Anyone with persistent Abscess and strong cramping STG IV

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Griffcl
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Joined: Mon Oct 30, 2017 7:57 am
Facebook Username: Chad Griffith

Anyone with persistent Abscess and strong cramping STG IV

Postby Griffcl » Mon Nov 20, 2017 4:08 pm

So the wife hit a road bump 5 weeks back. Some fever and pain so we went straight in. They identified an abscess, drained and treated with oral antibiotics, including flagyl which was rough on her. "Stomach cramping" picked up about two weeks ago, thought it was just form the antibiotics. Last Monday night she was vomiting every 15-20 minutes with severe stomach cramps. We went in first thing Tuesday, the abscess was back!

They put in a drain and and ran x-ray for small bowel obstruction, clear. She was better Thursday morning. Thursday night cramping and nausea were back and bad. The only thing that helped was phenegran and really only because it knocked her out.

Ran a CT last night, found additional fluid in her lower left side. Not too worried because there has been no pain in that area.

Now they are thinking the pain may be cancer related instead of just inflamed or partially obstructed bowels. I should mention that the two CTs she received lately showed no additional lesions or physical cancer growth.

She is freaking out and I'm beginning to lose my positive attitude. She is in getting an MRI at the moment. They are trying to clear her to resume chemo, FOLFIRI +Avastin, for tomorrow. So it really sounds like they are concerned with spread further into the bowels.

She is already Stage IV with mets to the peritoneum, but thus far they have remained localized in the lower right quadrant.

We could really use any positivity or experience with a similar situation at the moment. Much love! And thanks in advance!
Husband of Fighter!
Diagnosed 5/17 Age: 33
5/17 CR Adenocarcinoma 5x6x6 cm, T4NoMo
No Lymph nodes and clear margins
6/17 Began Xeloda
7/17 PET Showed additional activation
7/17 Lap discovered mets to Peritoneum
9/7/17 Began FOLFIRI
9/20/17 Added Avastin (bevacizumab)
10/17 Abscess on two tumor sites, treatment on hold
11/15 Readmitted, drain placed in abscess, partial small bowel obstruction, fistulas present
11/22 Discharge with drain, resumed FOLFIRI

veckon
Posts: 111
Joined: Thu Jul 27, 2017 7:44 am

Re: Anyone with persistent Abscess and strong crampi

Postby veckon » Mon Nov 20, 2017 8:20 pm

Sounds familiar to what I went through beginning around May. Ended up being peritoneal carcinomatosis. Where is her abdominal pain exactly? Does it feel like it’s near the bladder?

Edit: I missed the fact she already has been diagnosed with peritoneal spread. So... the only thing that helped me was immunotherapy.
27 yo male
Metastatic rectal cancer diagnosed 12/16
Liver metastases and peritoneal carcinomatosis
Lynch syndrome, MSI-H
Failed liver resection 3/17
FOLFOX6 12/16 - 05/17
Keytruda 5/17 - present
@Memorial Sloan Kettering

Mercy110
Posts: 73
Joined: Wed Aug 16, 2017 12:13 am

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby Mercy110 » Mon Nov 20, 2017 9:32 pm

I am so sorry to hear that. I will pray for both of you. Hopefully the MRI is still clean!
Daughter of Mum age 56, NRAS-mutate Q61R
2017-05: Surgery done. Temporary stoma. Path: T4N1M0. Stage3C. Chemo - Xeloda. Rejected radio. CEA: 7.3
2017-08: CEA: 8.0 (1st) CEA: 9.8 (2nd) CT Scan: Multiple lung nodules. Stage4.
Start from 2017-09: Chemo - FOLFOX + Avastin, 85% for serious diarrhea CEA: 7.0, 4.7 (10/10), 3.7 (11/10), 2.9 (12/3)
2017-11: Stable Multiple Lung Nodules from CT

WISH ALL MIGHTY GOD HEALS MUM WITH HIS MIRACLE

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bitchslapped
Posts: 1360
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby bitchslapped » Tue Nov 21, 2017 7:13 pm

Duplicate...not sure how that happened :roll:
Last edited by bitchslapped on Tue Nov 21, 2017 7:20 pm, edited 1 time in total.
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07 fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia

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bitchslapped
Posts: 1360
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby bitchslapped » Tue Nov 21, 2017 7:18 pm

Have you considered sending her records for 2nd opinion @ a major cancer center such as MD Andersen, Houston or MSKCC, NY if your insurance allows travel, that is. Might be worth the trouble considering all the trouble you currently are having. Of course you've got to get these abscess fires or what is causing her pain put out. Not sure just what you are referring to as "additional fluid" on DW's left side, but that sounds concerning as well.

Wouldn't surprise me if the abscess is still the problem & to some degree has been from what I gather from your post. Was she getting weekly IV antibiotics on an out-patient basis @ the hospital or followup w/doctor of infectious disease? You might remember I mentioned this in your previous thread.

Just seems like you guys are getting jacked around from the get-go, lack of cohesive care...possibly due to location. If you are not living in the vicinity of a comprehensive cancer center, that can explain some of that. Some lesions are too small to show up on CT scans + scans are only as good as those reading them or not caught b/c they are in between the "slices" so to speak of the scan. Think film editing splices.

My only experience to share, again, is in the case of my DH, abscesses (cysts)of the liver caused life-threatening sepsis TWICE, emergency situations. No stomach cramping; high fever, chills, dropping to the floor due to extreme drop in blood pressure. It comes on & it's fast. It could very well be a combination of things going on w/DW right now. Hope the docs are diligent in getting this resolved. Lot of stress going on for you guys!
Let us know how your DW's scans turn out.

Best Wishes
BS
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07 fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia

Griffcl
Posts: 7
Joined: Mon Oct 30, 2017 7:57 am
Facebook Username: Chad Griffith

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby Griffcl » Fri Nov 24, 2017 1:49 pm

So, here is where it all stands as of right now. Two CTs an MRI and and X-Ray later. Her Primary Oncologist, Surgical Oncologist, and Infectious Diseases have been working and talking together on a daily basis. This is where everything has settled for now.

Partial small bowel obstruction.
Severe matting of small bowels
Possible fistulas
Leakage of fecal matter


So the pain is coming from the partial small bowel obstruction.

The abscess is being fed by the small bowel leakage, thus the reason we were right back in. Infectious diseases has verified the bugs and their susceptibilities. IV meds have kept everything back and in check, drainage has decreased and now changed. What is draining is not abscess fluid it is now fecal in nature, green/brown and smells horrid.

Even in the face of this her surgical oncology team does not want to go in. They say an attempt to fix a small fistula and to fix the partial obstruction would be temporary and create more adhesion. Which is understandable. A temporary fix that delays treatment is not optimal.

Plus side further imaging shows no sign of tumor growth and her CEA continues to decline from 35.7 on 10/18 to 21.3 as of 11/22. So she went ahead with her fifth treatment. They are holding Avastin, just in case they have to go in and do something.

Her Surgical oncologist, Dr. Greggory Kennedy, reached out to a close colleague, Dr. Fabian Johnston, at Johns Hopkins to discuss a few things. This also included vetting options for HIPEC, which everyone is still in agreement is an option especially with the affect chemo is having on the cancer. Dr. Johnston recommended Dr. Joshua Winer Emory, whom we have already had a consult with. He did hios training at Piuttsburgh and urged us to reach out to other doctors if we wanted to. It was good to get some information back regarding steps to go form here.

What is interesting is seeing the recommendations and thoughts that the doctors have regarding HIPEC. Number of procedures and experience appear to be the largest factors and determinism in effectiveness of the procedure. Dr. Winer performed 344 last year and has averaged 31 since he began. Emory's HIPEC specialization unit preforms an average of 90 per year. MD Anderson has not been recommended. Three different doctors cited other facilites with much better resultss more experience, they were very particular not to discredit MD Aanderson, but cited proof in experience. Nothings set in stone, but its nice to have a road map with a couple of options.

Thanks for the concerns BS, there are times when Ive felt like we were being jerked around, but recently the cross communication within the teams has been amazing. UAB is a learning hospital, but both her surgical oncologist and medical oncologist have been more than available and responsive. Her surgical onc and medical onc are both well respected and came highly recommended. This whole hurry up and wait game is just what is so damned frustrating. The complications recently just further expand on that.

She was released Wednesday. We got to spend some time together with the babies yesterday. She over did it on the food because she felt so good. She has been cramping all day. Its like one step forward two leaps back. Like you mentioned BS I'm concerned with sepsis. We are monitoring her temp every hour, so far the only issues she is having are the cramping and nausea associated.

Hoping this will work its self out today and I can report back that she is doing better and better.

Thanks again for all of the input and thoughts.
Husband of Fighter!
Diagnosed 5/17 Age: 33
5/17 CR Adenocarcinoma 5x6x6 cm, T4NoMo
No Lymph nodes and clear margins
6/17 Began Xeloda
7/17 PET Showed additional activation
7/17 Lap discovered mets to Peritoneum
9/7/17 Began FOLFIRI
9/20/17 Added Avastin (bevacizumab)
10/17 Abscess on two tumor sites, treatment on hold
11/15 Readmitted, drain placed in abscess, partial small bowel obstruction, fistulas present
11/22 Discharge with drain, resumed FOLFIRI

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bitchslapped
Posts: 1360
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby bitchslapped » Sun Nov 26, 2017 1:13 am

Griffcl wrote:What is interesting is seeing the recommendations and thoughts that the doctors have regarding HIPEC. Number of procedures and experience appear to be the largest factors and determinism in effectiveness of the procedure. Dr. Winer performed 344 last year and has averaged 31 since he began. Emory's HIPEC specialization unit preforms an average of 90 per year. MD Anderson has not been recommended. Three different doctors cited other facilites with much better resultss more experience, they were very particular not to discredit MD Aanderson, but cited proof in experience. Nothings set in stone, but its nice to have a road map with a couple of options.


Yes, CRS surgery for removal of mets is most important, but those #'s are hard to find since most hospitals don't post their stats & MSKCC or MD Anderson not necessarily top for HIPEC imo.

Your DW certainly does have a few complications going on. I am all too familiar w/fistulas & drainage tubes/bulb, stench of brown/green gastric fluid (no fecal leaks). We were told @ temp of 101, head to the ER. So it sounds like the game plan is to leave everything alone as is, continue w/chemo w/focus on reducing peri mets. Which leaves me w/the question of: just what will be the determining factor of HIPEC readiness in your DW's current situation?

Assuming biopsy taken of peri mets to be of colon cancer origin. Has DW had any genetic testing through bloodwork, + tumor marker testing for mutations? Not seeing on your sig.

Best Wishes
BS
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07 fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia

SweetC80
Posts: 72
Joined: Fri Sep 01, 2017 1:28 pm

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby SweetC80 » Sun Nov 26, 2017 8:03 am

No advice, but following because my mother is in the hospital with an abscess now (first one), she will be on IV antibiotics for 3 weeks.

Hope you find answers for your wife and she's feeling better soon.
Mom's history
68yo at diagnoses
12/16 Stage IIIb Rectal Ca CEA 1.2
1/17-2/17 Chemoradiation CEA 4.4
5/17 Entire Colon, Rectum and Anus removed Perm Ileostomy Bag
7/17 FOLFOX
9/17 Stage IVb 9cm Liver Met and suspicious 7mm Lung Nodule CEA 197
9/17 Irincotecan CEA 160
10/17 Confirmed KRAS Positive CEA 210
11/17 Met growths, Liver 10cm and Lung 8mm CEA 425
12/17 Onco Apt to discuss options after treatment for abscess. Mom's not giving up

jep
Posts: 37
Joined: Sun Jun 11, 2017 7:45 pm

Re: Anyone with persistent Abscess and strong cramping STG IV

Postby jep » Sun Nov 26, 2017 5:33 pm

Hi, I'm so sorry to hear about all of your wife's complications....my husband also had a very rough road after open surgery in May....his fistula still has not healed and he has had a surgical drain for 6 months....is your wife on a restricted diet? My husband is still on the low fiber GI diet....
Husband DX Stage IV CC on May 16, 2017
47 years old
Tumor Location: recto-sigmoid
Tumor type: Adenocarcinoma
Tumor size: 7.4 cm
Tumor grade: G3
TNM code: T3N2M1
Positive lymph nodes: 8 out of 20
Baseline CEA value: .9
LVI: present
Perineural invasion: present
Surgical margins: clear (w/in microns)
Primary surgery type: LAR


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