Sunday, October 19, 2008

Lets hope Rebecca has Pneumonia!

So it has been quite a weekend... This is my last task before I fall into bed and get some sleep.

As you may know Rebecca has been 'under the weather' for quite a while. She first came down with 'flue-like symptoms' about a month ago. At first we all assumed that she had flue, it fit the symptoms and there was a fair amount of it going around. However, while everyone else around us got better; Rebecca didn't. A couple of times Rebecca thought she was on the mend only to be knocked back into bed with a fever again. Saturday she finally got sick of the cycle and had me take her to the hospital.

Rebecca, her primary physician and her oncologist had already decided that she should have a CT scan soon so we were pretty clear as we drove to the ER that we were going to get them to send her for a CT to see what was going on in Rebecca's lungs. We dropped the kids off with Sindry and Owen and headed to Kaiser Oakland ER.

We arrived at the ER on Saturday evening at around 6pm. By 6:30 we were in a nice private room. They got us triaged and booked in so fast that the registration person came and processed our registration in our private room... They were awesome... another BIG thanks to Kaiser for being great when we needed them to be!!

They warned us that the Kaiser Richmond CT scanner was down so there was a long wait in Oakland but readily agreed to the scan once they understood the situation and the history. We settled in, they even brought me a gurney to lay on next to Rebecca. At about 3am they came and took Rebecca for her CT.

Not long later she returned with the doctor; this is my tired brains' best attempt at recalling what they said:

They could see significant 'stuff' on Rebecca's right lung, but it wasn't clear what it was. Due to the cyclic nature of Rebecca's symptoms over the preceding month TB became a real possibility and the ER put us into 'lock-down'. In fact all they did was move us to a different room that has special filtration and started to wear masks around Rebecca but it seemed much more dramatic.

Apparently it's not uncommon for people with cancer to get TB; who knew?

As Sunday progressed, while I was off with the kids, the option that this is ALSO pneumonia has also been introduced. It seems that this is apparently a combination of things going on not just one. So... It takes a little while to get a positive diagnosis of TB so for now they are giving Rebecca intravenous antibiotics that SHOULD deal with any pneumonia that is present. Next they will start TB treatment either because they get a positive diagnosis or they will often start it prophylacticly just to be sure. Apparently it can take weeks to grow a TB culture. You can get a quick positive diagnosis by finding TB germs in spit under the microscope but proving a negative diagnosis once TB is suspected can take weeks. If the 'stuff' on her lung is neither TB nor pneumonia then by a process of elimination then it will be more metastatic cancer.

Another 'clue' is the swollen lymph nodes that are visible on the CT in her neck. Lymph nodes can get enlarged due to infection or cancer.... By biopsying the nodes (a needle biopsy is a pretty non-invasive procedure) they may be able to shortcut some of this guess work. I'm not quite sure how this works yet but I guess that if the biopsy the nodes and there's no cancer that has to be a good thing.

SO.... we already knew that Rebecca had a small amount of metastatic cancer on her right lung (that was the diagnosis from 2 years ago) it is possible that hasn't changed or progressed significantly. Best case... she has pneumonia and that's it... but when I have suggested that it has been hinted that is unlikely but I don't get why... maybe they just don't want to get hopes up. It may be something to do with the CT, apparently pneumonia looks quite different from TB and cancer but TB and cancer can look quite similar.

TB, if that's what it is, is treated with 12 months of some anti-biotic cocktail. I haven't heard yet if this is an anti-biotic that has many of the side-effects that Rebecca is very sensitive to.

Tomorrow her regular oncologist will be back at work and maybe I'll get more info from him.

For now, lets all just hope that Rebbecca has a nasty pneumonia and that a week of IV intravenous antibiotic will have her home and healthy!!

Watch this space for updates, facts and jokes.... Your current assignment is to complete this joke:

3 diseases; pneumonia, TB and cancer walk into a bar.... (should it be an oxygen bar? )

Love to you all

PLEASE call me or email me or leave comments here, I'd love to hear from you.

I will ask Rebecca tomorrow how available she is for visits or phone calls.

1 comment:

Kristin said...

Andy and Rebecca,
You guys are in our thoughts but we'll have to get back to you on the joke. I'm stuck on the "walk into a bar" line as it seems "crashed into one another" may be more appropriate...Anyway, Rebecca, just when I finished up some of my comparatively minor craziness and started to make time for my friends, this happens. If you want visitors let me know, I don't want to intrude but I've been missing you too.
Andy, please please please call me for help. I can pick up and drop off kids, walk the dog, cook meals or organize them, or whatever seems to be needed. Or wanted. No questions asked or justifications needed!
Love,
Kristin
(and David)