Waiting Game

Maggie has gotten a few fevers since Monday, most recently at 6 this evening. Her blood cultures from Monday's initial fever are growing a gram negative bacteria, so she has an infection. What does this mean? Well, it is again possible that her broviac (central IV) might need to be removed if they can't clear the infection from the tubing. Hopefully we'll hear tomorrow that they have a good antibiotic for her bug and that she's on her way to getting better.

For clarification sake--when she gets a fever, there is a standard protocol that they follow. First, they draw blood and send it to the lab to watch it "grow." At the same time, they mix some of the blood with different antibiotics to see which one(s) work the best to kill the infection. They also give her Tylenol to reduce the fever, and start her on an antibiotic that is good for a broad range of infections. Hopefully this helps get rid of the infection until they know more specifically what the infection is. However, it takes several days for this process to take place. They usually draw blood again 24 hours after the initial bloodwork and repeat the "culture" process to check to see if the infection is still there and if it is weakened. In a couple days, they then know more about the infection, sometimes they change the antibiotic to a better one, and hopefully it is just a short time before it is all gone.

Though we know little about the types of infections, they classify them into gram positive or gram negative bacteria. You can google those terms to learn more detail if you want. Typically, gram negative bacteria come from the intestines or from contact with stool.

Maggie's bug then, either is from her IV tubing coming into contact with her diaper area (not likely because Maggie was constipated the last few days from her chemo). The other way that she can get a gram negative bug is kind of a side effect of the chemo, if I understand it correctly. The chemo attacks cells that rapidly divide (to kill off cancer cells), but also tend to affect other cells that rapidly divide: hair cells(that's why it falls out), skin, and the lining of your mouth (hence Maggie's mouth sores), throat, stomach, and the rest of the GI tract. So, the lining of your stomach or intestines, which contain lots of bacteria naturally, gets broken down and the bacteria can seep into the bloodstream. Then, in a matter of time, fevers begin. That's my amateur understanding, probably filled with errors.

Our hope is that Maggie's bug is identified soon and more importantly, it clears soon and doesn't cause any more problems. Some bugs are easier to treat than others, so we'll hope for good news in the morning or whenever the situation becomes clear. That's the "wait" that I referred to in the title. We know that she's sick, we watch her feel yucky, cultures are drawn, we wait........we get a little more info, then we wait............and hope, and hopefully we don't worry too much in the meantime. Thankfully her counts are still high enough that they should help fight the infection for a couple more days before they are depleted by the chemo.

Please pray for good reports from the doctors, that her infection clears, that her broviac doesn't need to be removed, and that chemo continues as scheduled later this week. It is ironic to know that we received great news of Maggie's remission just days ago, yet we still have to be wary of the other risks to her treatment and health. The chemotherapy continues for another 20 or so months to make sure that the cancer cells are totally gone. Along with the chemo is the weakening of her immune system and the risk of infections. It is clear that we never get to fully relax. And the waiting is so hard.