I'm 42 and Bald - but it sure as heck beats the alternative

Birthday Flowers

I've been staying in Flagstaff all week due to the recent snow fall. It wasn't the return to the canyon that made me nervous it was getting back to Flag the next day. There was no way I was going to miss having the port taken out. So, here's the snow on the car on Tuesday morning. It has pretty much snowed constantly ever since. I've scraped this much and more off the car each day. It's been fun! Plus I have the world's best boss so I was able to work most of the week out of our offices here.
Everything you need for a successful port extraction. It took only around ten minutes and in the doctor's office. Much easier than when it went in.
The port coming out. I photoshopped out the blood and gore for the squeamish. It was much bigger than I thought. I'm trying to decide what to do with it. A necklace, bracelet, broach? It is sooo nice to stretch my neck out again!

Happy Birthday To Me!

I got the present I asked for - the port is out. It only took ten minutes and wasn't half as gross as I thought it would be. It did hurt though. And best of all they let me keep it! I didn't even get a chance to ask - they offered it first. I think they were surprised when I said yes. It's much bigger than I thought. I'll post pics soon. Anyway, it's nice to be able to stretch my neck again! And my birthday isn't actually until tomorrow so my present was early.

It Is Finished

Well there was no big celebration to send me on my way. The nurse did do a "chemo is over" dance for me and made me join in. We also went out for a yummy lunch of seafood Mexican. And I was definitely not heart broken to be walking out of the chemo room for the last time (the radiation side of the building has better snacks). I do wish I could say I am super happy tonight but while I am glad to be finished, the heinous hiccups from hell are already here to make sure I know what is coming. I'll be super happy after the weekend - or soon after.

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The meeting with the oncologist went very well. I had perfect blood work yet again. He says he will be the the doctor I'll be seeing for the next five years. He put me on Tamoxifen starting tomorrow. I'll start the radiation treatments in three weeks. I can get the port out in three weeks also! And he used the word "cured".

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I was really worried about the cost of the Tamoxifen since I will be taking it daily for five years. We got the presciption filled today and with my insurance co-pay they are only $15 a month. Yippee!

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Did I mention I can get the port out in three weeks? And that my treatments should be finished by the end of the year? That my hair should start growing in four weeks? That I only have one more bad weekend ahead of me? That I can afford my meds? That despite all my misgivings wondering if I had the strength to get through it - that I had my last chemo treatment today!?!! OK - maybe I am super deliriously happy tonight! I at least feel pretty proud of myself. Tonight I feel like there is nothing I can't handle.

Any Day Homemade Chocolate Chip Cookies Show Up in The Mail Is A Great Day!

Today was Day 14 - Blood Work Day. I had an appointment at the local clinic today for my two weeks after chemo blood work. I told them when I made the appointment that I had a port they could use to draw the blood. She said that the nurses there were as trained as any nurses and that it should not be a problem. But surprise surprise no one there had ever used a port before. Good thing I brought along my power port guide and the access needle they gave me after the port implantation surgery. Using them they sure gave it a good try. I got all sorts of attention from the whole staff. Alas though, no matter how they poked the needle into the port no blood would come out. I'm really hoping they were doing something wrong and that there is not a kink in the tube. That would stink. So, in the end we drew the blood the old fashion way - a vein in my hand. They are going to do some research on power ports for next time and we will try again. Call me paranoid but I'm starting to think that nothing is going to be easy for me in this process. Like I heard somewhere - I don't suffer from cancer, I suffer from cancer treatment. Anyway, I should hear tomorrow how the results came back - hopefully my body has been making white blood cells faster than the chemo has been killing them. It kind of feels like my first test to see if I'm passing cancer or not!

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The day ended with dinner at the El Tovar while watching the sun set on the canyon. I keep trying to convince myself that my life is on hold for the next few months but life keeps finding a way of happening and dragging me along with it.

No Interesting News

My little sister and her husband made it here just fine on Saturday night. We drove down to Sedona, explored, and bought fudge today. We also picked up the last of my meds for chemo this week. Seems like everyone has a different theory on what works for them with chemo. I'm trying to eat better - give or take a little fudge - and starting tomorrow I'm going to drink lots and lots of water. I keep reading that it helps flush out the poisons faster. I'm getting pretty nervous but once I get going and see it's not as bad as I imagine everything will be better. Still not embracing the port - the bruise ended up starting on the top of my shoulder and ending about half way down to my stomach. I can see why the surgeon wasn't happy when I started twisting around in surgery trying to see what was going on. I bet he totally knocks me out next time. With a baseball bat as my middle sister said! Anyway, I'm still sore from getting the port and sometimes it feels like I have a big rubber band around my neck which makes it hard to take a deep breath and makes me claustrophobic of all things. I was on the verge of a panic attack earlier this week and I was close to just walking back into the hospital and have it taken out. But now each day seems to get better and I'm sure once chemo starts on Tuesday I will be very glad to have it. It is really irritating when I drive though because the port is right under the seat belt. OK OK - I'll quit griping about the port - you have to admit though that it is kind of gross to have an implant sticking out of your collarbone and being able to feel the tube going up the vein makes me cringe even thinking about it. I really want it out but the thought of having it pulled out while being awake - ugh ................OK - back to ignoring it!

A Port for the Storm

My Lucky Sunflower Socks

My Support Team!

My Two New Scars My IV
My Gurney http://www.boston.com/news/local/articles/2008/08/20/cancer_blogs_become_part_of_treatment/

So, when they say it's only the size of a quarter - it's not. I must have a special one because it's more like the size of a marshmallow right now with the swelling. And it's purple - not that anyone can tell but it's a purple triangle the size of four stacked quarters. My surgeon called it my new best friend. No more needles in the veins - everything will now go through my port.

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The week started out with a very nice surprise - my parents brought my middle sister with them. She left her family and flew out from Texas to be here for the surgery. I would have said that my big mouth family would never ever be able to surprise me but there she was ringing the doorbell with me standing there trying to figure out which neighbor was standing there with flowers. Funny though - it did kind of upset me. "I must be really sick for you to be here" I said. "I'm not here here because you are really sick and I feel I have to see you while I can" she replies "I'm here because we are all in this together". It made me tear up. It is so nice to have her here.

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We got to the hospital bright and early and then spent much more time sitting around for this surgery. It's cold in those gowns but they brought me heated blankies. The surgeon said that when he takes the port out in a few months he can just do it in his office. They insert it in a hospital since there is a very real concern with infection. All of the hospital staff was once again wonderful - so very friendly. My sister was a little ray of sunshine. She took most of the above pictures and kept us and the staff laughing the whole time. She even conned some guy into letting her push my wheelchair out to the car. She didn't even run me into a wall.

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The surgery itself went pretty fast. They just had to sedate me. I remember being awake for most of it and trying to see what was going on but they kept making me turn my head. As you can see in the bottom picture above they put the port in under the skin right beneath my collarbone. They then sent a tube up towards my neck to where the top incision is and then inserted it into jugular vein down into the superior vena cava. I can feel the tube with my fingers - yuck. I don't remember much from the drive home except holding my sister's hand.

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I am very glad I did not start chemo today. I woke up still dizzy and nauseous. And I can't believe how much this thing hurts. It was impossible to lay down and not be in constant pain so I didn't get much sleep even with the percocet. It hurts to move my neck at all - even breathing. I tried to work this morning but only made it an hour and a half before I had to come home and nap. I made it most of the afternoon but spent a bit of time losing my lunch in the bathroom. The hospital called to check on me. She wasn't very happy that I was at work but I pointed out that I was not driving or signing legal documents. Tonight I feel better and dinner is staying down. It still really hurts though. And as you can see it looks yucky too. We will see if it's worth it or not - getting the port. I do get to wear a pretty purple bracelet to let any emergency personnel know that I have the port. So, we are all set to go next week. Next stop chemo.

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HAPPY 43rd ANNIVERSARY TOMORROW MOM AND DAD!

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And hey look an article about cancer blogs that I saw referenced on "My Cancer Deployment" blog -

More Cancer Knowledge You Never Wanted to Know But If I Have to Know It Then So Do You - getting bossy aren't I?

The day is set - I get my new little buddy called a "port" embedded under my skin on the 19th of August. What's a port you may ask? I know I did so I looked it up on wikipedia and here is what they said:

In medicine, a port (or portacath) is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical "needle stick". Ports are used mostly to treat hematology and oncology (hey that's me!) patients, but recently ports have been adapted also for hemodialysis patients.
A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava.)
The septum is made of a special self-sealing silicone rubber; it can be punctured up to one thousand times before it needs to be replaced. To administer treatment or to withdraw blood, a health professional will first locate the portal and disinfect the area. Then he or she will access the port by puncturing the overlying skin with a 90° Huber point needle although a Butterfly needle may also be used. (Due to its design, there is a very low infection risk, as the breach of skin integrity is never larger than the caliber of the needle. This gives it an advantage over indwelling lines such as the Hickman line.) Negative pressure is created to withdraw blood into the vacuumized needle, to check for blood return and see if the port is functioning normally. Next, the port will be flushed with a saline solution. Then, treatment will begin. Also, after each use, a heparin lock is made by injecting a small amount of heparin (an anticoagulant) into the catheter. This prevents development of clots in the system. The port can be left accessed for as long as required, the port is covered in a dressing to protect the site from infection and to secure the needle in position.
The surgery itself is considered minor, and is typically performed under both local anaesthesia and conscious sedation. Patients sometimes have a little discomfort with breathing after the procedure, and can be managed with over the counter anti-inflammatories & tylenol.
A port is most commonly inserted as a day surgery procedure in a hospital or clinic by a surgeon or an interventional radiologist, under a local anaesthetic. When no longer needed, the port can be removed more simply in a clinic or doctor's office.

Here are some of the complications (rare) that can happen according to wiki : Infection - a severe bacterial infection can compromise the device, require its surgical removal, and seriously jeopardize the health of the already weak patient.Thrombosis - formation of a blood clot in the catheter may block the device irrevocably. To prevent clotting the portacath is flushed with saline and heparin, usually by a nurse or other medical professional, at least once every four weeks, or more often in conjunction with administering medication.
Mechanical failure - is extremely unlikely. It is possible in a rare event that part of the system could break and become lodged in the circulatory system. In such case it is unlikely to cause any serious harm.Pneumothorax - Attempts to gain access to the subclavian vein or jugular vein (jugular vein!?! That ain't cool!) can injure the lung, possibly leading to this complication. If the pneumothorax is large enough, a chest tube might need to be placed. In experienced hands, the incidence of this complication is about 1%. Arterial injury - The subclavian artery can be inadvertently punctured. This usually leads to a subcutaneous hematoma and occasionally a pseudoaneurysm. An alternative site may need to be used for port placement. Puncture of the carotid artery is more rare, since attempts to access the nearby jugular vein is increasingly done with ultrasound guidance. I've also read about some that "flip" or move around a bit which seems to cause discomfort and a bit of difficulty inserting the needle into the port.

So, my next question was "why do I want one"? Here's what breastcancer.org has to say - Your oncologist may recommend (like mine) that you have a port or "port-a-cath" inserted in your upper chest wall (the space between your collarbone and your breast) to make chemotherapy easier and more comfortable for you. What? More surgery? Don't panic. This is a simple, same-day procedure that doesn't require general anesthesia (my surgeon says he will use an IV med to knock me out enough that I won't remember what happened - "you put a what - where!?!?"). You will have a chest X-ray to confirm that the port is positioned correctly. When chemotherapy is over, the port can be removed quickly in another same-day procedure.
The port is about the size of a quarter, only thicker, and will show only as a bump underneath the skin. There are several benefits to having a port:
No need to find a vein every time you receive chemo. A special needle fits right into the port, so all you feel is the stick—not the poking, prodding, and false tries in your arm. The nurse may numb the skin first with ice or a cream, to lessen any feeling at all (yes, please).
A port may be especially valuable for women who might be experiencing some swelling of the arm on the side of their surgery.
The medication goes right into the main blood supply entering the heart, so it can be sent quickly and efficiently to all parts of the body.
Some types of chemotherapy can be very uncomfortable if injected into a vein just under your skin. The port avoids this potential discomfort.
Getting blood for blood tests can usually be done through the port, decreasing the number of times you need to have a vein "stuck." One site I looked at even points out that it's possible to feel the chemo going through your veins while using an IV - eewww that can't be fun and it causes all sorts of damage I hear if some of the chemo meds get into the surrounding tissue near the IV needle site. Plus I have always had horrible veins to find for sticking needles into so with all of this information I've decided to go for the "Full Meal Deal" and get the port - might as well get the whole experience right? And I've kind of been missing the quality time my surgeon and I used to have together.