Today featured a trip to the Salem Hospital for the implantation of a semi-permanent IV device. I blogged about this the first time through, but practice has changed some over the last few years. For starters, we are now more aware of the risks associated with bacteria that are resistant to antibiotics. That means that part of the surgical prep involves two showers with "Hibiclens" (chlorhexidine gluconate solution 4.0%) - one the night before surgery and one in the morning. It also means a lot of fresh towels and clean linens. Instructions include: wash your entire body from the neck down, spending an extra 2 minutes on the procedure site; do not use Hibiclens in your eyes, ears, mouth, nose, or genital area (ummm, duh?); and do not use Hibiclens if you are allergic to the product (hmmm...). I was also told to not eat or drink after midnight - so of course I was parched all night long and struggled to sleep.
The intake process was pretty simple, and I was even shadowed by a "lean" transformation analyst - who was trying to get a sense of the patient experience for service improvement at the hospital. She was very interesting to talk to, and it turned out that we had both done some "hard time" on Kodiak Island. The world is a very small place. :)
This time I did not have a general anesthetic - opting for "managed anesthetic care" where I did not have a breathing tube. I could not tell the difference at all, though the anesthesiologist told me that I was only "out" for a couple of minutes while the port line was actually inserted into the vein near my left clavicle. I woke up in recovery, got dressed, took my wheelchair ride to the van, and went home. C'est finis.
My shoulder and upper chest are quite sore (Vicodin has been my friend this afternoon and evening), and I slept most of the day. Our kitten has been my constant companion, and is becoming quite the lap cat. For my book club boys - I carefully inspected the pills to ensure they matched the label and the Patient Information Leaflet ("this medicine is a white, oblong-shaped, scored tablet imprinted with M357 on one side").
Tuesday, February 1, 2011
Monday, January 31, 2011
Looks good (not to be confused with "good looks")
So, that is the succinct summary of my bone scan report, as communicated to me by my surgeon when he called this morning to schedule my new PowerPort. He thought tomorrow (2/1/11) at 9am would work, and wondered if that would fit my schedule. :-) Nothing quite like moving quickly! So, I report to the OR tomorrow at 7:30am. The port will be installed in my left upper chest, and we will use that device to ease delivery of chemotherapy drugs and CT scan contrast agents to my heart for whole-body redistribution. These things are SO MUCH easier than the arm-poke method.
What happens after that? Well, I take a nap and have a sore chest. I schedule and attend a consultative meeting with the liver surgeon at OHSU, and then the first rounds of chemo begin. He will be closely monitoring the effect of the chemo on the tumors... we want them to shrink, but not too much. Then we resection those bad guys. Then we bathe my insides in more chemicals. I will talk in some detail about the chemicals once I know which ones we are using.
Last tidbit... We are going to Orlando next week, prior to the beginning of chemo. I want to see Harry Potter World with Julia and Karen before the chemo begins, and we are going to Cape Canaveral too. I expect to ride every roller coaster, and drink some butter beer, and be silly. I think my girls deserve some fun before we dive back into chemotherapy hell again. We will be figuring out routines, and will work our way through the next several months. As of today, my outlook looks good.
Peace.
What happens after that? Well, I take a nap and have a sore chest. I schedule and attend a consultative meeting with the liver surgeon at OHSU, and then the first rounds of chemo begin. He will be closely monitoring the effect of the chemo on the tumors... we want them to shrink, but not too much. Then we resection those bad guys. Then we bathe my insides in more chemicals. I will talk in some detail about the chemicals once I know which ones we are using.
Last tidbit... We are going to Orlando next week, prior to the beginning of chemo. I want to see Harry Potter World with Julia and Karen before the chemo begins, and we are going to Cape Canaveral too. I expect to ride every roller coaster, and drink some butter beer, and be silly. I think my girls deserve some fun before we dive back into chemotherapy hell again. We will be figuring out routines, and will work our way through the next several months. As of today, my outlook looks good.
Peace.
Sunday, January 30, 2011
Books
I have been surrounded by books my whole life. From the moment I have distinct memories of places, we have always had books around our homes And since my Dad helped to manage university BOOKstores, they were always a backdrop for any conversation. This is all a good thing. I love books. They are such constant friends, ready to transport you into other minds and other perspectives.
I am a great fan of science fiction and fantasy, mostly because they begin in a reality and then move thoughtfully through that reality. All authors are skilled writers (duh!) but their gifts vary widely. Some are especially great at devising world systems, and then telling epic stories about those places. Others rely more on the human experiences of social development, but tell very interesting "alternates" to them, hinged perhaps on a subtle change to an outcome.
Of course, with an introduction like that, I could go in a dozen directions. But my intent was to talk about my little library. I have several hundred sci-fi/fantasy books. My wife has often referred to it as a part of my dowry. When we married, I sold off at least half of it, but have been building it back again. There are about 250 titles in the "already read" section, and another hundred or so in a "to be read" section. I keep that "to be read" section for the sole reason that I always want to have something that I know I will like at hand - it is a kind of reading security blanket for me. And I love me a good discussion about fantastic futures!
I expect that there will be plenty of time for reading in the next bit. I am always looking for good books to read, and participate in two book clubs already. Anyone with a good sci-fi/fantasy title to suggest? I am all ears. They help me focus on the future, and live outside the present...
I am a great fan of science fiction and fantasy, mostly because they begin in a reality and then move thoughtfully through that reality. All authors are skilled writers (duh!) but their gifts vary widely. Some are especially great at devising world systems, and then telling epic stories about those places. Others rely more on the human experiences of social development, but tell very interesting "alternates" to them, hinged perhaps on a subtle change to an outcome.
Of course, with an introduction like that, I could go in a dozen directions. But my intent was to talk about my little library. I have several hundred sci-fi/fantasy books. My wife has often referred to it as a part of my dowry. When we married, I sold off at least half of it, but have been building it back again. There are about 250 titles in the "already read" section, and another hundred or so in a "to be read" section. I keep that "to be read" section for the sole reason that I always want to have something that I know I will like at hand - it is a kind of reading security blanket for me. And I love me a good discussion about fantastic futures!
I expect that there will be plenty of time for reading in the next bit. I am always looking for good books to read, and participate in two book clubs already. Anyone with a good sci-fi/fantasy title to suggest? I am all ears. They help me focus on the future, and live outside the present...
Friday, January 28, 2011
Bone scan 101
New adventure in nuclear medicine today, and it was not too bad from a consumer's perspective. I walked over to the diagnostic radiology lab, conveniently located near our local hospital, to experience another tool in the toolkit of the oncology professional. As mentioned yesterday, my oncologist referred me here so that we can be somewhat sure that our treatment plan is oriented toward the right objective (which is hopefully those two tumor in my liver). The bone scan is meant to rule out additional mets that would not normally show up on a CT scan.
So, as I understand it, the idea is to inject the patient (aka, "Ed") with a radioactive element (Technetium-99m) that has a short half-life (6 hours) and emits a steady flow of gamma radiation that a gamma detector can detect. The technetium is carried by my bloodstream throughout my body, but it is especially attracted to the calcium in my bones. So everywhere there is blood contact with bone, a little of the technetium binds to the calcium there and emits gamma radiation until it has no energy left. More blood flowing to areas generates more technetium deposited, which then leads to more gamma radiation emitted. There is a ton of additional information on Wikipedia, should you really want to get into the science of that process. I was injected with the technetium at 10am and told to come back at 1pm for the scan. No special diets, no fluid restrictions... piece of cake.
Went back at 1pm and was asked to lie down on a gurney. The technician then gave me a cushion to support my knees (slightly bent) and two straps (one to hold my feet together and another to support my arms. He then wheeled me under the gamma detector and I took a nap (honest!) while the machine moved slowly over me. All of my bones slowly light up on the detector, and areas that have the highest concentration of technetium light up the most. The detector is very sensitive, so we will have a good picture of my skeletal health when all is said-and-done. The radiologist's report will be available on Monday.
Not too bad, really.
So, as I understand it, the idea is to inject the patient (aka, "Ed") with a radioactive element (Technetium-99m) that has a short half-life (6 hours) and emits a steady flow of gamma radiation that a gamma detector can detect. The technetium is carried by my bloodstream throughout my body, but it is especially attracted to the calcium in my bones. So everywhere there is blood contact with bone, a little of the technetium binds to the calcium there and emits gamma radiation until it has no energy left. More blood flowing to areas generates more technetium deposited, which then leads to more gamma radiation emitted. There is a ton of additional information on Wikipedia, should you really want to get into the science of that process. I was injected with the technetium at 10am and told to come back at 1pm for the scan. No special diets, no fluid restrictions... piece of cake.
Went back at 1pm and was asked to lie down on a gurney. The technician then gave me a cushion to support my knees (slightly bent) and two straps (one to hold my feet together and another to support my arms. He then wheeled me under the gamma detector and I took a nap (honest!) while the machine moved slowly over me. All of my bones slowly light up on the detector, and areas that have the highest concentration of technetium light up the most. The detector is very sensitive, so we will have a good picture of my skeletal health when all is said-and-done. The radiologist's report will be available on Monday.
Not too bad, really.
Thursday, January 27, 2011
dagnabit, muskie!
Alas, here we are again... four years out from the first roller coaster ride and I am back in line for another. It turns out that the elevated CEA levels from last week's blood test reflected two liver metastases from the colon tumor that we exorcised in early 2007. Too bad those rotten little cancer cells were resistant to the FOLFOX cocktail, eh?
So, tons of oncological fun on the near horizon. Tomorrow we have a full body bone scan to check for bone mets. For the uninitiated, "mets" is the lingo for metastases, or cancer that has spread from one organ to another place. It is possible that I have developed bone mets because, in the blood test that demonstrated an elevated CEA level, I got the bonus news that there was an elevated (barely within the upper band of normal) level of calcium in my blood. Calcium in one's blood can result from many things (including vitamins, though this is not the case for me), but we are checking to see if bone mets are the culprit for the elevated calcium. We are hoping beyond hope that this is not the case, since otherwise the metastatic colon cancer is going wild in my system and the liver tumors are the least of my problems.
If the bone scan is negative, then the next order of business is reducing the size of the liver mets. FOLFIRI is our new cocktail friend, possibly supplemented by cetuximab, a biological agent. FOLFIRI is fluorouracil (5-FU), Leucovorin (aka folic acid), and Irinotecan, and it is delivered intravenously. I will need to get another port-a-cath installed, so that they can deliver the FOLFIRI directly to my bloodstream near my heart. This cocktail will be administered every other week until the liver tumors shrink to a manageable size (as detected by CT scans). TOO MUCH FUN!
Surgical resection would happen next, followed by some more chemo to be sure there are no additional tumor-wannabes waiting around, probably with 5-FU, Leucovorin and Avastin. Maybe 2011 will end with an all-clear. Let's hope so.
In the meantime, everyone should relax, enjoy their lives, and hug their loved ones. Really, what else is there to do?
So, tons of oncological fun on the near horizon. Tomorrow we have a full body bone scan to check for bone mets. For the uninitiated, "mets" is the lingo for metastases, or cancer that has spread from one organ to another place. It is possible that I have developed bone mets because, in the blood test that demonstrated an elevated CEA level, I got the bonus news that there was an elevated (barely within the upper band of normal) level of calcium in my blood. Calcium in one's blood can result from many things (including vitamins, though this is not the case for me), but we are checking to see if bone mets are the culprit for the elevated calcium. We are hoping beyond hope that this is not the case, since otherwise the metastatic colon cancer is going wild in my system and the liver tumors are the least of my problems.
If the bone scan is negative, then the next order of business is reducing the size of the liver mets. FOLFIRI is our new cocktail friend, possibly supplemented by cetuximab, a biological agent. FOLFIRI is fluorouracil (5-FU), Leucovorin (aka folic acid), and Irinotecan, and it is delivered intravenously. I will need to get another port-a-cath installed, so that they can deliver the FOLFIRI directly to my bloodstream near my heart. This cocktail will be administered every other week until the liver tumors shrink to a manageable size (as detected by CT scans). TOO MUCH FUN!
Surgical resection would happen next, followed by some more chemo to be sure there are no additional tumor-wannabes waiting around, probably with 5-FU, Leucovorin and Avastin. Maybe 2011 will end with an all-clear. Let's hope so.
In the meantime, everyone should relax, enjoy their lives, and hug their loved ones. Really, what else is there to do?
Thursday, October 15, 2009
Neuropathy, continued
OK. We are what, nearly two years out from the last chemotherapeutic encounter with FOLFOX. And the idea was that after a certain period of time the tingling feet and the extreme sensitivity to cold in my fingers and throat would go away. And while I am certainly less tingly and sensitive, I am still aware of the peripheral neuropathy every day. Just yesterday, on my way to work, I had a strange itching sensation right above where my PowerPort used to be... and then today the itch was back again. I even thought that is was on the wrong side, but sure enough (I checked) it was the scar site.
So, what are we talking about here? I don't know. Except that the original purpose of this blog was to tell my story, and the story continues. My hands and feet are still susceptible to cold, though the tingling in my feet is confined to a very small area near the balls of both feet. I do not feel pain when picking up cold objects immediately, but I cannot comfortably hold cold objects for long periods of time in my bare hands. Swallowing cold drinks is not a problem at all. I have not "forgotten" how to swallow food/drink since the chemo ended.
That's the news for today.
So, what are we talking about here? I don't know. Except that the original purpose of this blog was to tell my story, and the story continues. My hands and feet are still susceptible to cold, though the tingling in my feet is confined to a very small area near the balls of both feet. I do not feel pain when picking up cold objects immediately, but I cannot comfortably hold cold objects for long periods of time in my bare hands. Swallowing cold drinks is not a problem at all. I have not "forgotten" how to swallow food/drink since the chemo ended.
That's the news for today.
Wednesday, October 7, 2009
Time to reinvigorate the blog...
2.5 years ago, I entered CancerWorld by way of a hyper-active glandular cell in my lower colon that forgot to stop growing. It has been excised, my immune system has been whacked and regenerated, and I have ridden thousands of miles on a bicycle. Time has passed, and I have completed two LiveStrong Challenge rides (40- and 100-miles in 2008 and 2009, respectively). I am very excited to Ride for the Roses with Lance Armstrong in just over two weeks - another 100 miles in the hills outside Austin, TX.
I stopped blogging for a while... but you already know that. I had tired of reflecting on the effect of a cancer diagnosis on my physical, mental, and spiritual health, and of the effort it took for me to write about those reflections. But I have found that being tired does not make problems go away. Be comforted that I am still "no evidence of disease" (NED), and that my exercise regimen seems to be a very good idea regarding recurrence. But cancer is patient and insidious, and I do not go a single day without thinking of possible futures involving more surgery, more chemicals, and the possibility of radiation. I am ready to take up the virtual pen again.
Two close friends recently detected recurrence of their cancers - one melanoma and one lymphoma... both are very nasty and agressive. And I am ready to maintain a blog of my thoughts on our journeys forward. I trust this meets with your approval. :)
I stopped blogging for a while... but you already know that. I had tired of reflecting on the effect of a cancer diagnosis on my physical, mental, and spiritual health, and of the effort it took for me to write about those reflections. But I have found that being tired does not make problems go away. Be comforted that I am still "no evidence of disease" (NED), and that my exercise regimen seems to be a very good idea regarding recurrence. But cancer is patient and insidious, and I do not go a single day without thinking of possible futures involving more surgery, more chemicals, and the possibility of radiation. I am ready to take up the virtual pen again.
Two close friends recently detected recurrence of their cancers - one melanoma and one lymphoma... both are very nasty and agressive. And I am ready to maintain a blog of my thoughts on our journeys forward. I trust this meets with your approval. :)
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