My VAD site did not wake me all night. I did not need to fill my pain killer prescription. I woke about five minutes before my alarm went off and was pretty excited to take a tylenol. I spent most of the day with an ice pack on the site and it is not too swollen now. I'm actually very glad that it will get a chance to heal before I need to use it next week. It's swollen and tender and the last thing I would want is a needle into the middle of it infusing poison. Also, the bone marrow biopsy sites that happened right before or right after chemo took longer to heal and gave me bigger scars. Having a smaller scar on my neck will be a plus. A lot of people get their VADs implanted and come back from the OR with it accessed, ready to go. I'm glad mine is getting to heal first.
Other news from today is that I went out to lunch with Diane which was lots of fun. We went to the Loaf and Ladle and I had another bowl of that delicious fish chowder which is still highly recommended by me. It was so nice to see her and Friday is not a usual day off for Diane so it was a special treat.
I wound a nice warp this morning and started to put it on the loom and then I discovered that the back and forth movement right at chest level that one does when one warps a loom really sets off every single little bit of the VAD wounds. Drat!
I came close to caught up on my journals today and the August 30 NEJM has a great clinico-pathological case conference if you are into medicine. It's a great story, too and I won't say anything more than that.
I think it's bed time for me. Below the fold is today's VAD picture.
We all have wounds, surgical or not. I hope you are able to heal well. Me, too.
 |
| The colors are kind of washed out, but I am working on a most excellent bruise inferior to the site. I'll keep you posted. |
Mary...would you agree that probiotics are not a good idea in an immunocompromised patient? I do not recommend them to this population but patients repeatedly want to challenge me on this.
ReplyDeleteI'm not an expert at all (except in eating the neutropenic diet), but I would say absolutely no probiotics while neutropenic. The current thought about neutropenic fever (NF) is that one gets it from one's own bacteria escaping from the compartment they are supposed to be in, where they don't cause troubles and in fact are helpful. So, taking something to augment the bacteria living, say, in one's colon which is where a lot of NF problems start, seems foolhardy. I am unaware that anyone has ever done the study and doubt it will happen. OTOH, some neutropenic diets allow yogurt with active cultures and some don't so it's clearly not a completely decided issue.
DeleteMy thought would be, probiotics causing problems is consistent with what we understand about the pathophys of NF, so, really, why would you do it?
People can always make tradeoffs and decide that they are so miserable from the antibiotics that they are taking (as most neutropenic people have to) that they *need* their probiotics and I would certainly never disparage choices that some one else makes for themselves, but I would agree with you, that "probiotics are not really recommended, but that that would be an excellent question for your doctor. Some docs think it's ok and some don't."
Thank you for the detailed response. Nice to know that a knowledgeable doc supports my stance.
ReplyDelete