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#57579 12-26-2005 06:16 PM
Joined: Nov 2005
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Mary M Offline OP
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Hi - just wondering if any of you have experienced what seems like it might be an infection at the site where the PEG enters the abdomen. John finished treatment over 2 weeks ago and yesterday ( Christmas!) showed me a bump at the edge of his PEG incision. This morning the bump had disappeared but the site itself - all around the PEG - is very red.

I keep taking his temperature and it has risen slowly over the last 24 hours from 36.7 to 38 and has now fallen to 37.4. The doctor stressed that we go to emergency if his temperature ever reached 38 but we held off for an hour to see if more liquid would help bring it down. We do not want to brave the nightmare of the extremely busy ER on Boxing Day evening if at all possible.

He has also had a particularly high level of nasal congestion over the last 2 days.Could they be related somehow?

We will definitely go the hospital first thing tomorrow. If the PEG site is infected, I hope they don't have to remove it because he stopped eating by mouth about 4 weeks ago and is still completely dependent on the tube.

Mary


Caregiver for John SCC left tonsil Stage III/IV dx Sept 05, tx started Oct 21/05 -IMRT 35, cisplatin 3 X 100mg/m2;completed Dec08/05.
#57580 12-26-2005 09:28 PM
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It sounds as though you have correctly diagnosed your problem, but you need to go as soon as the doors open and get this thing looked at. Don't wait or put it off until another day. The earlier you can catch the infection and get him started on antibiotics specific to the infection, the better chance you have of curing it before it goes systemic and REALLY puts him in a hospital room!
Keep us posted,
Andrea


SCC L lat tongue,Dx 9/15/05 T1N0MX L MND and L lateral hemiglossectomy 10/03/05. Recurrence 11/15/06 2nd surgery 12/04/06 hemiglossectomy 3rd surgery 01/15/07 tonsillectomy Radiation 01/25/07 to 03/08/07 3-D/CRT X 30
#57581 12-27-2005 08:25 AM
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Mary - Peg sites are infamous for getting irritated. The tube is basically preventing a serious puncture wound from healing completely. The constant movement of the tube in the site from breathing, coughing and sneezing are all keeping it tender and vulnerable. Sometimes yeast infections will start on the skin around the site and can be painful. Lowered resistance from treatment can let all kinds of infections get started at any vulnerable site on the body.

Those of us who live with our Pegs have learned to be really watchful and cautious of infection. There are anitbiotic creams that can soothe the skin around the site and help prevent infections, there are many oral antibiotics that can help get an infection stopped and quieted. And sometimes, the site is just angry looking and sore.

Don't underestimate how quickly a Peg site infection can spread. Lowered resistance and weakness after treatment makes him a target for flash infections. Red streaks on the skin near the site, swelling, excessive redness, discharge from the margins of the opening, and fever are all serious indicators and deserve immediate professional attention. When in doubt - go see your doc. Let us know how he is doing. And let us know how YOU are doing too. Be strong. Tom


SCC BOT, mets to neck, T4.
From 3/03: 10wks daily multi-drug chemo,
Then daily chemo with twice daily IMRT for 12 weeks - week on, week off. No surgery. New lung primary 12/07. Searching out tx options.
#57582 12-27-2005 08:59 AM
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Yeah, I think if he has a fever you should see a doc ASAP before it interferes too much with him geting nourishment through the PEG.

I had what seems like a little bit of pus that started oozing from my site about 4 weeks ago and I put antibiotic cream around the site, washed it with those disinfectant wipes three times a day, and put a gauze bandage on it which I taped so it would stay close to the place where the tube comes through (normally I don't wear a bandage around the tube opening anymore--exposing it to more air seems to keep it healed better). The gauze seemed to wick out the puss over a period of a couple of weeks and, along with the cream and cleaning, I think I got rid of the infection before it got bad. But I never had a fever or a lump or bump. That sounds like it could be an absess to me.
Nelie


SCC(T2N0M0) part.glossectomy & neck dissect 2/9/05 & 2/25/05.33 IMRT(66 Gy),2 Cisplatin ended 06/03/05.Stage I breast cancer treated 2/05-11/05.Surgery to remove esophageal stricture 07/06, still having dilatations to keep esophagus open.Dysphagia. "When you're going through hell, keep going"
#57583 12-27-2005 12:51 PM
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Go in and inquire if the DOCTORS would recommend iv antibiotics! Please don't complicate things by "just waiting and seeing". You have made it through a ton-your hubbie's immune system is likely fried. Just go in.


Dad Treated for T2N1M0 Tonsil Cancer August 2005. 35 IMRT radiation, 3 doses Cisplatin. Selective Modified Neck Dissection November.
#57584 12-28-2005 03:09 AM
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Posts: 79
Mary M Offline OP
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Thanks everyone for your usual great feedback.

When John woke up yesterday morning his temperature was back down to 36.4 and the redness around the PEG site had gone down. We went to the hospital anyway. The clinical practitioner radiation nurse ( who has seen hundreds of PEG incisions) said it looked okay to her but told us to come back in if redness spread to greater than 1 cm and if his temperature went over 38.

She said it sounded like John had picked up a virus (citing the particularly stuffy nose) but with the rise and fall of temperature it looked like 22 days after his last chemo that his immune system was starting to come back on track.

She also said that it takes the body a lot of effort to maintain the PEG incision and when he gets something like a cold we should automatically expect the site to get somewhat more red. She stressed that we had to come back in though if there was oozing or, as a I said above, a lot more redness.

The nurse also suggested a simple decongestant at night for a night or two ( nothing that included medication for anti-fever, anti-runny nose) to help with the stuffiness.

It's amazing how scary these flare-ups of different types are. I guess we all know that sometimes it is something small and other times it's something to be really concerned about and when it first happens there's no way of knowing what path you are heading down this time.

Thanks again for taking the time to post your helpful replies and I hope everyone is enjoying the holidays right now.

Mary


Caregiver for John SCC left tonsil Stage III/IV dx Sept 05, tx started Oct 21/05 -IMRT 35, cisplatin 3 X 100mg/m2;completed Dec08/05.
#57585 01-01-2006 08:51 AM
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I am glad that it worked out! Thanks for the update! Way to go you for going in, moments are precious, this is such a hard time. Keep plowing!


Dad Treated for T2N1M0 Tonsil Cancer August 2005. 35 IMRT radiation, 3 doses Cisplatin. Selective Modified Neck Dissection November.

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