Infections
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lmcnish
When my husband Tom starts w/an infection….he rarely has a fever, so in his case we watch for him being unusally tired and worn out. Chills is another sign we watch for. He was on long term medication, Levaquin (YES it is very expensive, Cipro not so much) but after his latest bout with an infection in the liver, they have decided that the long term antibotics are not working for him, so now we are having his external drain tube changed out every 4 weeks, in the hope that it will cut down the rate of infections.Anyone with any kind of an indwelling tube runs the risk of getting an infection and it’s generally from the tube. Each time they have tested Tom’s blood, urine, sputum which all are fine, then I have to suggest that they test the contents of his bile drain bag….and sure enough that is where the infection is! (I could be a doctor!) Common sense should prevail and they should know that 9 out of 10 times it is going to be the bile!
A person can be on long term antibotics for any length of time, however, you then run the risk of the ‘germs’ becoming super germs (super bugs) that are resistant to antibotics. After Tom’s last infection they had him on a three week regime with three different HIGH / SUPER strength IV antibotics and the infectious disease team told him that the levaquin was doing nothing for him and recommended that he stop taking it.
Not sure what the answer is for sure, each person is different and each person’s doctors have different ideas. Hope this has helped somewhat!
Go with God and KEEP KICKIN’ THAT cancer!
Margaret
As others have said, it sounds like cholangitis and needs to be treated with antibiotics asap. I have been having recurring episodes for a 1-1/2 years and now keep antibiotics with me. The minute I have symptoms I take an antibiotic and watch for spiking temperature, rigors (uncontrollable chills), nausea and dropping blood pressure. If symptoms worsen I get to the ER quickly.
God Bless,
bobI’ve had cholangiocarcinoma for 3 1/2 years. In my experience, fevers indicate cholangitis, and cholangitis can cause or be caused by the stents blocking. Sometimes I take antibiotics right away when I see and feel the symptoms coming on (fever, dark urine) and sometimes the antibiotics work. Sometimes they don’t, and I need a stent replacement ASAP. Please don’t wait to see if your dad gets sicker. Run, don’t walk to the doctor and hospital right away for treatment. When I wait, I get really sick and am in the hosptial for a week at a time. You have to nip the infection in the bud, so to speak.
Lately I have noticed symptoms of cholangitis coming on two or three days after chemo. I think it is because my blood counts are low and I can’t fight the burbling infection without the help of antibiotics. I am going to speak with my oncologist about this on Monday.
I asked the infection disease specialist doctor who practices in my hospital about how long can a patient be on antibiotics ? eg. for bone infection or chronic cholangitis.
He said in his group of practice, he has patients that are on long term antibiotics like vancomycin (for bone infection) for months and Cipro or Levaquin for years. It is not common but necessary for some patients.he prefers Cipro (ciprofloxacin)because it is much cheaper than Levaquin.
As a few of you mentioned above ,it is always a good idea to prepare and watch for signs like
fever(>39C or 102F);or even lower depend on patient.
persistent abdominal pain;esp. right upper quadrant.
jaundice.
For elderly CC patient and patient taking corticosteroids(eg. dexamethasone)add hypotension and confusion as symptoms to watch for and seek help accordingly.
I hope the above info.helps.My Dad is on constant antibiotics to help prevent infections, Ciprofloxin (sp), perhaps you could ask your Doctors about this. My Dad has 3 metal stents and an external drain. The stents being metal can’t be replaced, so I take it your Dad has plastic stents.
I know when Dads stents have become blocked his jaundice re appeared, therefore his bilirubin was raised. They also told us to look out for itching, dark urine and fever/chills.
Best wishes
Andrea
Dear Imcnish – My son used to run high fevers and — many times — they could never find the source. They would do blood culture after blood culture which would always come out negative. He would be on antibiotics for a few days and then be fine., Then the fevers would come again! It was very frustrating. His stent had to be replaced more often than the “norm.” I personally would wait to see how he is doing and if the fever returns, push for stent replacement. It’s very hard when you’re dealing with such high fevers…scary when you are 2 hours away….very understandable that you are a bit afraid. But, I think I might still wait and see…..hope this helps.
Dear Imcnish, Mmmmm this is a tough one. Do you have an ONC locally that your dad is using that you could call and ask what he thinks. I am thinking that if the infection has cleared they will not deem it necessary to change the drain yet. In that case you will just have to moniter dad closely for rises in temps. I am so very glad that you had such a wonderful Christmas as so many Memories were able to be made. Good luck on the stent.
My dad was diagnosed with cc on October 2, 2010. He has had 2 stents and we were blessed to have him relatively healthy over the holidays. We got to play our annual 3 cent limit poker game with the family on Christmas Eve. He also celebrated his 90th birthday. Great fun and wonderful memories!
On January 2 he had a fever of 102 and was nauseated. we took him to the ER and he was told he had flu. We thought differently and pushed to have him admitted. he has been hospitalized for the last 5 days with a blood infection. I know infections are common with CC, but I do have a question. They have eliminated his heart, lungs, kidneys and urine as the source of the infection. I am assuming it is coming from the stent. We have had the stent replaced just on a regular schedule. He is not due to have this stent replaced until the beginning of February. Do you think this is the cause? Should I push to have the stent replaced earlier? He is now home and the infection is cleared, so do we wait and see? The problem I have is that we are 2 hours by car from Mayo Clinic in Rochester and he gets so sick so very fast. It would be so hard on him to drive that far when his is that sick to be admitted for the ERCP. Any thoughts or ideas you have would be appreciated.
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