Monday, April 12, 2010

It begins

Today's Tarot Card said - "The Strength card suggests that you should try to be flexible and receptive. (trust my Super Heroes and my micro-snipers!) Listen to your instincts and believe there is light at the end of the tunnel and you will be able to persevere (I will win this battle!!), take action (accept the chemo in good graces, knowing my friends and supporters and warriors are there to help) or get over it. Be honest with yourself and open to suggestion (me? open to suggestion?? I'll try! :o). Trust in your own ability to demonstrate patience and hang in there; courage, determination and action -- not words -- can help you more effectively influence and deal with the demands of daily life. (courage, I've got that - determination, that too - patience? I'll have to work on that one too!)"

Yesterday, I had the port implanted - boy, that was fun.

A port - this one is called the Power Port - "implantable port for IV therapy treatments - also called a port-a-cath - a long term venous access device" - in my case, and most chemo-therapy treatments, for ease of administration and to save the veins in my hand and arm from collapsing from needlesticks and overuse! -- a good thing!!

It's a cylinder with a hollow space inside that is sealed by a soft top. It is inserted entirely under the skin through a small incision, and has a plastic tube (a non-tunneled catheter) threaded directly into the designated vein, in this case, my carotid artery. The catheter is held in place with sutures and then the incision itself is closed up with sutures. To assist with the proper location of the catheter, x-ray contrast dye may be injected thru the catheter, but from the gel one of the nurses placed on my neck, I suspect they used ultrasound in my case.

The port is flushed with sterile heparinized saline after each use, called a heparin lock, to help prevent blood clots from forming. The port must typically be cleaned and the heparin changed every 4 weeks, but since I'll be receiving my 'healing joy juice' every three weeks, that, at least, won't be a concern.

As seems to be the norm, the list of risks and complications are nasty enough to make me want to run screaming from the hospital.

Embolisms are possible, meaning the possibility of 'stroke, heart attack, or even death.'

The veins used for the needle and catheter placement are very close to the lung. Puncture may cause a pneumothorax (collapsed lung) requiring the need for a chest tube while they rush to fix that little problem.

Infection is, of course, always a possibility.

Sepsis (infection of the bloodstream) or phlebitis (inflammation of the vein wall) are the major risks, though considered small, and may require IV antibiotics or surgery, and in rare cases, that lovely word 'death'.

Thrombosis is a blood clot inside the vein near the catheter, which may cause blockage of the vein, leading to swelling and pain, possibly requiring anticoagulation blood thinning drugs and/or surgery. Goody.

Nerve damage is possible which may cause permanent injury.

Cardiac Arrhyhmia, a change in the normal pattern of the heart beat, may show up if the catheter moves from the vein into the heart. 'Usually' goes away when the catheter is pulled back. There were 6 more potential risks listed, but I quit reading at that point.

Had to be there at 11am with the surgery scheduled for 1 pm. They were running almost an hour late - never schedule anything for a Monday! Then, the procedure that was supposed to take only 15-20 minutes took an hour, and so far I don't know why.

The surgical staff was fun - they've worked together for a long time and teased and laughed and joked. But my appreciation declined a bit when I woke up to find my hair wet. Asked about it. Oh, sorry, we spilled a little too much Betadine (the dark yellow/ orange topical antiseptic stuff - povidone-iodine (PVPI) - they paint all over you as an important first line of defense against infections) AND whatever the liquid green stuff is, presumably another antiseptic or liquid antibiotic maybe. A little too much?! I looked like I was wearing a Green Bay Packer helmet!

My RN was kind enough to bring in a couple warm wet towels and my Silver Fox spent about 20 minutes trying to get the junk out of my hair. When it was dry and I tried to brush it out, I did just that. My hair broke off and FILLED my hairbrush with loose ends. Three times! I had to cut two inches of length off all the way around this morning because of the damage. Oh well, it's all going to be gone in 14-15 days anyway, allegedly.

The doctor left the appliance 'accessed', making it easier today to start the chemo, saying the area would be pretty sore and by leaving the access needle in place, the techs wouldn't have to stick my tender skin again. That sounded good, until I took a look at the bandage and thought of sleeping with it. The damned needle sticks out about an inch and the tubing is just dangling in place, waiting for it's joy juice. And the damned thing hurts - more than the cancer surgery itself did! Hopefully when they disengage all the 'equipment' and leave me with just the little 'Power Port' making a three-bump bump under my skin, it won't be so distasteful.

Otherwise I felt fine immediately upon awakening, again. I do love these new anesthetics! I remember the 'old days' when waking from surgery was an entire new trauma! No more! At least for me!!

And what's especially nice, the nurse immediately brought me ice water and asked if I was hungry. YES!! So I received a decent little lunch - a turkey sandwich on wheat bread, with lettuce and tomato (sort of a tomato) and mayo and mustard, and applesauce and a package of honey graham crackers. I've never seen that done before! And of course my Fox had to catch me with my hand in the bag of chips, which I grabbed first!

Not a good night for sleep - I hurt and the bandage was tight and pulled and was uncomfortable as hell. And yes, today was THE DAY for the first chemo. I'll write about that event tomorrow, 'cause I'm exhausted, but I'm very pleased with how it went! No problems, yet, at all!

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