to heal and enjoy being at home. It's hard not to feel freaked out about this liver thing, but as usual, speculation only seems to lead to unanswerable and worrisome questions. Right now there's really no new information beyond what the scans showed: there was a mass that was bleeding near the edge of the liver capsule. The mass is pretty large, 4-6 cm, but it's unclear how much of that is blood and how much is something else. It seems unlikely that something that large would have grown in the span of a month and a half, but I suppose it's possible (or it's possible that it was much smaller but located precisely to cause a bleed). There's an outside chance this was all caused by a random blood clot, but the radiologists seem to think the mass doesn't look like it has a homogeneous make-up.


Mary said...

Hi Alex. I'm so glad that you are finally home! I hope you heal quickly and feel better soon.

Sharon U. said...

Dear Alex's Left Lung: Good job cleaning things up and getting back to normal.

Dear Alex's Gall Bladder: Settle down! There's nothing to get all inflamed about!

Dear Alex's Liver: Time to get with the program, buddy. No more blood clots, y'hear?

Dear Alex: Glad you're home. Take good care of yourself, OK?