day 16 listing to port

Yesterday went pretty well. Ironically, the biggest challenge for me was the relatively late start to the day, which was dictated by the OR slot assigned for the port placement. These are relatively simple operations, and quick, and of course elective so I imagine they are scheduled as possible. It turned out that yesterday things were running behind, no doubt because the doctor, one of our Thoracic and Cardiovascular surgeons, had bigger cases that morning, which can take longer. So my problem was not the waiting per se, but the fact that dehydration is something that triggers migraines for me, something I discovered 20 years ago when I moved to California and hiked in the San Diego back country, underestimating the heat and dryness. And they are very strict about no food or drink from midnight the day of surgery. Around 2 pm it got pretty bad and I started feeling nauseous too. Talk about dumb – here I am on the first day of my chemo, and no one has even touched me and I am feeling like I want to just curl up in a dark corner.

Soon after, the team brought me to the back, and started an IV and I met the anesthesiologist who gave me some tylenol IV and took great care of me. I was feeling much better soon. I noticed as we were doing consent that the anesthesiologist was using a fountain pen, and had excellent penmanship – not something either associated typically with doctors (sorry colleagues!) or with the forms that make up a significant part of modern life. We had a great chat about this shared interest, and he gave me some great tips for a website. I have to say that I find it remarkable how many friendly encounters I have as I move through so many people’s hands in all the many places at MD Anderson and how important that is – the positive impact on patient morale is hard to overstate.

The port placement is done with a sort of heavy sedation, so that you are awake, and I have to say I was very comfortable. It felt like it went very fast, and every few minutes a friendly face would pop over the drapes and ask me how I was doing – actually felt better than I had so far that day – and I noticed nothing of the actual operation except for the topical lidocaine they used to numb up the area. Here are couple of pictures of the port, which are from the education model that the team used the day before to explain it to me. You can see how it sort of bulges out from the skin so it can be found and accessed. It really is cool – no more IVs except if I need to do a PET at some stage (can’t put radiotracers in the port as they get stuck).

_port1Port2

Of course when you have a new toy, you need to take it for a spin, so after a half-hour in recovery I moved up to infusion therapy for my first chemo. In the ambulatory clinic they are open late – until 10:30pm I think – which is pretty remarkable. They were expecting me and got me started, and the taxol started flowing at 7:17pm. Take that, tumor – our first broadside!

I was able to catch the first part of the Presidential debate on TV, and was home in time to tuck the kids in. This morning I feel good, though my neck is a little sore from the incisions. When I was a post-doc in California I had a colleague and friend who was battling leukemia. When asked how he was doing, he would sometimes describe himself as a ship, and say the was listing to one side or the other. I have been thinking about him these days, and how he faced cancer at a much younger age. 

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