Dear Friends,<\/p>\n
My chest port was successfully installed in a 1+ hour sedated operation on Tuesday (though, in truth, I was in the hospital several (long) hours for both pre-op and post-op activities). Yesterday Krysia drove me to the Cancer Clinic for my first chemo infusion. \u00a0It began around 9:30 a.m. and continued steadily (one bag of medications being sequentially replaced by another) until 3:45 p.m., by which time Monica had relieved Krysia and was to take me home. I was sent home with a little fanny pack containing a bottle of chemicals that needed to be infused, continually, for an additional 48 hours. \u00a0As I write this, I’m connected to the fanny pack through my chest port. I slept connected to the bag last night, have had it pumping away all day, and will have to sleep with it again tonight. \u00a0Tomorrow, when the bottle is exhausted, I report back to the Cancer Clinic to have it disconnected. \u00a0After that, I’ll have a week off, have some blood tests taken, and–blood results proving acceptable–will repeat the process on Wednesday 14th (and thence every two weeks for the next 6-7 months).<\/p>\n
I’ve already experienced two side-effects: one, predicted; and one, not quite. \u00a0The first is that my blood sugars are elevated. \u00a0That is explained by a steroid drug that is part of my protocol. \u00a0The elevated blood sugars are likely a temporary aberration, as far as we can tell. \u00a0(We’ll be monitoring the levels.) \u00a0The second side effect is that whenever I attempt to put any food in my mouth (be it moist or dry, savory or sweet, etc.) I immediately react with a sharp pain right beneath my ear lobes, about the point where my jaw hinges. (Some of you may recall experiencing something of the kind when, as a child, you may have accidentally chomped down on a sour plum.) \u00a0What is causing this second effect is being explored at present. There have been previous patients at the Clinic who have reported similar side effects. Their records are posted in the archives for my benefit and the benefit of other incoming patients like me.<\/p>\n
So, all continues to be well. \u00a0I’m delighted to be actively engaged, finally, in the process of ridding myself of the cancer that was first diagnosed six weeks or so, ago. \u00a0Since that time I’ve been involved in what I call “preparation and training.” Now I’m happy to be finally actively dealing with the elimination of the cancer. \u00a0It feel emotionally satisfying.<\/p>\n
Disclaimer<\/strong><\/p>\n Before I delve into the details, I feel a preliminary observation needs to be stated at the outset: \u00a0It is clear from my reading and intuition\u2014and it is verified by my observation of other patients at the Cancer Clinic\u2014that each person reacts to their cancers differently, as they do to the medications that are prescribed for them. The protocols to treat individual cancers are themselves unique, having been formulated, as precisely as possible at any given point in time, through clinical observation of individual cancers and how each metastasizes. \u00a0The results of those studies are matched with laboratory analysis of the behavior of specific chemical molecules and compounds. The chemical prescriptions are precisely designed to thwart and curtail the damaging action of specific cancers. \u00a0Each is different; and each patient’s reaction to the chemistry is also different.<\/p>\n This is so complicated that nothing I can write about my personal experience can be directly applicable to any experience others undergoing cancer treatment may have, except in a most anecdotal and general way. \u00a0Whatever may be applicable or useful is likely merely to be how I convey my personal attitude about my own experience. \u00a0I suspect personal expressions are generally interesting to read because\u2014in the aggregate\u2014accounts of different personal reactions are ones from which we can glean bits and pieces to help us understand the variability of our individual, nevertheless common, human experience.<\/p>\n Specializations<\/strong><\/p>\n Previously, I expressed my enthusiasm about the anticipated Chest Port that had been recommended to me. \u00a0I can now say my hopes have been vindicated. \u00a0Having a Chest Port through which the various poisons (er, “medicines”) can be administered is wonderful, obviating the individual, painful, top-of-the-hand IV insertions. \u00a0I’m becoming more aware of the specializations of service providers in the medical profession. \u00a0My Chest Port was installed by surgeons in the Interventional Radiology Department<\/em> (a department I formerly never knew existed). I was sedated just above the level of consciousness at which I’d require an artificial breathing apparatus to help me breathe. \u00a0But I was thankfully uncomprehending of what was taking place as the surgeon sliced into my chest, at shoulder level, dug out (there’s probably a more appropriate and delicate term to be used here) a little “cave” into which he could slip the appliance (I called it a “doohickey” in a previous e-mail) and suture the wound shut. \u00a0Then, he attached a small tube to the appliance and snaked it further up into my shoulder, where he cut another slice so as to better grab the tube and insert it into the major vein heading into my heart. \u00a0Having made the insertion, he was then able to snake the tube further down towards my heart, tap everything into place, and close up the two slices with derma-glue (which is basically a form of super-glue detoxified and neutralized for surgical use). \u00a0The Chest Port appliance has a little membrane atop it, surrounded by Braille-like protuberances that can be felt, through my skin, by a qualified nurse. \u00a0She\/he can then insert a special needle through my skin, and thence, through the membrane. \u00a0Once inserted through the membrane, the needle is held quite firmly. Access is thus easily provided directly to my circulatory system. The opening to my vein and heart, at the other end of my tube, is at a point where it can readily and rapidly circulate my chemical cocktail throughout my body. \u00a0One can even take blood draws through the port, should it begin to be difficult to obtain them in the regular way through my arms. \u00a0So its a very satisfying simple-but-effective device inserted by a specialist that was likely imagined and manufactured by a (mere) highly insightful and empathetic medical engineer, wherever in the hierarchy of medical status such a person might be positioned. I’ve benefitted from a huge variety of differing skills of the (already) more than dozens of individuals who have had responsibility for a unique and specialized piece of my care.<\/p>\n Online Document Database<\/strong><\/p>\n My Clinic has all its health documents online in a centralized database. \u00a0My caregivers can see what every other caregiver has prescribed and what procedures I have gone through. \u00a0They can access all the relevant reports related to my previous care. \u00a0Not only that, but I, too (and my family) can have the same immediate access to the same information via a password protected web site: procedures, medications, reports, etc.; my entire health history. \u00a0The exciting benefit of this collection (of otherwise inert) data, is that its easy availability enables collaboration among disparate specialists (giving the inert data a form of life). \u00a0Having the data so easily accessible actively encourages collaboration. \u00a0It is easy to ask questions or make consulting phone calls because all the relevant data is at one’s fingertips, along with the contact information (e-mail addresses, phone numbers, pagers, etc.) of each of the specialists involved in my care. \u00a0This has reinforced my positive opinion of President Obama’s encouraging the conversion of medical information from paper to electronic form. \u00a0Its a good idea, “whose time has come”. \u00a0It can have many ancillary productive and economic benefits!<\/p>\n A more pedestrian observation I noticed yesterday is about the arrangement of my wallet! \u00a0I was surprised to find that the most convenient plastic card slot (the one that has “primacy of position” in my wallet) is presently occupied by my Medical Identification Card (so often must I retrieve and show it to someone). \u00a0The credit card that used to enjoy that favored position in my wallet had been displaced. \u00a0I was bemused to find it had been relegated somewhat lower and behind the Medical ID Card. \u00a0(I daresay, somewhat reluctantly, that the credit card will likely be obliged to return to demanding service in days to come!) \u00a0In the meanwhile I’ve been searching for the “Frequent Visits Program” to which I can enroll to collect awards points for each visit to the Cancer Clinic. I am looking forward to eventually trading in my multiple points for BIG PRIZES. \u00a0I haven’t found it yet… if you happen to know the URL, please send it to me.<\/p>\n I felt entirely well and energetic all day and reported for cantoring duty at the Cathedral at noon. \u00a0But I almost couldn’t lead the Communion song. \u00a0Having received the consecrated wafer on my tongue, I had to sit down to let the pain in my ears pass. \u00a0You would think, wouldn’t you, that the Good Lord would excuse reasonably devout people receiving Communion from suffering side effects of cancer treatments?!<\/p>\n Sorry to be so long in sharing these observations. \u00a0Brevity certainly doesn’t come easily to me. \u00a0That’s what the “Summary” and “Detail” sections (above) are about. \u00a0If you don’t want lengthy rumination, just read the Summary, stop, and delete the rest of the e-mail (or simply stop reading the blog entry). \u00a0The Summary will be sufficient to let you know that I’m doing well and continue to be appreciative for your support, prayers, notes, cards, and good thoughts. \u00a0They each contribute to a feeling of humility, goodwill and healthy optimism… nearly as important, I’m convinced, as the protocols of medications I’m receiving. \u00a0(Though I wouldn’t want to choose between them, if only one were on offer.)<\/p>\n Chet<\/p>\nRelated<\/strong><\/h2>\n