Following Up

Okay, say this four times rapidly: CEFUROXIME AXETIL. I sat holding the little amber jar in my hand and started at the label saying sefum, sefor-ix  a meh. And then just asked the doctor what it was. “This isn’t one of those superdrugs to fight MRSA or something, is it? I mean, I’m not going to start sloughing skin like a leper or something, right?”

“No no.” replied my doctor. “It’s a very potent antibacterial agent that we only use in cases where we’re combatting a severe and well entrenched bacterial infection. You pneumonia qualifies, especially since it’s spread itself beyond your lungs and is invading other areas of the body. You need to take the full regimen –that is, take every single pill, and make sure that you take this drug with food. It can be a little hard on the stomach. In fact, we’re giving you a little Omeperazole to reduce your stomach acid.”

“It’s a pretty big pill,” I said, looking at one. It was like a one inch long segment of a pencil.

“Take it with a big mouthful of milk and take it separately from your other meds so you don’t choke yourself.” I nodded my assent. “How are you getting along with the oxygen?” he asked me.

“Well, it’s made a big difference in a number of things. I was getting weird vision flashes and having difficulty focusing on stuff, and would run out of air just trying to talk to people. I breathe a lot easier and that weird stuff has gone away.”

“Good. Your oxygen density was down in the high seventies and making your heart work extra hard trying to get oxygen to the organs of your body, especially the brain. Heart attack and stroke are likely results if your oxygen isn’t pumped back up to at least the mid 90s.” He looked at the oximeter on my finger and said “see, your heart rate is 72 and your oxygen is at 96. That’s pretty good but it’s taking us pushing 2 liters of oxygen up your nose to get those values.”

“How long will I have to wear this thing in my nose?” I asked.

Probably between six weeks and the rest of your life. It depends on how well you respond to the treatment. Your pneumonia was masked by the pain and other symptoms of your cancer lesions and so it had a good, long chance to spread and take a strong hold on you. Your lungs are damaged and part of that damage is permanent.  We’ll do all we can to get you off the oxygen, but your ability to absorb and distribute oxygen will dictate the action we take. Keep in mind that your red cells are low, your platelets are low and you’re anemic, so your whole system is suffering. It’s not just the pneumonia, it’s that and the Multiple Myeloma that are working you over. You’re getting a one-two punch here so take the meds, get plenty of rest, try to exercise and and eat well.”

“Okay, how come you’re giving me lasix?”

“The Furosemide is to make your body purge water. Your illness and the meds we’re giving you tend to make you retain urine and so the lasix pushes it out. Note the edema in your ankles; that will go away because of the furosemide. The potassium is to make up for the fact that lasix will reduce your system potassium, and that can cause irregular heartbeat and other risky situations.”

“Well, this was a pretty crappy way to start the year.” I complained.

IMG_20140105_174900[1]“It’s been a bad year on a number of basis’ …the influenza season is on us and we’re seeing a much larger spread of mutations (types of flu) affecting people, and they are spreading more rapidly because they’re passed by both physical contact and breathing each other’s air. There seems to be more global travel going on this year and so we’re getting hit by viruses from all over as well as exporting ours to other countries. It’s a serious situation and people are dying because of it.”

“Yeah, I heard. I was sent a notice to report for a flu shot.” I said.

“Well, in your case, don’t. All it will do is give you a case of the flu because your system is too weak to create the antibodies flu shots are for. You already have a nasty bacterial infection and to add a virus to your woes could be catastrophic. I’ll put a note in your file so you won’t be inadvertently given a shot.”

“Okay, well, I stopped by the lab and gave them the blood samples you asked for. They took 9 little vials of blood from me and then handed me a cup and sent me to the rest room.”

“I know. I have the results back. It’s how we know the infection is in your bladder and stomach. But we should make short work of that.”

“Thanks. The idea of being sick makes me nauseous.”

“Good one. I certainly never heard that one before.” said my doctor, pokerfaced. “I want a followup xray in six weeks. Go in around the first or March and I’ll have an order in for you. There’s no need to make an appointment. Xray now works like the blood lab. It’s walk-in.” My doctor held out his hand indicating we were done. I shook his hand and thanked him for his help. “It’s what we’re here for,” he said, “but it’s nice to hear appreciation anyway.”

My wife stepped up behind my chair and rolled me out of the office and out to the parking lot. Time to go home and take a nap.