Cycle 8 Day 1

My bout with cellulitis and the other weird bacterial infection seems to be under control. I finished a 10-day course of antibiotics on Monday and visited Dr. Sebeny that day for a followup. Unless it gets worse, I don't need to go back. The pain is gone, and the discoloration and scabbing are slowly disappearing. It's all good!

The one glitch in this experience is that the abdominal CT scan I got in the hospital showed a "spot" in my left kidney. I got a CD of the CT scan to take to my Dana Farber appointment on Tuesday. My PCP, Dr. Ray, also got a copy of the scan. Her office called me this week to give me a referral to a urologist. I guess I need to follow up on this. It seems that there is always something.

My Dana Farber appointment on Tuesday went well. I told them about the CT scan, and they checked my previous history. I had a PET scan last year, which didn't show anything, but my nurse, Ally, said that a PET scan is not the best way to check for kidney issues. All my blood test results continue to show completely normal kidney function, which is great!

Some of my CBC blood test numbers improved from last cycle. My platelets and neutrophils are both back in the normal range, so I didn't need to get a GCSF shot on this visit. My white blood cell count also improved some, although it is still low. I got another IVIG infusion to continue boosting my white blood cell count. 

So far, I have gotten two results that track my progress on the clinical trial. My free Kappa light chain value and Kappa/Lambda ratio are still both in the normal range. That's great! My 24-hour urine monoclonal protein study also came back negative with "No monoclonal protein detected". Also great! This time, it didn't note that I have hypogammaglobulinemia, which might be a reflection of my improved white blood cell count.

I'm still waiting for the serum protein electrophoresis result, which I should get early next week, but I expect that will be negative as well. Unless it shows a probllem, I won't bother to update my blog with that result. All in all, things seem to going very well!

My next appointment will be after we return from Ireland next month. I'm really excited about this trip! Slainte!

Medical Glitch

 WARNING! Do not scroll down if you don't want to see a graphic photo of my latest medical adventure.

After my post on Cycle 6 Results, where I showed a picture of the purpura on my arm, Brian suggested I warn people if I plan to show any potentially upsetting photos. So consider yourself warned!

WARNING #2!: This is a long boring post.

This all started last week. We were having a wonderful time at the farm celebrating the 4th of July and enjoying the products of my new Traeger electric smoker. The roast pig, smoked baby back ribs, and smoked skirt steak were all delicious! The weather was awesome and life was good.

On Saturday, Jeff and I took the ATV down to check out the trails. We took a shortcut through a swampy area and unfortunately got stuck. Even with 4-wheel drive, we kept sinking in the mud. With Jeff pulling on the tow rope from the back and me rocking the ATV, we still couldn't get it out until Jeff stuck branches under the rear wheels to get some traction. 

After about 20 minutes, we finally got out, but we were both covered with swamp mud. Jeff even had a leech on his leg! Yuck! When we got back, we had to hose off the ATV and ourselves. Correction: Jeff had to hose off the ATV and ourselves. 

Now I have had some swelling in my lower legs for the last few months. My left leg had also been leaking a little bit over the previous few days. That turned out to be a problem.

On Monday after coming home, I was watching a movie, when my lower left leg started itching badly. It turned red and was hot to the touch. I was in a lot of pain when I tried to walk. Donna, my landlady came up to give me some flowers (she always does that), but she saw me in pain and offered to take me to the ER. Being a stubborn O'Halloran, I declined and went to bed soon after. 

I was in too much pain to sleep until about 3:30 am when the pain went away. In the morning, I took a picture of my leg:

It wasn't pretty!

I called my PCP and Dana Farber. Their biggest concern was that I had a deep vein thrombosis (blood clot) that could detach and go to my lungs causing a pulmonary embolism. My symptoms were consistent with this, so they sent me to the ER.

I was freezing in the waiting room to be triaged, so they got me a blanket. Once I was in the ER, they put me on IV antibiotics and scheduled an ultrasound. The results showed that I didn't have a blood clot, which is a good thing, but that I did have cellulitis, which has similar symptoms.

They admitted me to the hospital and began an intensive regimen of antibiotics. I must have had 15 to 20 doses during the time I was there. They took multiple blood samples and a urine sample to track progress. Dr. Sebeny was my disease specialist. He was great! I told him all about my recent adventures and my MM journey. He related well, as he has a family member with MM and he knows Dr. Richardaon

At first, he thought everything was okay, but then he found that I had a bacterial infection in my blood. There are 2 types of bacteria: gram-positive and gram-negative. Cellulitis is gram-positive, but the type in my blood was gram-negative! This was a mystery, so I was stuck there until this got figured out. 

They did an abdominal CT scan so see if there was an internal source of the gram-negative bacteria, but that was negative, so did it come from the outside?

Finally, on Friday, he had the answer. The mystery bacteria was "Acinetobacter". He was very familiar with this from his military experience in war zones, having written several papers about it. Similar to cellulitis, this bacteria lives in the soil and can enter the body through any opening. The story finally hung together: I got both infections at the same time from the swamp!

Fortunately, this bacteria is easily treated with the same antibiotic as cellulitis, so he sent me home on Friday with a prescription for Levofloxacin to treat them both. I'll follow up with him a week from Monday.

Dana Farber is changing my next appointment from next Friday to the following Tuesday until after my antibiotic treatment has stopped. This should work out well, and the next cycle will then come just after our return from Ireland. 

When I got home yesterday, I reveled in showering, shaving, and changing clothes. I then went to bed early and got a good night's sleep in my own bed. My leg looks and feels better today, and I feel great, so it's all good! What an adventure!

I know this is too much information, so you should have listened to one of the two warnings above!