The Abscess

Well, we didn't accomplish any of our goals yesterday.  Rather, there was enough concern over his increasing pain and redness near his incisio, that we performed a CT scan.  J was a trooper drinking the nasty drink we force people to take when we need to know what part is bowel and what part isn't.  The scan is pretty quick, so it wasn't as difficult as the MRIs he has had to endure.


Where the mass in the pelvis had been is now a big fluid and air collection.  It extended into the the incision, definitely the cause of his pain.  This is what an abscess looks like.  My guess is that as the tumor died, it turned into a liquid goo (medical terms here) that any bacteria would see as a paradise retirement home.  Somehow the bacteria found it and have been growing.  The body tries to wall it off to contain it, but unfortunately that prevents it from being treated by antibiotics.  The only treatment is to open up the wall and get the bacteria out.  This can happen by poking a small hole and placing a drain, letting a surgeon cut it open, or letting it grow bigger and bigger until it bursts open (not the preferred method of draining, in case you were wondering).

Since his platelets were low, it is a decent bleeding risk to perform any procedure.  He had to get a transfusion of platelets to get his counts to a better level.  After the platelets were going, he was taken to another CT scanner where we do simple procedures.  He was put to sleep by anesthesiology, and with guidance from the CT scan, a drain was placed.  All this happened in the middle of the night.  He left his room at about 12:30 am.  We were back in his room by about 3:30 am.

We'll see how long it takes, but this should help to stop him from spiking fevers.  This should also significantly improve his pain.  Now if he could only get some rest.  With morning rounds, nursing shift changes, beeping IV pumps, and pain, it's difficult to get any sleep.