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Injury & Hospital Stay #3

7/29/2014

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I'm hanging out in the hospital again, stay number 3 since starting chemo.  I just completed my 4th round of chemo on the 21st of July.  I actually received a slightly smaller amount of chemo during round 4 due to my two prior hospitalizations so I was hopeful that I wouldn't end up here this time.  Let's back up a little bit so you get the story here, I was scheduled to come in this Friday, August 1st, and have a procedure completed by my interventional radiologist and my urologist, in this procedure they would attempt to place a stent by inserting a loop via my bladder and a hook via my nephrostomy tube hole and meeting in the middle of my ureter.  

On Thursday, I was asleep on the recliner on our couch and turned over.  Apparently my nephrostomy tube had been hooked in the recliner in my sleep and when I turned over it pulled the tube a pretty good amount.  I have done this before so, although it hurt, I just pushed the tube back in to where it should have been.  I went on with my day and traveled out of town two hours to pick up my son who was with his grandparents.  The pain increased throughout the day on Friday and on Saturday I decided that I was going to have my son stay with his grandparents because it hurt too bad and I wasn't going to be able to care for him.  My husband drove me back to Indy where I took medicine and went to sleep.

I called the on-call doctor to see if there were any additional things I should be doing to alleviate the pain, or any warning signs I should be watching for.  We discussed options and I went to sleep for the night.  On Sunday I woke up and was physically unable to walk to the bathroom without being in immense pain.  I looked at my nephrostomy tube bandage and saw that it had green/yellow drainage on it.  I decided it was time to call the doctor again.  We discussed the immense pain and new drainage, he decided it was time to direct admit me to the hospital.  I have to say that was an interesting thing on a Sunday.  Admitting isn't open on Sunday so I just came in, picked up the phone, and they told  me which room to go and check in to.

Sunday was full of tests, medications, and attempting to nap.  I was able to eat until midnight, but after that I couldn't eat or drink just in case urologist or the interventional radiologist decided to do a surgery on Monday to attempt and place the stent and/or repair any damage I might have done when I pulled the tube.  I knew the tube was still in tact because it was draining.

Monday afternoon they took me down to meet the interventional radiologist, he reviewed my files with me and said he was going to attempt to place the stent but that he would be placing another nephrostomy tube until Tuesday when he could verify if the stent was working properly.  He showed us what the nephrostomy tube was suppose to look like when inside, which is a pig tail:


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This is what the tube should look like.  When I pulled it on Thursday that loop opened up and the pointy end was stabbing me from inside my kidney.  It was horrific!  The X-ray on Sunday confirmed that is what happened.  So, they were able to do the procedure to stop that pain on Monday evening.

On Tuesday morning they came in to let me know that I had a staph infection again (still?).  They said its possible the internal wound that was causing the staph infection had not closed up yet and caused it again.  I will be here a few more days while they try to determine which antibiotic to fight the staph infection with.  I'm hoping that doesn't entail going to the infusion center for ten days again but we shall see.

The stent placement was successful, however, my bladder was retaining urine.  When they cut the nephrostomy tube approximately 1 1/2 liters of urine drained out.  They were worried that the urine would continue to drain and leak outside my kidney so they placed a foley catheter for the next few days to allow the nephrostomy tube hole time to heal.  The interventional radiologist wants me to work with urology on the bladder retention issues now also.  The big win is the stent is placed and hopefully I will get the foley catheter removed soon too.
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There's a what in your back?

7/20/2014

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Since my cervical cancer reoccurrence was so far advanced, my right kidney was completely blocked.  We found out that there is a tumor which invaded the right ureter and blocked the urine from being able to get to the bladder.  On May 5th I had my first nephrostomy tube placed.  The interventional radiologist thought he might be able to get the stent in so he attempted again when I was under anesthesia already for my biopsy with the oncologist on May 9th.  They were still not able to get the stent in.  The interventional radiologist said we could attempt the stent placement again before the wedding after a few rounds of treatment.  On June 20th we attempted to place the stent a third time, this attempt went better as they could see that the tumor was shrinking but we were still unsuccessful at putting the stent in.  So, I still have the nephrostomy tube.  

The nephrostomy tube could be much worse for sure but it is still not ideal.  The most difficult part has been that I am unable to swim with my son, he is 5 and it is difficult for him to understand.  
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A little history...

7/12/2014

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I am currently having treatments once every three weeks of carbo/avastin/taxol. They take anywhere from it will take 8-11 hours.  As I mentioned before, this treatment is for a cervical cancer reoccurrence.

Here are some of the highlights of my journey so far:

Diagnosed with Cervical Cancer (due to bleeding with intercourse) - October 2012 Stage 1B2
Trachelectomy - November 16, 2012 (cervix removed and lymph node dissection).
Uterine Tear Repair - December 31, 2012 (I tore my uterus by lifting my son after surgery)

Blood in stool and urine beginning December 2013. Colonoscopy 1/18/14 indicated internal hemorrhoids, but no other concern. The blood in the urine continued intermittently, I would have bright red blood, sometimes only blood clots, sometimes strands of blood, and sometimes normal urine.

I was treated for an UTI with ecoli as the bacteria found in March 2014. The blood in my urine continued, I was referred to a urologist. Went to the urologist, they immediately were concerned about the possibility of cancer. We did a CT scan on 4/21/14. I met with the urologist on 4/22/14 and he said there were masses all over my pelvic area. My right kidney was completely blocked due to the tumor. He sent me to the hospital that day, I talked with the urologist and the oncologist resident. Since they were not going to do surgery immediately they released me that evening with an appointment with the oncologist on 4/30/14. At this appointment we discussed that the CT scans did not look good at all, which was surprising considering I had been in to the oncologist for my most recent exam on 10/2013. This was my regularly scheduled 6 month appointment.

Immediately he scheduled me for a biopsy and exam under anesthesia. I asked what else it could be, he told me it was cancer, there was nothing else that would be this large. 

On 5/5 I had a surgery to attempt to insert a stent into the right kidney. They were unsuccessful and I left with a nephrostomy tube and bag draining my right kidney. I was also scheduled for my biopsy and exam under anesthesia for 5/5 but the OR was full and we had to reschedule that procedure.

On 5/6 I had a surgery to put in the Baird PowerPort in preparation for chemo. That procedure went very well.

On 5/8 I worked a 1/2 day, it was hard but I am a teacher and state testing was going on so I really wanted to work at least a little.

On 5/9 we did the exam/biopsy under anesthesia with the oncologist. The interventional radiologist also came in and made a second attempt at putting a stent into the right kidney. They were unsuccessful with the right stent again, they actually had the stent threaded but when they went to flush it they realized it had actually inserted into the tumor and not the bladder.

So, the results of the 5/9 exam/biopsy indicated that the tumor extends from the uterus and is wrapped around the ureter. There are also three enlarged lymph nodes along my aorta.

I have since found out that the tumor has actually invaded the ureter, which is what is causing the blockage.

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    Author

    Erica is a 32 year old cervical cancer advocate who is out living cancer for the third time. When she isn’t advocating for cervical cancer and HPV awareness as a Cervivor Ambassador, she previously oversaw the STEM program at the school where she was an educator; she now helps coordinate the robotics program. Erica enjoys spending time with her husband and son in their Indianapolis neighborhood, as well as pursuing new and adventurous hobbies. She can most recently be found fawning over kayaks and daydreaming of returning to whitewater kayaking with First Descents, an organization for young adults impacted by cancer. 

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