I have had four radiation treatments now. Seems to be going well. If you would like to know more about the rads experience (or how by accident I peed on my own leg after a struggle with camel toe) read my last post, entitled Meet Trilogy. So who would have thunk that the bane of my existence, after sailing through chemo and with four short weeks of rads to go, would be my right thumb.

That’s right, I have a thumb infection. It appears to be under the nail, which was damaged by Taxol, the chemo drug I was on for the second half of my treatments. How the infection got under there I have no idea, as there is no obvious cut or other point of ingress. But man is it obvious the thing is infected. Here, see for yourself (caution, don’t eat while reading this — oops sorry too late):

No I did not alter that image. That would be my right thumb. It looks, my friend Susan pointed out, like a toe. A big toe. Naaaaaaaaaasty. It feels awesome too, let me tell ya.

The whole thing started just about two weeks ago when I was awakened in the middle of the night with excruciating pain under my right thumb nail. It was dark so I didn’t look at my thumb. I just figured it was the last of the effects of the Taxol rearing their ugly heads after  treatment. Pain under the nails is something I experienced frequently during chemo, but not on this level. It woke me up again about four times that night. And in the morning I took a gander and that sucker was red and swollen and clearly infected.

So I called my GP and (after seeing me) he prescribed Augmentin. Didn’t touch the infection. Frustrated and a little concerned I asked my oncologist when I next saw him, which was about a week later. He spoke to the folks in the chemo treatment suite and we decided to try another antibiotic: Flucloxacillin. After a day or so the pain was better and I thought it was working but then the discolouration began to spread and the pain to return so I decided it wasn’t working and asked my radiation oncologist (four days later) what to do. We decided I would go to the dermatologist. So I did.

The derm took me off the second antibiotic, ordered an urgent ultrasound, and put me on Clindamycin, a broad-spectrum antibiotic I had never been on before.

I asked him if they would have to amputate (I was sort of joking). He said, deadpan, “I don’t know.” Good Lord, man. That isn’t funny! He said “well, anything is possible.” Although true, this is not a nice thing to say to a cancer patient who didn’t really think it was possible she would get breast cancer at the tender age of 39 and who can now well imagine the news that the top of the thumb will just have to go.

The ultrasound revealed thickened flesh but no abscess (no accumulation of fluid) behind the nail and the bone appeared to be normal. All good things. So I went home and took my first clindamycin and then another before bedtime and went to sleep. It didn’t look better in the morning nor did it the day after that, which was yesterday. I painted my nails red for the 4th of July party (even though it was July 1st — details) at the American Ambassador’s residence. That made it look somewhat better. The thumb became “Big Red.” I faithfully took my meds at the allotted hours that day and this morning I woke up and it was significantly… worse. Shit.

After fumbling through getting the kids ready for camp (it is hard to make sandwiches without using your thumb) I called the dermatologist. He was away until Friday. Super. Then I had to skedaddle off to radiation so after my treatment I asked them about it and the doctor there took a look. She ran through the good things: no redness, no systemic symptoms (I feel well and don’t have a fever, etc.) and said that antibiotics take time and I should give it at least 72 hours and that if the thumb still wasn’t improving they could admit me to the hospital for intravenous antibiotics. Delightful.

“Worst case scenario,” she said, “you lose the finger.” “WHAT?” I cried? “Oh sorry, the fingernail.” That is definitely a distinction with a difference. Next time spare me the heart attack.

It doesn’t help that at the moment I am reading Ian McEwan’s Solar. There is a scene toward the beginning in which the protagonist travels to the North Pole to study global warming. After a number of mishaps involving cracked goggles, subzero temperatures and failure to empty his bladder anytime in recent history, this dude stops his snowmobile to take a piss and his unit freezes to his zipper. He has to pour booze from a flask he happens to be carrying on the thing to get it unstuck and then as he mounts his companion’s snowmobile he experiences a terrible pain and then feels something small, hard and cold drop down his pants and settle by his knee.

Naturally he believes that his penis has broken off following the peeing incident. We later learn that this is not the case, but I felt for the guy. I really did. I looked down at my thumb and shook my head.

Then tonight my husband (the one who hasn’t had a day off in over a month) came home early so I could go to the movies with Susan. We saw Friends with Kids. It was cute, albeit predictable.

I walked to the theatre and on the way I spotted the broken off tip of a banana lying sadly on the pavement. Hmm. It looked just like my thumb above the joint, except more yellow. I didn’t like it.

I was just about to settle down and read my older daughter a chapter in Sky Island when the phone rang with a “withheld” number. It was my radiation oncologist. She had contacted an infectious disease doctor who is a friend of hers about my case. This doctor said that one can develop a nasty and persistent infection of the nail bed and that I should be on a combination of strong antibiotics to deal with it and also of course be seen. I said I was already on clindamycin. That was one of them. The other, it turns out, was Ciprofloxacin a/k/a Cipro (yeah, the stuff you take if there’s an anthrax scare). “Really? Together?” I asked. “I happen to have some in my stash of meds from chemo.” It was true. I have meds out the wazoo from all of my chemo and Cipro was always on hand in case I developed an infection. And it was the right dose and everything. So now I am on BOTH.

We’ll see how that works out. And I will see this doc on Wednesday. Meanwhile, I told my radiation oncologist I thought it was awfully funny that I had breezed through chemo only to be felled by an infected thumb of all things. “Yes,” she agreed, “it is your Achilles.. ‘thumb'” we said in unison. Giggle, snort.

I’m going to Wimbledon tomorrow. Of course it will probably rain all day but whatever. I will still have fun. If I can’t watch any tennis I will eat strawberries and cream and take meds every five minutes. Then Wednesday I get to find out more about how to kill this stupid infection if it has the nerve to look this disgusting for another day.

Good thing I am not a hand model.