Infection and liver abscess – I know, I know, last yukky post!

I wanted to get this post done and dusted so that I can start writing about more joyful topics!

I touched on my infection in the last post. Infection is a reminder that even when surgery is over, there are still risks lurking! After returning home, I’d say about a week or so in, I started to feel ‘off’, I knew I would be fatigued post liver surgery but as usual my body was trying to send me a message and intuitively I knew something wasn’t right. I also had pain on my back around the right rib cage, painkillers were not working. I had my follow up with Prof. Ramos and he didn’t like the sound of my right lung and he referred me to radiology (also at Wits Donald Gordon Hospital). The sonar scan conducted by Dr. Charles revealed a build up of fluid around the right lung and the diaphragm. He said, he needed to perform a pleural effusion (drain fluid around lung) and insert a drain into my diaphragm under local anaesthetic (awake basically) and off he went to consult with Prof. I was with Neela, my mother-in-law, she was basically my caregiver after surgery, driving me to appointments and looking after me! I went and told her what had to be done and she kept Damian in the loop.

I wasn’t sure what to expect as I had never heard of any of these procedures, I guessed it wasn’t going to be pleasant though. I was sent through to a sterile room and laid on a bed with a sonar machine attached. I was administered local anaesthetic which hurt A LOT as the area was also tender from pain. The doctor then used the sonar to guide the thin tube (drain) from my right side (upper rib cage) to my diaphragm, this is probably one of the most painful procedures I have ever had, as the tube is pushing through muscle and tissue. The tube was then stitched in place and then the larger tube is attached to a plastic catheter bag which I had to carry. Next, he sliced another hole and drained all the fluid from around my lung. The nurse was so kind and held my hands which I had to raise above my head. Afterwards, I felt very woozy as I was still very much recovering from surgery so Neela got me home.

I had the diapraghm drain removed a few days later by Prof as not much was draining……erm big mistake. I was soon back again having another drain inserted on the 22nd September! Long story short, I had three diaphragm drains, the last one was inserted in the 12th October as the second one was dirty and blocked and two pleural effusions (second drain on 12th October was one litre of fluid and they cut from the back of the ribs). Early October (2nd), I had a large abscess drained from my liver (27 ml of pus),  Dr. Charles made an incision in my existing scar and pulled out a bunch of gross brown pus, he also drained 80 ml from my diaphragm before the drain was inserted. The scar incision leaked (brown pus) and I had to clean and dress it everyday. You get my point, I am sure you are as confused as I was. The dates merged and it’s only because I made some random notes that I am even able to tell you this story! It was a nightmare. The pus and fluid was tested and I was told the bacteria did not culture. Basically, go home and wait it out.

I saw Adam (oncologist) on 16th October and he was shocked to hear that I still had this diaphragm drain and was not on any treatments for the infection. My usual blood tests revealed that I had an infection marker of 239, 5 being normal. No wonder I felt so bad and looked a nice shade of grey. My blood platelets were also 9.0 which meant I needed a blood transfusion. I had fluids in the clinic the same day and I began IV antibiotics as an outpatient, I could not have coped to go back to hospital. Neela drove me to the clinic on weekdays for my IV antibiotics and I used our local GP at the weekends, I did ten days like that then five days oral antibiotics. I had two bags of blood on the 19th October which made a world of difference, I was almost human again! By the 26th October, the diaphragm had stopped draining the infected pus and I went across to radiology to have it removed! To have tubes stuck in you is awful, the referred pain is horrid and it is very difficult to sleep comfortably, also Arabella had to be so careful round mummy. So, when it was finally over, we were more than ecstatic!

I have slowly been introducing exercise (I joined the gym) and feel great. I had a minor hiccup where I was worried the infection was back but it was nothing and only a small build up of fluid where the second incision had been made. That is shrinking slowly. CT results show a healthy body that is infection and cancer free! Adam did tell me that from the CT results, the fluid around my lung that had been drained was the size of two cricket balls….erm ouch! Going forward, I will start my biological treatment on 4th January 2021 which is administered through my Portacath, it will prevent cancer recurring, there are no side effects and I go to the clinic, have the drip and leave!