Saturday, March 26, 2011

So much for an "off week"

This was supposed to be my good week, the week between chemo treatments when cancer moved to the back burner and I felt human again. I did feel human, but cancer still had a starring role.

On Monday, I had to go in for a dye test to see what was happening with my recalcitrant chemo port. The port disc is the size of a quarter and sits below the skin in my upper left chest. A tube running off to the side of the disc is supposed to feed directly into large vein. In my case, the tube makes a complete loop around the port, before feeding into the vein. This is probably what's making the chemo treatments so sluggish and time consuming.

"Never seen that before," said Dr. K, who did the dye test. From there, it was a series of phone calls to convey the test results and schedule to surgery to fix the port. So, Monday I'll be going under the knife again to, most likely, get a new port. Because chemo's supposed to start the next day, the surgeon will place the chemo needle during surgery so it's in place for Tuesday's third round of chemo.

Not a major complication, by any means, but enough aggravation to be depressing. How depressing? I spent 45 minutes wandering a department store's super sale with a 30 percent off coupon in my pocket and couldn't find a thing to buy. That's just not like me.

Tuesday, March 15, 2011

Nothing's ever easy!

My chemo port is misbehaving. Today, it would give no blood (so I had to have a stick in the arm), and unless I was flat on my back, the chemo drip slowed to a random drop every few seconds. Normally, being told to lie down would be music to my ears. However, even good things like recliners have their limits and two hours flat on my back is mine.

Phyllis pointed out that a gentleman who was getting the exact same chemo as me started a half hour after I did and finished  a half hour ago. I still have 800 ml to go, plus another smaller bag of something else after that. I've already been here four hours!

So the next adventure in my treatment will be next week (my "off" week) to get some dye injected into the port so that any problems in my line will be visible. Phyllis says I may need a new chemo port, which probably means another surgery. But if it speeds things along, it will be worth it.

Thursday, March 10, 2011

Chemo: 1 down, 25 to go; er, make that 1 down, 12 to go; oops, 1 down, 11 to go!

I always have been math challenged. Somehow, when they said six month's of chemo, I divided the 52 weeks in a year in half, and figured I had 26 treatments. Amanda was driving me home after my first treatment and I was filling in a friend via phone: "So, I've got 1 down and 25 more to go." Amanda said: "WHAT?" and pointed out the fallacy in my calculations. I had totally overlooked the fact that my treatments would be every other week, thereby cutting 26 in half. What a relief! I'd gone from mentally preparing for 26 treatments and, in the blink of an eye, it had been cut to 13! Two days later, when I related that story to my chemo nurse Phyllis as she disconnected me from my pump, she gave me even more good news. "Actually, six months of chemo is only 12 sessions. You've just got 11 left!"

So, I've survived my first chemo experience. It began with nurses complaining about my chemo port placement. Seems instead of surgically placing it in a "pocket" with the incision above the device, mine had been placed so that the tender five-day old incision ran directly over the membrane nurses need to access to get the poison flowing. There was much hemming and hawing as two nurses tried to determine exactly where to stick the needle. (Have I mentioned how much I love getting stuck with needles?) In fact, when the port was first described to me, I envisioned it as more of an IV hookup that permanently hung outside my body for easy, needle-poke free access. I think I was confusing a chemo port with a PICC Line.

Anyway, lucky for me, it was a one-stick wonder and the only remaining concern seemed to be positioning me to maximize the flow. Amanda was my chemo buddy and kept me company for the nearly four-hour process. There were at least a dozen chemo patients in the room; some younger, some older; some with buddies, some alone; some sleeping, some chatting. Not everyone's chemo is the same length, so some came and went while I was there; others were there when I arrived and still there when I left. (Note to self: Pick a better chair next time. My recliner partially blocked the doorway to the nurses station so I was constantly pulling up my legs trying to get out of the way of passing nurses.)

I expected some "momentous occasion" feelings, but none came so I passed the time reading magazines, snoozing, people-watching, eaves-dropping and chatting with Amanda. The side effects kicked in later that day. They warned me about hyper sensitivity to cold and that happened with my first drink of water. The sensation was akin to dipping your foot in a too-cold pool. Only it was happening inside my mouth and throat. It wasn't painful, like a ice-cream brain freeze, just jarring. The next side effect happened at home when I carried a Diet Coke in from the garage fridge to my dresser. Halfway there, it felt like pins and needles were shooting into my finger tips. Sort of like accidentally shocking yourself. Or like having a hand or foot fall asleep.  Thankfully, the sensation stopped as soon as I put the can down.

They start you off with anti-nausea medication — and it worked for me. The in-office portion of the chemo cocktail took four hours. Then they hooked me up to a pump that would give me an hourly dose of one of the drugs over the next two days. I was invisioning a tiny little pump, but this thing was like a first-generation cell phone. Fortunately, it came in a case that I could carry over the shoulder, in a purse or wear as a fanny pack. At night, it rested on the pillow next to me — softly whirring once an hour. I had to remember to carry it with me for middle-of-the-night pit stops. Only once did I forget and start waltzing into the bathroom, only to be yanked back by my tubing. No harm done.

On Thursday, I went to be disconnected from my pump. I told Phyllis about a dull-but-definite headache I'd had for 30 or so hours post-chemo. No amount of Tylenol or Motrin knocked it back. "That's the steroids," she said. STEROIDS???? (There goes my chance of making it into the Baseball Hall of Fame.) Turns out steroids are part of the anti-nausea medication included in the chemo cocktail. Next time, they'll cut the steroids in half and I'll get to figure out whether I'd rather be more queasy or take my chances with the headache.

Thursday afternoon, the fatigue side-effect kicked in with a vengeance; I could have slept 24-7. By Saturday, I was perking back up.

My "week off" has been good (aside from a lingering side effect that has made Imodium my new best friend). I've heard conflicting reports: One, that chemo gets worse as it goes along; two, that your first experience is pretty typical of how you'll tolerate it. Personally, I'm hoping for the latter.

Thanks to all of you who've inquired how it's going. Didn't mean to keep you in the dark for so long, but I've spent the better part of my "week off" rounding up tax papers. To paraphrase Ben Franklin: "Nothing is certain except chemo and taxes."

Monday, February 28, 2011

Just another complication

'Twas the night before chemo and all through the house ...
All the creatures were stirring, and so was the house.

Just to complicate life further, we may have a nibble on the house. OK, so it's not an official offer. Just a report from our listing agent. A couple who came to see our house on Friday apparently liked it enough to inquire if we would consider a 30-day closing. Apparently, they are cash buyers (not too many of those floating around these days) with an ill family member and they want to get settled quickly. They wanted to come back and see the house again tomorrow afternoon — chemo day — but I had to beg off because I just don't know how I'll be feeling. They are considering another house near us, but supposedly ours is the leading contender. They are scheduled to come again Wednesday.

Many people probably think I'm crazy to even consider selling/moving amid chemo. Secretly, I think my sister is one of them! And she may be right. She has pointed out that I'm right in the middle of three of life's major stresses: divorce, cancer and moving. The first two were out of my control, and I've turned control of the third over to the Real Estate Gods.

After my surgery, when it became apparent that chemo was in my future, my soon-to-be-ex generously offered to put everything on hold until I'm done with chemo — no more divorce negotiations, take the house off the market, focus on getting better. It was a kind and tempting offer, but I turned it down. I'm afraid that if everything goes on hiatus, it will feel like starting divorce proceedings and house selling from square one when chemo's done. Right now, I'm mentally prepared for divorce and leaving my "forever home": Not happy about it, but ready to deal with both and get on with my "next" life.

So, I've turned my future living arrangements over to the Real Estate Gods. If a good enough offer comes in during chemo, a move is in my future. If not, I've lost nothing and can muddle through chemo in my cozy little downstairs bedroom. The fact that Mark and I are still amiably living under the same roof is an interesting ("Awkward," says Amanda) twist to our divorce. But, hey, the house is plenty big and he works long hours anyway.

Got my chemo port put in last Thursday. Surgery was easy, but I seem to have developed an intolerance to anything taped to my body. The 4-by-5-inch adhesive bandaging covering the port has been itching like crazy. I've gently loosen much of the adhesive and tried to soothe my reddened skin with lotion and antibiotic ointment, to no avail.

Another "fringe benefit" to the chemo port is that it apparently sets off sensors. Amanda and I were popping into Kohl's Sunday night when the alarms started beeping. I'm looking around to see who's sneaking out with unpaid goods. Amanda says, "Mom, that's you!" Then she reminded me that I left the surgical center with a "Medical Alert Identification Card" that I'm supposed to carry in my wallet. I can't wait to see what I do at airports these days!

Monday, February 21, 2011

I was supposed to be in England!

I was planning to spend late February visiting Amanda in England, from where we would launch a side trip to Paris. Instead I am sitting in a recliner in a dimly lighted room waiting while radioactive material meanders through my veins in preparation for a PET/CT scan. This scan is supposed to pinpoint any remaining cancer hotspots so they can be monitored for changes down the road. (Details: http://www.wcrc.com/pet_ct.shtml.)

With England out of the picture, at least for now, cancer treatment is full -speed ahead: The Feb. 18 PET/CT scan, surgery to get a chemo port put in on Feb. 24 and chemo starting March 1.

On Jan. 28, I met my oncologist, Dr. George Miranda. (When you can use the phrase "my oncologist," it's official, you have cancer.) He spent an hour explaining what my future would hold: Various tests, six months of chemo,  possible and likely side effects, procedure, prognosis and everything in between. I'd arrived for my visit with a long list of questions. When Dr. Miranda was done talking, he'd covered them all without my having to ask. Never once did he glance at his watch. I took an immediate liking to him.


My treatment will involve a 3-4 hour office visit where chemo will be dispensed. I will go home with a pump that continues circulating chemo in my system for 48 hours. The procedure will repeat every two weeks. According to Dr. Miranda, I'm likely to feel fatigued during the week of the actual chemo, but should bounce back the next week.

I met Phyllis, the chemo assistant. She showed me the chemo room — a dozen or so recliners, all occupied, with people undergoing treatment. Some were reading, some knitting, some eating, some sleeping. Some had a friend or family member keeping them company. All had blankets.

The good news: chemotherapy for colon cancer is well tolerated compared to the chemo for other cancers. I shouldn't lose my hair, though it may thin. The dreaded nausea is headed off at the pass by anti-nausea medication that is given with the chemo. My body will likely become hyper-sensitive to cold: keep gloves handy for reaching into the freezer, skip ice in beverages, wear slippers on tile floors. Food may have a metallic taste. I remember having that reaction to food while on some heavy-duty antibiotics while hospitalized some years back. It was a total appetite killer. (This could be a positive!)

In the past 5-10 years, a new drug has been added to the colon-cancer chemo cocktail. The chemo is preventative, rather than "treatment." The expectation is that surgery got all of the cancer. But typically, patients like me with Stage 3B colon cancer have a 40 percent rate of recurrence if they skip any post-surgical treatment. Chemo cuts the recurrence rate in half. I'm willing to give up six months of my immediate future for an improved chance at a long-term future.

Back to the PET/CT scan: Once my radio active material was well-disbursed, the actual scan was a piece of cake. I slipped into a hospital gown and lay down on the bed that would slide through the scanner. The scan would take 16 minutes (who decides this?). I felt like a hot dog in a bun. (What is it with the food metaphors? Could be the fasting I have to do before these procedures.) The scan went by in a jumble of whirring, sliding, lights and a disembodied voice: "Beginning now," "Don't move," "One more minute."

Two hours out of my life and another step down the road in cancer treatment. Europe will be there when I'm ready.

Friday, February 18, 2011

Opening Day here I come!

BC (before cancer) I was planning to spend lots of time in Longview, Texas, watching Nate, 20, play for the LeTourneau University Yellow Jackets. He'd had a magical season in 2010, but I'd seen very few games. For 2011, I'd planned to see alot more.

AC, and knowing that chemo was looming, I jumped at the chance to travel to Longview for the Jackets opening weekend, Feb. 11-12. Amanda and I lucked out with some decent airfares right into Longview, eliminating the need to rent a car in Dallas and make the 2+-hour haul back and forth to East Texas.

Our first day there, we awoke to freezing sleet and weather that didn't look promising for baseball. Fortunately, each day after warmed up a few degrees and by Friday's first pitch, it was nearing 50. Not to brag, but Nathan had an amazing opening day. (Details for the sports fans: http://www.letuathletics.com/sports/bsb/2010-11/releases/2011021134i4w6.) He had the team's first homer of the season (That's my boy!). It was puzzling to see him playing left field this year when he owned first base last year, but the intricacies of coaching baseball are beyond me.

We got to see a doubleheader on Friday and another on Saturday and Nate ended the four games with a batting average over .500. Not too shabby. But I felt an overwhelming sadness at the end of Saturday's games when I realized I may have seen my only games of his season.

The night before we left, Nate shared some more good baseball news: He's been offered a position to play this summer for the Lorain County (OH) Ironmen, based in his dad's hometown. It's a wood bat league, which is what baseball scouts like to see potential players wield. Maybe I'll be breezing through chemo and able to travel to Ohio this summer for a game or two during an off-chemo week.

Whether I'm in the stands or following the games online, I hope Nate knows I'm in his cheering section.

Saturday, February 12, 2011

The "secret" pathology report

Surgery was Friday, Jan. 7. The IV was a one-stick wonder (yes!) and I don't remember anything between being rolled into the operating room and waking up in my hospital bed. Mark, Amanda, Nathan and a dear friend, Shari, all assured me that the surgeon had nothing but good to report after the surgery. "Got it all!" What a relief! Pathology report would be in on Monday.

I awoke Saturday feeling like a heavy-weight title bout had taken place in my gut. Every movement hurt and being tethered to the bed by a cathader, gastro-nasal tube, IV and assorted other wires was no help. NG tubes — for the fortunate who've never had one — run though your nose and down to your stomach, sucking out everything so your battle-weary bowels can rest. Good concept, but really annoying. You can't eat, obviously, but drinking anything or even sipping ice chips is verboten. Of course, once something has been forbidden, it becomes the thing you want most. I could live without eating, but I was soooooo thirsty. The hospital's answer to that was a 1-inch star-shaped pink sponge on a lollipop stick that I could dip in ice water and use to moisten my mouth. That's what I was supposed to do with it. What I did was suck every drop of water out of the sponge and savor it as it trickled down my parched throat. It wasn't long before I was scowled upon by a nurse when I was caught with a half-empty ice water cup and my mouth puckered up around my sponge: "You're not supposed to be drinking that!" It may have been a small act of defiance, but I held my ground: "This tube is sucking everything out of my stomach, so what difference does it make if I take in a bit of water?" There must have been a bit of logic to that because she left me with my water and my sponge-sucker.

By Monday morning I was virtually untethered and I awoke to Heather, the surgeon's physician's assistant, hovering over my bed for a gut check. "Is the pathology report in?" I asked. She checked, and said not yet. Then she told me that only Dr. Shaver could tell me the results. "He who removes it, delivers the path report."

From then on, every hour on the hour (it seemed) I inquired after the whereabouts of the path report and Dr. Shaver. After the report turned up, I asked every nurse or assistant who popped in where Dr. Shaver was. "In surgery, due here at lunchtime." No show. "Surgery at 3, after that." No show. "Still in surgery." No show. "Surgery is running really long." No show. "Gone for the day." WHAT????

The night nurse took pity on me and offered to call Dr. Shaver's service to inquire. The on-call doctor asked her to read him the path report, which she did. He said he would call Dr. Shaver. No promises he would call back. The nurse asked if she could share the path report with me. "No. The patient will have questions and you won't be able to answer them." As soon as the nurse told me that, I knew this was not going to be an "all clear" path report. If it had been, my only question would have been "When can I go home."

Poor Amanda had waited patiently all day with me. (Nate had flown back to Texas to start classes on Tuesday.) I kept my assumptions to myself and sent her home so we could both get a good night's sleep. I don't know about Amanda, but my sleep was elusive at best and sweat-drenched at worst. Awaiting bad news is worse than knowing it.

The whole process began anew the next morning. Another PA from Dr. Shaver's office did the morning gut-check and assured me Dr. Shaver would be in and that I could go home that day. I busied myself showering and putting on civilian clothes. Amanda arrived and the hours trickled by. Just as I stepped into my bathroom, Dr. Shaver showed up. It was 1:30 p.m. and the news wasn't good. Instead of a Stage 0 or Stage 1 surgical cure cancer, I had State 3. Two of the 15 lymph nodes they removed were cancerous. Chemo was in my future.

Amanda and I shed a few tears over the path report, listened as Dr. Shaver explained what he thought would be the next steps: Heal from the surgery, meet my oncologist, get a PET/CT scan that could pinpoint any areas of concern, and undergo four to six months of "preventative" chemo.

Instead of the end of my colon cancer, it was only halftime. Damn!