Infection

Preventing infection is important during chemo. Fighting cancer is enough of a strain on your body. Every additional condition that needs treatment is something other than cancer you have to throw resources at. Infection prevention is most important, though, during chemo cycles that wipe out your immune system. The last thing you want is the combination of an infection with no immune system to fight it.

However, even with your best efforts, if your immune system is wiped out long enough, you're bound to get something. This happened to me during cycles 3, 6, and 9. Each time, there was a very short hospital stay involved, with antibiotics given by IV. Cultures were taken as well, but nothing grew in them, so if there was a bacterial cause, it was not found.

This time around, it was a little different. Once again, germophobia didn't save me, but this time, I was quicker to develop an infection, and something grew in one of the cultures. It all started just a couple of days ago. In the morning, I felt almost entirely fine, except for being a little tired. But late in the afternoon, I started feeling weak, and my head felt warm to the touch. Sure enough, I had a fever, and it was off to the hospital. And it took some time to get under control -- by the evening, my temperature was at a whopping 40.3 C (104.5 F), a record for me. At that point, my head felt like it was burning up, and I felt overall just drained, enough to ask for a wheelchair to take me from the urgent care unit to my hospital room. This even though I'm one who insists on not wasting a chance to walk, knowing how I can't take it for granted now.

After enough Tylenol, my temperature finally started coming down during the night, and sometimes dipped below the fever threshold of 38 C the next day, but would come back up after the effects of the Tylenol wore off. I felt quite drained, without much of an appetite, and nodded off for much of the day. The blood cultures that are taken each time I come in for fever during low immunity week didn't grow anything, but a stool culture found the infection -- Clostridium difficile, commonly known as C. diff. It is known to often cause diarrhea, though this was absent in my case. This discovery has me on a specific 10 day antibiotic regimen, and my getting a single room so I wouldn't infect a roommate in the double room that the typical hospital patient gets. Thankfully, the antibiotic regimen is oral. If one of the blood cultures had grown something, the 10 day regimen would have been intravenous, keeping me here for quite a while.

Now I'd mentioned earlier that germophobia didn't save me. I don't think the source was from outside my body either, which means I gave this to myself! As to why it was C. diff -- I remember Dr. Wexler once saying that suprax, the antibiotic used to control diarrhea when getting irinotecan, causes C. diff diarrhea in some patients. And I've had plenty of that, plus another antibiotic, bactrim, for pneumonia prevention, during my treatment. I was also given plenty of IV antibiotics during previous hospital stays. I'm guessing all of those antibiotics left more and more room for C. diff in my intestines, and when there was enough, and my immunity was low, along came the infection. Ok, so I'm not a doctor, but this seems to make sense to me at least.

I'm still in the hospital now, waiting for my white blood cell counts to rebound. I haven't had a recurrence of fever since 6am this morning, and this is without Tylenol, so at least that part is currently under control. I might need platelets or blood depending on how low my other blood counts get, but they so far have not gotten that low. If my blood counts follow the pattern of cycles 6 and 9, I'll be out of here on Saturday, though I won't count my chickens before they hatch with all the chemo I've gotten!