Shingles

Susan has been diagnosed with shingles, a nerve-root infection caused by Herpes Zoster, the virus that also causes chicken pox. The biggest problem is the painful sores she's got right now, but they should clear in a few days. There's some risk of a neuralgia that could occur later - nerve damage under the skin at the infection site that causes chronic pain in about 20% of patients.

It's a blessing we were able to get her treated with anti-viral meds within 72 hours of the rash appearing since it may have moderated her symptoms. Her symptoms were classic - painful, non-itchy rash on just one side of the body, headache and malaise, with no fever. The rash is contagious for the virus; but those infected would get chicken pox unless they had them already. Shingles can occur later since the virus lies dormant and may spring to life when some has a weakened immune system like Susan. We're thankful to finally name and treat her condition, ending our current mystery.

She'll have an MRI/MRA scan today since her medical team is concerned about blood found in her spinal fluid that could indicate an aneurism. This scan will also be an early view of her tumor instead of the MRI she would have had in two weeks, so I'm sure we'll have a chat and tumor update in the next few days.

We'll meet with her medical team in a few minutes to confirm the outlook, next steps, and find out when she can come home.

Still in ER, still testing

We had a long night in ER and are waiting to transfer to a bed upstairs and for test results to confirm a diagnosis. Susan is stable - she has pain and fatigue, but times of alertness and good spirits after resting. She became dehydrated and is receiving fluids.

She's had a CT scan (looks okay), blood and urine tests, and endured a marathon 1 1/2 hour spinal tap at midnight that would earn the respect of a maple syrup farmer. And she thought I was a drip.

Early spinal fluid results seem to rule out bacterial infection; but fungal results take longer. Urine was positive for a significant infection they're treating with IV antibiotics. If meningitis is ruled out, Susan could be dealing with a combination of the UTI and diabetic issues. That's it for now. We're confident in the Lord she'll improve with the right treatment and are grateful for everyone's support and prayer.

Meningitis again?

We're admitting Susan to ER at UCLA with persistent headache, stiff neck, confusion, and some sensitivity to light. No fever. As many as 4 Vicodin in six hours didn't relieve her pain. Her neuro-oncologist suggested we go to ER to check for meningitis, given her history. 

Susan now has a lovely new bracelet. We know the drill and expect to wait a while for tests. We're glad Susan has her port for easy IV access, and we have our Lord who's with us in all things.

Complications persist

This has been a tough couple of weeks for Susan. A nurse at Broadway by the Sea called late Friday to inform me the blood cultures taken earlier in the week had come back positive for e coli – the infection had spread from her urinary tract to her bloodstream. They were starting her with an antibiotic called recophin to be given IV for ten days. A quick call to Dr Nghiemphu clarified that a blood infection can be serious; but it’s encouraging that they caught it early. She feels the recophin will do the job.
I took Susan for follow-up to UCLA yesterday to visit Dr Uslan with the infectious disease team, who said urinary tract infections involving e coli can be an issue for patients dealing with incontinence and they can sometimes travel to the kidneys and infect the blood. He examined her port catheter also since infections can also result from IVs; but the catheter site looks ok and is contained under the skin. He confirmed recophin as the treatment of choice, took another blood sample, and ordered a follow-up blood test for several weeks from now to check her status.

We finally got Susan scheduled for her lumbar puncture (spinal tap), so we were back at UCLA this morning for the procedure. We checked in to the radiology unit at the Ronald Reagan Medical Center so the neurosurgeon could use their fluoroscopy (video x-ray) equipment. The procedure went smoothly – the surgeon collected about 25ccs of fluid. That alone should help the hydrocephalus for now, while the fluid will be checked for infection. Susan was in a lot of pain since all the bed-wheelchair-car transfers aggravated her back injury. She said everything hurt, so I couldn’t tell what was back pain or spinal tap pain or what. I stopped by the oncology clinic to get Susan some vicodin before we headed back to Long Beach. Nurse Nikki was alarmed that Susan wasn’t kept lying down – standard protocol is to lie flat on your back after a spinal tap to prevent any leakage. (What do I know?) Dear Nikki found Susan a bed in the clinic so she could rest a few hours and gave her some pain meds. Such great staff have made the Jonsson Cancer Center clinic a refuge at UCLA when Susan needs help. We’ll be back next week for MRI, doctor visit, and chemo, and we continue to pray for her healing in all respects.

Susan keeps the physical therapy staff at Broadway by the Sea laughing. One day last week as she was ready to walk while holding parallel bars, John prompted Susan to step towards him. She didn’t respond right away, which is not unusual since she sometimes has trouble initiating an action. He prompted her again, but she still didn’t react. When he encouraged her a third time and she just stood there, he became concerned she might be having pain or something. He asked, “Susan, is something wrong?” She gave a droll reply, “Well, I do have this illness...”