57. Hives, Hospital & Hair

A week ago today at this time I was in the recovery ward at St George Hospital. Sometimes it has felt like a really looooooong week and other times it's hard to believe it's been a week already.

The hives are back. EEEEKKKK!!!! Little red itchy bumps along my arms, shoulder and across my collarbone area, a bit on the sides of my neck. They started to appear and make themselves be known on Sunday. Maybe my theory that I had a reaction to the lemon myrtle moisturiser is wrong? The hives last time were a couple of weeks after the operation, these were 4 days. Maybe because of the chemo my immune system isn't quite as strong and so it's come out early? I ended up in hospital on Monday (tell you about that below) and I asked Dr Brittany what it could be. She thinks possibly I am having a reaction to something they gave me in the operation, or even a reaction to the surgical drapes that they use during the operation. Last time they wouldn't probably had it mostly on my right side which is why it only came up on the right last time. This time both sides operated on. Perhaps it's coming out quicker cos I am fighting an infection. Whatever it is I'll see if Dr Inder has an idea on Friday when I go see her. I have been taking an antihistamine tablet in the mornings and that has just kept the itchy at bay, mostly.

Hospital. The left side drain site has always been a bit more pinchy and painful than the right side. On Sunday afternoon I said to Mither that I needed to have a look at it cos it was really starting to bother me. It was quite red. The community nurse hadn't changed the dressing on it since the operation. She'd changed the right side as that dressing had started to come off. On Monday it was a different community nurse. This was Janine. She had a look at the left drain and said it definitely needed looking at by a Dr and I would probably need antibiotics. Both drains has some tissue moving out of the tubes up near the drain sites. She squeezes and folds the tubes to move it. She calls it "milking". She redressed both sides for the drains, using a nice foam padded dressing and putting on some skin protection wipe stuff to help with my skin breaking and getting abused. April and Ash are here in the morning and April was very interested watching Janine work on the dressings and the drains. Once Janine had left I call up Donna and Jason to see if one of them would be available to take me to the hospital. I figured it would be better to just go there first as they can do blood tests quicker and if there is something serious they can deal with it there.

I get to Sutherland Hospital Emergency just after noon. I check in using my red card and in about 20 mins I see the triage nurse. She takes my obs, BP 143/92, Temp 35.6c, 97% O2. She checks with another nurse about when I might get a bed and that nurse said it was pretty busy so perhaps an hour. I go back out into the waiting room and suddenly it's like a bus has dropped off a full load of people. It's filled up in the waiting room, hardly any seats left available. A kid had been bitten on his arm by the next door neighbours dog, a lady thinks she has snapped her ACL playing laser tag in the backyard with her kids, a lady doesn't know what she has but she has a high fever and is shaking so much with chills her teeth are chattering, some other guy has issues breathing and has a fever (he goes through straight away), a young girl hops in with her toes all bleeding, a main comes in with his hand wrapped in a tea towel with blood seeping through, a few older people are wheeled in...the list goes on. A call comes over the intercom "all available staff to resus 1" that doesn't sound good.

At 1.44pm I'm taken through to bed 24. A nurse comes in and he says he's going to put a cannula in and take some blood. He looks at and taps my hand and elbow then puts a yellow elastic tourniquet just below my elbow and says "you have some great veins in your hand, I could use this one (just above my pointer knuckle), this one (behind my ring finger) or this one (behind my thumb), do you have a preference?" I told him that the one behind my ring finger had been used before and that people have complimented me on my veins previously and then sometimes they work fine and other times they don't. I tell him they should have names so they can be cheered on. He laughs and says "Ok Bob, you can do it". He sticks me in the vein above my pointer finger - doesn't work. Obviously Bob is not impressed with being told what to do. He sticks me in the vein above my ring finger.....and it sort of works. "Someone turned the tap off!" he says and pulls the cannula out. Now I have two holes in my hand and two dressings taped on. He says he needs to put a call in for a nurse to use an ultrasound to find a good vein. At 2.45pm Dr Brittany came in and she decides to try the vein on the outside of my elbow crease and gets it first time and it works perfectly. No need for the ultrasound. She says she is going to send off the blood and come back and look at the drain sites.

She comes back at 3.30pm and asks a few more questions about my operation, when was it done, where was it done, who was it done by. What was the main reason I came in. Told her the community nurse said I should come in and I also felt that it was infected as it was sore, red and hot. She peels off the nice dressings that Janine had put on in the morning (she said they had been dressed very well) and says yes, very red and hot. She takes a photo of it and then has a look at the right drain and takes a photo. She says the right one looks fine and I tell her it feels fine as well. Dr Brittany also took a swab of some gunky stuff that was coming out of the right drain hole. It's a light brown colour. She says she'll send it off to the lab and see what grows.

Around 3.45pm I'm moved to another section in emergency and the nurses Andre and Sandra take my obs. BP 151/78 - bit high. I'm asked if I'm in any pain and I said the panadol I'd take at 10am was wearing off so possibly the reason. Temp 36.3c and 99% O2. 4.50pm Dr Brittany comes back and said she'd spoken to the surgical team at St George Hospital and sent them the photos she'd taken. They also agree there is some infection going on and to give me Cephalexin - "wait, that's what you are allergic to right?" says Dr Brittany. Yep! She says she'll find a different one to give me. Blood tests show that my lymphocytes are low so I am fighting an infection. Dr Brittany said it was good that I came in when I did as if it was even a day later then I probably would've been admitted to have IV antibiotics. At 5.25pm I'm given 3 capsules of Clindamycin (150g each). Dr Brittany says I can go home and to take 3 capsules 3 times a day for 7 days. It's a high dose but she hopes that it will kick the infection quickly. She tells me to get Dr Inder to review it on Friday. Jason comes and gets me around 5.45pm and we stop off at the pharmacy on the way home to fill my script. I get home around 6.30pm and take a couple more panadol. The ones I took at 10am had well and truely worn off and I feel like I have a ring of fire around my chest.

Tuesday Janine comes again and redresses both drain sites. She says it looks a little less red. I tell her that it not any more painful that it was but still sore. I also called our local pharmacy this morning to check that the clarytine, clindamycin and panadol wouldn't have an adverse reaction together. She says they won't. I wouldn't want to have that on top of everything else. Polypharmacy is a big reason people end up in hospital, especially older people and people living with dementia. Often times they are bouncing between hospital, care and GP and the updated scripts don't get communicated quickly enough between medical teams and support carers. Wednesday (this morning) Janine is back and the right side drain is a lot less red and it is definitely less sore than it was. Let's hope it keeps on working and the left drain can come out soon. Maybe by Friday?

Drain volumes

Friday - Left 100ml, Right 180ml

Saturday - Left 80ml, Right 180ml

Sunday - Left 40ml, Right 180ml

Monday - Left 28ml, Right 120ml

Tuesday - Left 40ml, Right 120ml

Wednesday - Left 30ml, Right, 100ml

I feel like my temperature gage needs to be readjusted as I have been feeling the cold a bit more than I usually do. I'll put it down to the fact that seeing as I don't have two E (or F?) cup sized " hot water bottles" attached to my chest that makes a difference. The cold helps the itches though. Last night I slept with my arms out of my covers but my hands under a blanket. Awkward but effective.

My leg hair is coming back almost like it normally did which means it's a bit pokey and itchy at the moment. Not itchy like the hives. I was hoping that it wouldn't come back. My head hair is coming back. It's a combination of white soft fuzzy hair and darker thicker hair. Once it gets a bit longer I'll probably give it a buzz cut to help it even out. My eyebrows are starting to come back. At the moment they sort of look like I've had a smudge of charcoal drawn on my forehead.

I've been doing my exercises four times a day, about due to do them again now. I can tell that the "iron rope" around my chest is getting looser. At the moment I am not allowed to reach above shoulder height (hence why Mither had to hang up my washing today - she is bringing it in right now - thanks Mither) until the drains are out. Then there are new exercises to do. I am really looking forward to when I can lie on my sides again. I seem to remember last time it took a good three months or so before it was comfortable to lie on my right side for any length of time. I can't quite pick anything up off the floor yet. Bending at the waist is limited to sitting in a chair. Bending side to side is very limited.

Tonight I am going to a breast cancer support group at Tradies at Gymea. The guest speaking is from Restore Oncology Clinic and talking about exercise post cancer surgery and treatments. I have an appointment at Restore in a couple of weeks so it will be nice to meet some people from there.