Surprise!

BOX SCORE




Element

Current

Std. Range

Trend

Hemoglobin

10.8

13-17

^

Platelets

69

140-375

^

ANC

70

1800-8300

v

Don't you just love surprises? Especially this time of year. There is so much good cheer...well, if you stay away from crowded malls and such. Even there a festive air seems to penetrate the  madness of frantic Christmas shopping. 

And then, there are the OTHER surprises. In this case, I'm not really surprised; it's more like bemused.  I have had an open wound on the perimeter of my Vascular Access Port (VAP) for a couple of weeks. For all the gory details and history of this wound, please see my post No Fair.

The wound has been covered with a waterproof dressing since Monday, when it was getting really ugly. That brings us up to today. I was so hopeful that the nurse would tell me things were healing up. I was also in hopes that my blood counts (read, ANC) would be up so that we could begin going out a bit. As you can see in the Box Score, my platelets and hemoglobin did go up marginally, but my ANC went even lower. But, you know what? When ANC hits bottom, there's only one way it can go from there. 

Now, where was I. Oh, yes. Francisco took the dressing off this morning and the wound has progressed to about four times the diameter it originally was. (If you are a math geek, you will quickly realize that means the area of exposed sub-cutaneous tissue is 16 times as much!) What's more, the edge of the VAP that is supposed to be completely covered by skin is actually protruding from my chest. Eww! He took more pictures and sent them off to the Infusion Center, dressed the wound and bid us farewell. 

Around lunch time I got a call from Dr. Brow's case manager. She had called the surgery center, and was told they would be able to see me tomorrow, but if not, I was to go to the ER on Saturday. Ugh. 

Surprise!! While we were out doing our daily constitutional around the neighborhood, my phone rang. It was Nicole from the Skyline (Salem area! No trip to Portland required!!) Day Surgery Center (DSC). She said I am to come to the DSC tomorrow morning at 11:30 to have the VAP removed. Thank You, Lord! I did not want to go to the ER. 

I will miss my VAP, but I won't miss the crater. I am told another VAP can be inserted after I heal. I am confident that this episode is a fluke. I think the pocket under the skin in which the VAP was inserted was just a little too shallow, leaving the scar directly over the edge of the implant, where there is just too much tension on the scar. That means the scar tissue, which doesn't have as much blood supply as undamaged skin, essentially starved for oxygen and the nutrients it needed to thrive. Reminds me of some mishaps with oral surgery, when I was practicing dentistry. Once in a while, the gum tissue over a recent surgical site, especially if it were sutured over an open tooth socket, would slough like my skin is doing. The difference is that in such a case what was exposed through the soft tissue was not plastic but living bone tissue, which can be very painful. Ouch! Let me just take this occasion to apologize again to those patients for their discomfort.

If I may sum up here... Think of all the worse things that could have happened to me. Think of all the serious and common side effects that I haven't had from chemotherapy. Think of the story I can tell my friend Brian, who is also undergoing treatment for AML, Oops! He has a VAP, too. I don't want to worry him, so mum's the word! 

After our walk this afternoon, during which we received the good news that a DSC appointment is available, Jill remarked that this is one more instance of God being very gentle with us in a less than desirable circumstance.   I guess that's why the Apostle wrote to the church in Thessalonica: 

"Rejoice always. Pray without ceasing. Give thanks in all circumstances, for this is the will of God for you in Christ Jesus." (1 Thessalonians 5:16-18) Thank You, Lord!


P.S. Francisco called this afternoon to see how I am doing and whether surgery has been scheduled. How can you complain, when people take care of you like that??


 

 

 

 

 

 

 

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