Complications

Good Friday 6 April, midday

I was on the phone with Lara at about 8:30AM and she sounded pretty weak. Things hadn't exactly gotten better since we spoke shortly after midnight. So what happened?

Round about the time that our friend Caroline de Gruyter dropped by for an evening visit, last night, Thursday, Lara developed a temperature and she started shivering with fever. One has to understand that Lara normally temps at around 36C or lower and that 37C, for her, is already elevated. However, like last year, the nurses here are so fixated on the 37 level that they won't even call a doctor. They are programmed to do so only when a patient clocks at 38C! So Lara had to get sicker first before action was taken. Go figure.

This morning around 7:00AM her temp had risen to 39.4! That is a steep temp for an adult, and a fortiori for Lara.  A few hours before she had been put on two different antibiotics to fight a stomach/intestinal infection: Ceftazidime, Clindamycin, plus of course glucose and natrium chloride. Right now, she is too weak to get up from her bed and has to be helped with all basic functions. She looks like a high-end dish rag. No appetite for breakfast. Couldn't keep it down this morning. Her CRP was slightly up at 7:30AM (1.4) compared to yesterday's 0.04. The antibiotics and the Dafalgan have made her feel a little better, but she prefers to just rest. She also felt pressure on her chest, but signalled it is better now. Samples of everything have been sent to the lab.

Round about midday the doctors (unfamiliar faces to me, weekend staff) came by. They were reassuring, saying that nine out of ten patients in chemotherapy contract some kind of infection like this in this stage of the treatment, i.e. the onset of aplasia. Her temp was down to 37.0C.

Just so you know: Ceftazidime is a broad-spectrum antibiotic for both Gram-positive and Gram-negative bacteria. Together with Clindamycin (effective against anaerobic infections; look it up) they seem to cover pretty much everything that could be wrong in Lara's intestines. Culturing out samples will take two days, and test results will possibly lead to to more specific antibiotics once doctors know what animal they are dealing with.