[2023-07-27] Setbacks and recovery day 20
So this was to be the day my second drain came out. It didn't go to plan.
As I was writing last night's post, I was conscious that I felt warm, something that's uncharacteristic for me. I took my temperature. I was running a fever, which is never something you want to experience soon after surgery.
I contacted Telehealth Ontario via online chat and requested that a nurse call me. When Nurse Meghan called and had heard my story and asked a series of questions, she recommended that I go to emergency. Ever one to err on the side of caution when it comes to my health, I headed to the emergency department at The Ottawa Hospital's General Campus. It's not the closest hospital to me, but it is part of The Ottawa Hospital, which is where I have received all my treatments since 2020.
The General emergency department was packed when I arrived at 9:30. Nevertheless, I was checked in at reception almost immediately, triaged by nurse Amarpreet at 9:35, and registered by Emily by 9:40. Amarpreet advised that they would do blood work and if my results in MyChart looked OK, I could decide to go home at that point, as the queue to see a doctor was many hours long. That seemed like a good plan. So I sat down to wait. Some 40 minutes later, at about 10:20 PM, Amarpreet took a blood sample to send off to the lab. And 40 minutes after that, at about 11:00 PM, the first results started showing up in MyChart. I was encouraged by these initial results. I texted them to my niece, the nurse: Creatinine. Glucose. Urea. Electrolyte panel. All normal. She replied that those results would be normal. The important test was still outstanding: my white blood cell count. That would provide an indication of whether I was fighting an infection.
Finally, at 1:30 AM, the last set of results came in. White blood cells 6.9—within the normal range but very high for me (I'm usually at about 3.8). Neutrophils 5.83—within the normal range but very high for me (I'm usually at about 2.8). By then, though, my fever had subsided. I spoke to a nurse who reiterated that I could go home and follow up in the morning.
I called Chris to pick me up. He had gone home to nap after having dropped me off. By the time he arrived at the General and we had returned home, it was 2:45 AM. I had not yet slept and was exhausted. Though I hadn't accomplished a lot from my five hours at the hospital (except for a lot of Duolingo), I did leave with those blood results, which corroborated that something was up.
By the morning, my temperature continued to move in and out of the low-grade fever range. I called The Ottawa Hospital's Breast Health Centre and asked that a nurse call me back. The receptionist told me that it could take 24 to 48 hours to receive a call back.
Next, I called my surgeons—both on vacation. I called the Riverside Surgery Department—closed for vacation. I called the General Plastic Surgery Department—closed for vacation.
My first bit of luck came when I called the office of my family doctor (she, too, is on leave) and miraculously landed an appointment for 1:30 PM with a doctor filling in for mine. I also contacted CBI Health home and community health services to ask whether my appointment for drain removal, which had been scheduled for 1:00 PM today, could be moved to Friday. It could. That made it possible for me to talk to a doctor before moving forward with drain removal.
I met Dr. Carnes at 1:30. Immediately, she put me at ease. As I would discover, she was thorough, compassionate and proactive (and reminded me of my family doctor, Dr. Daverne). I explained my story. Prophylactic bilateral mastectomy with immediate reconstruction almost three weeks ago. One drain out, one drain still in. Fever. Some chills. Trip to the emergency. Elevated white blood cells and neutrophils. A warm, red spot on my right breast (the one with the drain). Dr. Carnes listened attentively, reviewed my online charts, took notes, and backed up everything I was saying. The next step was to check my breasts. Her visual and physical inspection confirmed that I had an infection. She prescribed antibiotics—a high dose to hit the infection hard. She wrote a requisition to repeat much of the blood work from my emergency visit, to see whether the infection is getting better or worse. And she committed to following up with the Breast Health Centre to get clarity on when my drain should be removed. For now, it remains in. She would like me to be on the antibiotic for 48-72 hours before the drain comes out, even if that exceeds the three-week threshold. Though she didn't say it, I found myself thinking—once again—that the drain is my friend. Dr. Carnes explained that the drain would give an outlet for the fluid that often builds up when a body fights an infection. That explained why my volume of drainage has been increasing rather than decreasing. Dr. Carnes indicated that the risk of infection associated with having a drain in for more than three weeks is mitigated by the fact that I will be on antibiotics. And, I thought, it's a moot point, as I already have an infection. So my drain will remain for at least another 2-3 days, likely more.
After my appointment with Dr. Carnes, I headed to the Bio-Test Laboratory in Bells Corners. There was only one patient in the waiting area. More good luck. I was served right away. I provided a sample of the fluid from my drain, which will enable the lab to do a culture and determine exactly what type of bacterium I have.
Then it was off to Kanata Costco. I called the Pharmacy, requesting that they fill my prescription as soon as possible. Most non-urgent fills and refills are done within 24 hours, so I was immensely grateful when the receptionist confirmed that they could have it ready for me in 30 minutes. Even more good luck.
The end result of all of this is that less than 24 hours after experiencing a fever and discovering a warm, red spot on my breast, I am on antibiotics.
Dr. Carnes was incredibly empathic. Her key messages were these. I'm sorry you're going through this, especially after everything you've been through. We can fix this. You will get better. This is just a bump on the road.
How lovely that was to hear.
