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Sunday, June 28, 2015

Gut Feelings, Part 5

My port placement was scheduled for May 19 at 6:30 in the morning, about the same time that Brian was scheduled to fly back to Illinois.  Fortunately his brother, Jonathan , was able to drive him to the airport  that morning.  Mr. G and I arrived at the outpatient surgery  clinic in the hospital, filled out some paperwork and waited, along with a roomful of other patients.  A hospital worker came out and   said a prayer (this is a Baptist hospital) and shortly thereafter I was called back to prep for the procedure. After disrobing (isn’t that a lovely word?) I attempted to  don the gown they had provided but had a devil of a time trying to figure out how to get it on- it seemed designed for someone with  more than two arms. With some help from the nurse I finally got in on, along with some lovely little fuzzy lime green socks.  The anesthesiologist came in   to ask questions about my health and the surgical nurse hooked me up to some monitors.  I was finally wheeled across the hall to the operating area where I was transferred onto a narrow table.  The doctor came in to tell me not to worry; they were going to take care of me.  I wasn’t actually worried up until that point. I told him I’d heard mafia bosses say the same thing in movies and it wasn’t a good thing.  The anesthesia nurse began cracking jokes as she   put some tubes up my nose and soon I was out like a light. I woke up in the recovery area, where someone came around with a portable x-ray machine, and  put a metal plate   under me.  I discovered later that this was to make sure that the port catheter  was  placed properly in  the vein.  All went well  and I now have this funny  hard bump on my upper chest.  It reminds me a little of the stories of  alien implants and I envision it one day coming to life and  trying to break through my skin. What is really neat, though, is that from now on, no more needle sticks for blood tests or injections- it will all be done through the port.  Another neat thing was that I was not allowed to drive, lift anything (not even a skillet, the nurse said) or exert myself for a week, so Mr. G had to wait on me hand and foot.  I  played that part for all I could get out of it! Mr. G was  good humored, though.  He bought a package of little plastic minion figures and told me to call them when I needed anything!

Once home, I phoned Dr. Vance’s office to let them know the port was in so they could set me up with the portable pump and coordinate with the radiology dept.. A nurse came on the phone and told me the plan had changed and I would not be getting the radiation therapy after all and would be coming into the clinic for infusions on a different chemo regimen of  several drugs in addition to the 5-FU.  This of course, freaked me out, since they didn’t give me a reason for the change. Dr. Vance phoned me back, apologized for the lack of communication and explained that the PET scan showed that the spot on my liver was indeed cancer – metastasized from the rectal tumor.  Under the circumstances, she and the radiation oncologist had decided that the best course of action would be to try to shrink the tumors with a stronger dose of chemo and forgo the radiation for now.  My first chemo treatment was scheduled for May 27 at 8:45 in the morning. I was told to expect to be there for 4 1/2 hours. I was also told that the copay for each chemo session would be between $600 and $700 dollars.  That came as quite a shock,  but the clinic’s financial adviser told me there was a foundation that covered the  co-pays for eligible patients and that she would put in an application on our behalf, so I kept my fingers crossed.

Saturday, June 27, 2015

Gut Feelings, Part 4

I met with the medical oncologist, Dr. Vance, on April 29.  I had blood drawn, asked for a copy of the results for my files, and was weighed.  I’ve lost weight, was down to just over 81 lbs. Dr. Vance was concerned about the spots on my liver and said she wanted to rule out liver metastasis so she scheduled a PT scan.  She explained the treatment plan to me, which called for the drug 5-FU (Fluorouracil) to be delivered via an infusion pump worn 24/5. Once I have the port in place, I’ll go to the clinic on Mondays to have the pump set up and return on Fridays to have it removed. She said she would work with the radiation oncologist to coordinate the radiation therapy with the chemotherapy. The PET scan was set for May 11 and the appointment with the radiation oncologist for May 12.

I was given a set of instructions to prepare for the PET scan, including what to eat and not eat and was instructed to avoid strenuous exercise such as jogging or weightlifting.  Since I have become more akin to the tortoise than to the hare lately,  this should not be a problem.

The night before the scan was scheduled I had a dream that I lit up the scanner like a Christmas tree and knocked out the power to the entire wing of the building. Needless to say, I was a little apprehensive!  I arrived for the PET scan and was shown into a small room with a reclining chair.  The technician asked some questions, then injected radioactive glucose into  my arm.  He   accidentally dropped the syringe on my leg, which meant my pants were now radioactive.   He brought me a pair of scrub pants to change into. I think they were designed for someone built like a linebacker, but I dutifully put them on, cinched them as tight as I could, rolled up the legs and waited in the chair for an hour while the radioactive stuff seeped through my body.  I then waddled across the hall in my Bozo the Clown pants  and climbed onto the scan table. If you close your eyes in a PET scanner, it's easy to imagine you're on a farm listening to noisy machinery while a neighing, whinnying, snorting horse tap dances all around you. At least that was my experience. The whole experience took a bit longer than the CT scan but wasn’t too bad and the power didn’t go out, after all, thank goodness!

The next day I met with the radiation oncologist, who  gave me yet another digital rectal exam,  and explained what the radiation would involve. I was directed to a lab for another CT scan and I was marked to show where the  radiation beams  were to be directed. I mentioned to the  doctor that I’d  had a PET scan the day before, and his nurse suggested that the results might be available on the computer, so she  pulled them up.  I sensed, from the expression on her face that all was not well, but they didn’t say anything and I, uncharacteristically, didn’t ask because I was determined to enjoy the next week.  Our son, Brian, was due to arrive that afternoon from Illinois and would  be leaving the day I was scheduled to have the port placed. We did enjoy that week, we fitted in a  ball game to watch the Birmingham Barons play at Regions Field, and a Sunday afternoon spent enjoying blues music by Earl Williams at Daniel Day Gallery downtown.