Wednesday, August 19, 2009

Shingles and portacath update

Because there's not much else to write about.

I wound up keeping my appointment with my primary care physician, PZ, for this past Monday AM. He is one of the leading infectious disease doctors in the US (I started going to him long before this specialty) and I almost felt good seeing him about something other than strep throat. I always feel like I am cheating him. I also usually feel a little worried that everybody else in the waiting room has stage four schistosomiasis or ebola.

I didn't get either of these while there, but I did get a quick confirmation that it was, indeed, shingles, and quick confirmation that the therapy (4000 mg of Acyclovir) is appropriate. Then I got an explanation of what shingles is, why it is localized, what to look out for, etc. Fairly interesting, actually. Shingles is a re-activation of the chicken pox virus and it starts with a single nerve root and spreads only to the part of the skin that ties back to that one nerve. This is why it appears on a swath of skin rather than all over the body.

Anyhow, I itch and hurt (a dull pain, like a bad bruise) but it's not getting any worse at this point, so hopefully it's contained and will soon begin to abate. It's not the worst thing in the world but I certainly hope I don't get it again -- it's very difficult to sleep, between the itch and the pain.

When then doctor was examining me, he looked at the scar on my chest and said "is that the portacath?" "Yes," I said. "Does this you?" He said "Honestly...I've seen better." Knowing PZ as I do, this is tantamount to a less kind person saying "this looks totally horrible." He said the key is to see what it looks like after a month. It will be three weeks tomorrow, and it is still causing me pain at night and is swollen, though not nearly as much.

I continue to refuse to have bloodwork done until it can be done from this stupid thing, but my righteous indignation is beginning to give way to a desire (mostly on the part of Jill) to have current bloodwork. I will probably go in next week to have labs done, whether they can use the portacath or not.

I have my next series of tests scheduled back in Little Rock on Monday, September 14th through the 16th. Hopefully, the result of these tests will be a formal declaration of complete remission from BB and instructions to commence my three years of maintenance therapy. We are running into a little trouble scheduling the fine needle aspirations. I want this done under conscious sedation, and as usual the one scheduler there isn't as aligned with the plan as I'd like. My retort is simply that I won't do any FNAs if she can't get it scheduled under conscious sedation. My marrow was disease-free BEFORE the last round of chemo, and it will certainly be disease free now. There's no point in the FNA except to gather data, and I'm not going to undergo a lot of pain in order to do something just for the sake of data if there is no therapeutic value to me. I have provided a LOT of data before, and they gather data from my bone marrow every time they draw it. The cells drawn from the FNA sites were no different last time than the cells drawn from elsewhere in the marrow.

Still tired, but other than that, and the shingles, I feel pretty good. I am itching (haha) to start some kind of exercise to recover some lost muscle tone and shed the extra fat but the shingles, and to a lesser degree the discomfort of the portacath, are making this difficult. Hopefully in a week or so I can begin.