Sunday, December 24, 2006

Four Doctors and a CT Scan

The swelling and discoloration of skin on my right chest have gotten much worse despite three days of antibiotics. I’ve been to see four doctors today: my medical oncologist (chemo doc), radiation oncologist, surgeon (who solved my last medical mystery), and reconstruction surgeon.

The two oncologists and one of the surgeons still think it’s most likely an infection, but the infection is under the implant so the antibiotics are having a hard time getting to the site. Apparently, this is because the tissue under the implant has formed a protective layer against the foreign body, so the antibiotics can’t penetrate to the infected area as well. Or... I’m resistant to this antibiotic. My oncologist has put me on two new antibiotics now:
Augmentin - 625 mg. twice a day
Dalacin C (Clindamycin) - 300 mg. 3 times a day

So the two oncologists are still treating it as an infection, but they say we need to consider it might be cancer again. The cancer cells might have come back in the chest wall muscle or in the skin above the implant, or both. So they sent me for a CT scan.

The surgeon did an ultrasound of both breast implants and said the swelling on the right side was edema (swollen tissue) and not fluid.

The reconstruction surgeon thinks it’s mostly likely ripped scar tissue inside the chest cavity from overexertion. That ripping might have caused bleeding and swelling. Or it could have caused an infection. If the infection invades the implant cavity, fluid would form around the implant and could break through the skin and ooze out. But this usually happens just after surgery, not two months after, as in my case. If this is what’s happening, I’ll have to have another surgery to remove the implant. If it’s just ripped scar tissue, it can heal on its own if I limit use of my right arm and chest muscles. But just in case it IS an infection, I should go along with my oncologists and take the prescribed antibiotics. He says it’s unlikely it’s a recurrence of cancer.

Bottom line: nobody knows for sure. Looks like an infection or ripped scar tissue or both. Very slight chance it could be cancer, but highly unlikely. But we’re all just guessing here. Let’s just treat it as an infection and see what happens.

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