Tuesday, October 19, 2010

I went to Doctor Quaid's office today with Rhiannon and my Mother-in-Law, Marie. The surgeon I met yesterday had told me that they would be able to take the port out in the Doctor's office. This had frightened me a little bit. I immediately thought of laying down on one of those crinkly sounding exam... "beds" or whatever they are. If anyone knows the name technical name I would be interested to know it. Anyway, I saw in my mind's eye me sitting on one of those things while the good doctor told me to take a deep breath then pulled the port out. Yikes.

On the contrary, in this Doctor's office they have a miniature Operating Room, which I did not know, when the nurse led Rhiannon and I back to this room. I felt a wave of relief. The nurse told me to take off my shirt -- I always have this inappropriate inclination to joke with them when they say that and respond by saying, "You'll need to buy me dinner before that's gonna happen." I know, like I said, 'inappropriate'. I suppose once you have had as many Doctor's appointments as I have had in the past few months, where people are poking and prodding, you lose a certain sense of discretion and/or dignity. For example, yesterday when they told me to remove my shirt, they pulled the curtains for privacy. Privacy? How about privilege! In most places it is "No Shirt, No Shoes, No Service." Okay, I suppose a Hospital is different, but if you can't laugh about the things you have to do for Doctors, cancer would be pretty gloomy.

So back on track. The nurse led me in and told me to remove my shirt (we've covered that part), and take a seat on the operating table, which was covered with red disposable shop cloth material and what looked like a puppy training pad, only without the pheromones. I hesitantly took a seat; hesitantly because I didn't want her to start doing anything to me without the Doctor seeing me first. I suppose I wanted to feel in control of what was going on until he got there.

The nurse started raising the operating table and all she had to say was "we're gonna bring you up to eye-level for Doctor Quaid." really, that's all she had to say for this to be funny, because Dr. Quaid is close to 6'5". So her, me and Rhiannon had a little laugh about it.

The Doctor came in about the same time I was getting the dressing removed from the port incision. He looked at it like a painter looks at a painting after brushing on a stroke and stepping back. He put on some gloves and poked next to the infection to see if there was any discharge, but there wasn't. He mumbled something about that being encouraging. I was on baited breath waiting for the verdict. At this small, pin-prick sized point in my life I felt all my faculties focusing on the words this person was about speak.

I had to break my own tension, so as I was laying down I said with a smirk, "I've only had this thing for 10 days, is there some kind of return policy??" He threw his head back and laughed and that made me feel a little bit better as we talked about the differences between doctor's fees and the fees associated with using a Hospital O.R.. The conversation lulled and he look another inquisitive look at the incision as I, once again, felt frozen in place.

"I want to try and save it." he said casually, "let's go ahead and clean it out real good and stitch it closed."

He explained to me that it looked like there was some tissue break down, but that he could see the failed sutures in the wound tract.

"The worst-case scenario is that you get a delayed infection inside, that we'll treat with antibiotics. Since you'll only have that in there for another month to month and a half I think we can save it for at least that long and prevent you from adding another cost."

I know this seemingly over dramatic presentation of events appears to be overkill, but I honestly can't express to you the relief that I felt once he said those words. So if my sculpted description doesn't help, suffice-it-to-say: I would have stood on my head if that helped him treat me in any way!

He put a cloth curtain up to separate my head from my chest and explained it was to avoid contamination through me breathing on it. He turned on the operating lights which were incredibly bright, they were actually very warm. I could feel him poking and pinching the affected area. He asked the nurse for some scrub, iodine and other things he'd need. He talked to me about my past few days and asked when the infection presented itself. I was surprised to... well, he was listening to me! He actually listened to what I was saying, and made me feel like the information I was giving him was pertinent. This was surprisingly a boost for me.

There was pain here and there as he scrubbed me out, but it didn't really hurt. I just felt pressure was all. Rhiannon who was in a chair 7 feet from where my head was on the table, said during the conversation he was discarding bloody things, but it was probably the iodine or the scrub. The Doctor said that he found very little blood, which is a good thing, it means the tissue is still alive.

Then the stitches. He asked for (i think) 375 Nylon. The nurse went and got it and he started stitching up the affected area. This was very needley. I delt with what felt like the first 3 in-n-outs, but asked for a local after that. He gave it to me, i think. There were so many needle pokes it could have been more stitches. The bad news is that the local didn't do much where he put it. So i could still feel the last few he put in.

When he said that was the last of it, i had noticed how clenched my body had become to bear the pain. So i relaxed. He put gauze and a cellophane looking sticky sheet on to seal it up. Then he told me to take it easy for a while. I told him that the nurse in Oncology had said my white blood count was right smack dab in the middle. He said, "oh, that's encouraging!" After he gave me a few instructions he sent me away with some antibiotics and a follow-up appointment for Tuesday. He told me to go ahead and get chemo on Monday, then see him on Tuesday. He also said that the stitches would need to come out. I'm guessing that is when he'll do it.

While I was leaving I tried to put my shirt back on and realized I didn't want to chance bringing my arm over my head this soon. So I put my left arm in the sleeve and left my right arm in place: elbow at my side firmly, and forearm and hand wrapped around my stomach. I have been telling everyone that I am going to take it easy, let this heal and be very aggressive about it. So on Thursday I'll quit looking ridiculous and move my right arm around normally, but until then I'm going to treat it like I have a dislocated shoulder -- only without the ice. The Doctor said to be very minimal with things like that.

Overall I am pleased and humbled. The past few days I have had an increasingly poor attitude about treatment. I have been complaining about how dizzy I feel and so on, just complaining. I feel like the Lord has shown me through this experience that it could be a whole lot worse. That Jesus Christ (the ultimate cancer survivor, because of experiencing our pains through the Atonement) even complained a little, but he still acknowledged His Father as the one in control. It wasn't until now that I feel I have surrendered this disease to the Lord, letting Him be in control.

I realize that is a weird sounding thing for me to say, but it wasn't until now that I stopped relying on my own strength, because I see how far that got me. I spent all weekend undressing the wound, putting Hydrogen Peroxide on it, then putting Triple Antibiotic on and covering it with cotton balls then taping it down. I did that every day this weekend. It only seemed to get worse.

I took that two ways 1 - I should never become a doctor or 2 - I should probably rely on the Lord more during this time. I already knew the first one! The second one was less proven, until now.

Day 8

Monday, October 18, 2010

I went to go get my normal chemo today. For the past few days the nurses have been concerned about the fact that my incision (from the port surgery) isn't healing up properly. They have been fearing infection for a few days, but through just about every nurse in the Oncology Department checking me out with my shirt off, they had collectively decided that it was a surface infection - nothing to worry about.

On Friday (Day 7) I had gone home and cleaned the affected area and treated it with triple antibiotic ointment. In the eyes of the untrained medical professional (myself) it was looking pretty good.

It wasn't until today when the nurse pulled the dressing off and looked at it, she had the first glint of what I saw as worry. She drew another nurse into the cubicle to take a look. This nurse's name was Nina, she'd taken care of me all last week. She bit the corner of her lip in concern and said that it wasn't looking too good. They squeezed the incision to see if there was anything that would come out, nothing did. As a precautionary measure, they put a hold on my Chemotherapy for today and called for labs.

The nurse drew blood from my port, then they had another nurse come from a different Department of the hospital to draw blood from another part of my body. This is called a Blood Panel, I think, I can't really remember because my head reeling by this point. Basically, they wanted to draw from two different places to have a variety of results.

They called a surgeon from the office of the Doctor that put my port in, so he could come in and look at the incision to give the nurses some insight. However, this Doctor was in the Operating Room and it took about an hour for him to finish. So there I sat. Shirtless. For an hour.

When he came in he told me that there appeared to be tissue break down around the incision. This means that the incision should have closed, like it normally does, and fuse together -- but it didn't. For reasons unknown it didn't heal together and it opened back up, except only half of it opened back up, the middle of the incision is fine. I'll illustrate it with equal signs, hyphens and X's. The X's represent where it's closed, hyphens represent where it's healing and the equal sign represents where it's opened, the aforementioned case:

======XXXXxx-----

Since the incision is like a pocket where they slip the port into, this is how the incision literally looks, almost to scale, maybe a little longer. As you can see, the healing is rather odd. The surgeon thinks the best thing to do now is to remove the port and put a new one in the other side. In fact, you know Doctors: they don't think, they know!

I guess this is a good thing that they're decisive, but it doesn't leave much room for hope. Seeing as this means that tomorrow (Tuesday, October 19, 2010) I have an appointment to have the surgical doctor (Dr. Quaid) who put this in, take it out. Well, the Surgeon that looked at me today told Dr. Quaid he should be prepared to take it out tomorrow, but that he could decide for himself. Then he gave me a slight, smug micro-expression. I can pretty much bank on the fact I'm getting it out tomorrow. I asked the "good" Doctor what his return policy was on 10 day old merchandise. Seeing as how this little gizmo is not cheap. He gave a scripted, diplomatic answer of, "We provide the services, it's not really about purchasing them or returning them." Makes sense I guess, but his follow up question was if I would be paying out of pocket. When I said yes, he didn't seem empathetic. He mentioned the financial aid that was available, and didn't say much else. Poor people must make him uncomfortable.

On Wednesday, October 20, 2010 I am scheduled for surgery to get another port put in. On the following day I have an appointment scheduled with my Oncologist Dr. Brown, whose name I see all the time, but I haven't seen her for a couple weeks. It will be good to ask some questions.

I'm really not thrilled about the news, as you can probably tell by my chiding and sarcastic tone in my post. I guess the truth is I don't want to lose momentum and I feel like this hiccup will contribute to a huge loss of it.

It's kinda funny that cancer is self-sustaining to the point where it actually runs out of inhabitable room, yet the patients themselves have to dig deep inside (as well as drawing on support from others) to find what sustains them through the process of killing it.

Day 1

Monday, October 11, 2010

My first day of Chemo went alright. I met a really nice nurse. I went to the treatment with Dibe. It felt weird the whole time having something coarsing through the largest vein in my body. It kinda felt like: excitement, hunger and heartburn all rolled into one. The minutes dragged on like weeks. We had a good time with the nurse we joked back and forth, Dibe humbly flaunted her medical knowledge to which the nurse asked "aaand how do you know all this?" Although it would have been really interesting if Dibe said, "from WebMD" instead of her actual response wihch was, "I work on an Ambulance."

There isn't much to tell about this day except they spray froze my port area, and jammed a needle in, then took my blood at the beginning. Apparently the Silicone membrane on the port is a lot thicker than I gave them credit for originally.

They pushed my Saliene fluid through too fast so i feel woozy and dizzy. I thought that was how I was supposed to feel, but i thought I would ask anyway. The nurses assured me that I didn't need to feel that way, that they could push it through slower. So my nurse, Nina, wrote that in the notes.

At the end of this seemingly uneventful day a woman suffered an allergic reaction. The Oncology nurses called in people from Intensive Care and a Pulmonary Specialist. There were a bunch of people gathered around her asking questions. The Intensive care nurse looked frazzled -- like she's always in a hurry where ever she goes. Unrelatedly, I told Dibe she should be an ICU nurse. She declined saying that her job is more fun. I asked why? and she told me because when ICU gets their patients they're already stabilized -- stabilizing them is the fun part, she said. I agreed, that sounds more fun. Before we found out the outcome of the lady's condition, it was time for us to go.

Friday, October 8, 2010

I woke up at 7:10 this morning for my surgery. We had to be at the Hospital at 8:00. We got registered for the surgery, then played the waiting game. Finally the nurse came back and got me for my weight. After that they brought me into the pre-op room and gave me a bag for my clothes and other belongings.

After getting situated I laid in the bed and this really funny nurse came in and introduced himself as being the teller of bad jokes. (i.e. what do you call a bear with no teeth? .......... a gummy bear!) Needless to say he lived up to his introduction. He shook my hand, then grabbed the tips of my fingers, then when I put my hand back at my side he coaxed me to "finish it!" so we pounded knuckles. I have got to say that's the first time i've received "knucks" in

a Hospital!

He prepared to give me my IV so i did my usual and looked away. He gave me a local, then put the IV in and asked if i was okay. I told him I was, i just didn't like to watch. He responded with, "me neither, I like to close my eyes!" The man got jokes, I tell ya what!

He told me he'd see me in recovery and another nurse would look after me. When she walked in it was a very familiar face. I had seen her just two weeks previously before my Orchiectomy surgery! I said, "yooou look familiar!" and she told me how she bragged about me to other nurses for the past two weeks about how i just had a great attitude, and was at a rea

lly good place mentally during that surgery. I thought that was cool.

Eventually I had to go to the bathroom, so a nurse helped me down the hall, and of course as luck would have it, the Anesthesiologist tried to come visit my little room while I was gone. My Mom recounted the details when i came back. After i got re-situated she came in a short while later. She explained the anesthetic and how the meds i take make me more tolerant to it. So she'll have to give me more. She also explained they would give me a breathing tube, so i might wake up with a sore throat.

A really nice nurse wheeled me into the Operating Room and I started to get a little nervous. It always kinda gives me the willies to see how laid back the surgeon and surgeon's assistants are when you first get wheeled in. They were chatting about the Iron Man competition in Kona, Hawaii. Then the lady at "The Long Table of Sharp Pointy Objects" asked the guy who wheeled me in, "what's missing in here today?" and he said, "music!" so she asked me my favorite band. I was a little busy being transferred over to the Operating Table and getting my gown untied to answer. She asked again later though and I told her.

They set me all up then they p

ut the oxygen mask on my face and the Anesthesiologist hooked something up to the IV. She told me that most people feel a sting that goes away right away -- within thirty seconds -- and that i'd feel the wetness that i felt last time. Then, I started to feel really tired but kept my eyes open, the large Operating Room lights started focusing and unfocusing and my eyes were involuntarily listing lazily from side to side.

The next thing I remember is waking up in the recovery room with a killer sore throat. They had one of those oxygen nose things on me and it felt insanely uncomfortable to my still heavily sedated self. Instinctually I trie

d to pull it off, but the nurses stopped me. When I wake up in the morning usually I rub my eyes a lot to get the sleep out of em, it also seems to help me feel more awake. I tried that and the nurses batted my hand away again, thinking I was going for my new nose-piece. I told them I wanted to rub my eyes -- no relief. It was a deep feeling, clear in the middle of my head, rubbing my eyes wasn't going to help.

As soon as I could I asked for ice chips, cuz the thing that hurt the most was my throat! They told me it'd go away in about a day. I started feeling more awake, I joked with the nurse. She kind of looked at me like "is h

e serious?" They must get a lot of boring people in recovery or she must have thought i was talking nonsense because I was still high off Anesthesia. It may have been nonsense. I remember it being about my robe, but I can't remember it all. I just remember her laughing. In my state it was not a good idea to keep making jokes, but i made another one. It was about wearing so many clothes into the hospital i had to have two bags. I remember feeling disappointed to hear her say, "oh was it cold outside?"

They forgot to take an X-Ray to make sure that the Catheter feeding the vein was in the right spot, while I was in the OR. So they did it there.

They wheeled me into the next room which is basically the wait to be released. They were waiting for the phone call from radiology to confirm it was in the right spot. While we waited my mom took a picture of me. I sat there with my ice chips, with no modesty, looking stoned out of my mind because the sun was shinning in through the window i was facing, but life is good!

No more IVs!

Finally the nurse caring for me went on a calling spree and tracked down radiology and asked them herself if my results were back yet. They were and I was fee to go.

A really close friend of mine named Craig recently had collar bone surgery, so I can imagine that he looked something like me in this picture after he got out.

I got home and felt pretty good. I just feel like I have a sore neck, like I slept on it wrong. Other than that, i feel pretty good. The Doctor said no spiking of any Volleyballs for a while. Darn, that was on my to-do list!

I start Chemotherapy on Monday and my wonderful friend Dibe is going to be picking me up at 6:30 in the morning so we can make it there by 7. Then the 4 hour treatment, but hey... no IV! Plus she's an EMT so she knows medical speak and will be able to help me out with all the stuff they tell me.

Monday, October 4, 2010

I was called by Karen from UCH today telling me to plan on not having an appointment this afternoon, because the two doctors that were deliberating on my admission were still "at it" Friday when they left. She said that she'd call me if anything changed. Although it looks like I may not be going to UCH.

I talked to Patty from the Financial Aid organization called RamStrength. She's an Oncologist nurse. I asked her if the Chemo was typically done at PVH and was covered. She said, "yes!" All I would need to pay out of pocket would be Oncologist "check-ups." Even then if i am eligible for RamStrength then they'll pay up to 500 dollars on each bill.

She also said that the Oncologist that i was going to was trying to have their office converted over to CICP. So that's good news too. It's almost looking like Cancer Center of the Rockies would be a better choice than UCH. I mean, I would love to go to such a successful hospital, but at the same time I am kind of feeling okay about going to the Cancer Center of the Rockies too.

Friday, October 1, 2010

Today I went to Medical Center of the Rockies to get another CAT scan. I thought it was just going to be a normal CAT scan so I told Rhiannon to wait in the waiting room. The last time she came in with me for a CAT scan the technician looked at her funny. Almost as if to say, "it's just a CAT scan..." Then she had to leave anyway. So this time I told her to go ahead and just wait in the waiting room.

The Nurse took me back and as we were walking down this long hallway she was telling me what was going to happen and mentioned "a dye" and I was thinking, "oh man, i've heard of this before."

So she took me to this room with a curtain for a door. She told me that the nurse was going to give me an IV. Then the nurse asked if i wanted a warm blanket. I said no and she asked jovially, "are you sure? I just love getting them out!" I laughed and told her no, i was sure. As she left I looked across from where I was sitting and saw a chair for guests and internally kicked myself, because I could have had Rhiannon with me! The other nurse came in and gave me an IV, it was the weirdest feeling to not have it attached to anything and walk down the hallway to the CAT scan area. I felt like I had to hold the IV port part up so gravity wouldn't drain me of blood, but those seals are pretty good!

The other nurse came back and "handed me off" to the original nurse who walked me the rest of the way. We went into the room for the CAT Scan. They did the normal in and out thing, scanning me. Then she walked out of the observation room and told me that she needed the hand with the IV. She told me she was going to do a Saline flush. I didn't like it, as soon as she put it into my blood stream the air tasted salty and stale, and smelled the same way. After that she told me she was going to put the dye in. It was an interesting feeling. It felt wet at my IV, just like when I got the Anesthesia for the surgery. Only I didn't pass out.

I felt this really warm sensation start at my right arm, move to my chest, then from there it moved simultaneously up to my head to make me really dizzy, and to my left arm, then like a really slow wave it moved down my torso 'til it hit my feet. It was then that i felt something she had warned me about. She said most people feel like they're wetting their pants, but you're not, and it will only last for thirty seconds. Well, it did, it felt warmer and warmer in my nether regions until it felt like I was essentially wetting myself, but I deduced that's because that area houses the most blood vessels in such a small area. As compared to my head where I just felt dizzy, I could concentrate on how it got warmer and warmer down there, then as soon as it came it was gone! So was the CAT scan, it was done too. She told me she'd extract the IV, which I instinctually braced for, but it was fast and smooth, I didn't really feel it.

She told me the reason they put the dye in me was for contrast on the CAT scan. That I should drink lots of water over the next two days to prevent kidney damage. I think she said 6-8 full glasses of water. I just drank 2 liters of Gatorade when I got home, then 2 more the next day.

When I got out of there I told Rhiannon everything that had happened and she sympathized telling me she had to get a CAT scan with contrast before too and it was weird. When I got out I asked the receptionist for a copy of the results when they come in. I'm supposed to call Monday the 4th and pick them up.