Port-a-Chemo

So, "Chemo: The Sequel" has officially begun.  But first, I had to get my port "placed."

This took place on a Wednesday morning a couple weeks ago.  My friend Bernadette came with me (since Mom and Dad were in Europe at the time).  We arrived at the Interventional Radiology department (sounds fancy, doesn't it?) right on time.  Only thing was, there was not a soul in the department when we got there.  Seriously, we could have tried surfing on the gurneys and no one would know!  I looked around for a bell to ring or something, but then I remembered that it's not a hotel.

After a few minutes a nurse came in and assigned us to one of the "rooms" (more like a bay).  After waiting there for a few minutes another nurse came by and asked me a few questions and had me change into a hospital gown.  She was bright and funny and before I got changed she closed the shades in my room so that "all of New York City" couldn't watch me change (because then my boob flash count would have seriously increased!).  She then gave me an IV, because even though the point of this procedure was so that I would no longer need IVs, I still needed one last IV so I could get the antibiotics and sedation.

Next, the Physician's Assistant  (PA) came by and explained the procedure.  She said first the area would be thoroughly cleaned three times - they are very vigilant about infection control.  Then, they would give me the sedation drugs before they started the actual procedure.  These drugs wouldn't put me out completely, but would relax me so that I didn't feel anything.  Also there was a chance I might not remember the procedure afterwards.

Before they placed the port they would temporarily have the catheter travel down to my vena cava, the large vein in the center of the chest.  She said as it went down, sometimes it diverted into the heart, and if it did this it might "tickle the heart" which would cause me to have an irregular heartbeat for a bit.  She said if they saw it go near the heart she might tell me to take a deep breath and that sometimes gets it back on track to where it has to go.

Once this was done the port would be placed.  There would be a small incision in the left part of my chest and the port itself would be placed just below the incision.  The catheter would lead up to a large vein in my neck.  When I was done I would have a bandage on the incision and another on my neck where they would make a tiny incision to get to the vein in my neck.

So after this was all explained to me, I was wheeled into the procedure room.  Unlike my big-time surgeries, I didn't walk in and climb up on the table myself - I was wheeled in and then had to scootch over to the table.  I noticed large monitors over the table, which would show the doctors what was happening during the procedure since this whole thing was CT-guided.

They had me turn my head to the right and placed a drape over me - including my face - so I really couldn't see anything during the whole procedure except for the wall.  After they washed the area three times as promised, the sedation drugs kicked in and the procedure started. 

Now, the night before my procedure I had watched the Britney Spears episode of Glee.  If you haven't seen it, in the episode several of the kids have to go to the dentist and while they're under anasthesia they have dreams that they are in Britney videos.  I'd had Britney songs in my head all morning (I've got to admit her songs are catchy), so of course as the drugs kicked in I was wondering if I would have a Britney fantasy too.  Sadly, it was not to be.  But they did play music and they even asked me if I had a preference as to what station they played, but I let them pick the station.  I think I remember some Rolling Stones and maybe some Springsteen, but the details are fuzzy.

I was awake for the whole procedure, and I remember it, but I didn't feel anything except pressure.  At one point, they did ask me to take a deep breath, so I wonder if the catheter was about to "tickle my heart"!

The whole thing took about an hour.  As it was finishing up I started to shiver - all of a sudden I was FREEZING.  This happened the whole ride back to my "room" (really not a long ride) and my teeth were chattering when I got back.  The nurse said that the drugs can cause this, and luckily it didn't last long.  When I got back I was perfectly lucid and "normal" - I think a little to Bernie's disappointment, since she was probably hoping I would say some funny things!

After the procedure they monitored me for a bit and during this time the nurse noticed that my upper back was very red - like I had a rash.  I didn't feel any pain or itchiness - in fact, I would never have known that it was red if she hadn't noticed it.  The nurse, PA and doctor all took a look and thought I might be having some kind of allergic reaction.  So they gave me some hydroxysine, had me wait a little while longer, and then when they saw the redness start to go down, they sent me home.

Bernie and I went back to Hoboken, got some pizza (I was pretty hungry since I wasn't allowed to eat anything before the procedure, and only had a couple cookies and ginger ale afterwards) and then I went home and took a nap, since the hydroxysine made me very drowsy as usual.  When I woke up about 2 hours later, the backs of my knees were pretty itchy - this is the same place that the itchiness started when I had my allergic reaction after liver surgery.  It wasn't as intense as it was the first time around, but I did have some itchiness the rest of that day.  It's a bit of a mystery as to what I am actually allergic to.  The first time around we thought it was the Dilaudid (painkiller), but I didn't have that drug this time, or any drug in the same "family."  It could have been the antibiotic they gave me - and the nurse did ask me if I could be allergic to penicillan - but I've had other penicillan drugs before with no problems.  So I'm not really sure what I'm allergic to - or if it was just some kind of fluky coincidence!

As they had promised, I had a larger bandage on my upper chest and a smaller one on the side of my neck.  I joked that I would tell anyone who asked that the neck bandage was due to a run-in with a vampire. (But people are pretty respectful and no strangers asked me about my bandages, so I didn't get to use my joke, to my disappointment.)

The area was a little sore, but really didn't bother me too much.  In fact, the worst part about the whole port experience is that I wasn't allowed to shower for three days.  And I should point out that these three days were during some of the rainiest, muggiest weather we've had in awhile.  Ugh!  But at least with my short 'do my hair pretty much looks the same all the time so I don't think the griminess was really too noticeable.

Two days after the procedure, I noticed that the area was a little black and blue around the bandage.  I figured this was probably normal, but just to be safe, I called Interventional Radiology just to be sure.  Sure enough, they wanted me to come in so they could check it out.

So, I hightailed it up to the hospital from my office.  The PA and a nurse changed my bandages - but not before putting masks on themselves and even giving me a mask; I told you they were vigilant about infection control!  They said that it looked really good and the bruising I had was normal.  I guess they just wanted to be sure, but that was OK by me.

The port itself looks like a bump under the skin.  It has three little knobs - this outlines the points of the port so the nurse knows to place the needle in the area inside the little knobs.  My scar is about an inch wide, and you can hardly see the tiny incision in my neck, but if you look closely you can see the catheter that leads up from the port to my neck.  Kind of creepy.

The funny thing is that before I left the hospital the nurse gave me what I call my port "Welcome Pack".  It came complete with a little booklet that explains everything about the port; a card that I'm supposed to keep in my wallet to show to any doctors or nurses who might need to access it; a bracelet - like the Lance Armstrong ones, but purple witht the words "Power Port" on it; and even a tag to put on my keychain to "remind" me to share my port card with doctors and nurses.  I think this is a case of the port company's marketing department going a little overboard.  I am officially a "card-carrying" port owner and I did put the card in my wallet because it does have some useful info and you never know when I might need it, but I draw the line at wearing a bracelet and putting something on my keychain!!  That would cramp my style just a bit too much.

A week and a half after my port surgery, I had my first chemo session.  My friend Liz came with me.  Everything went as usual, with my vitals, then a visit with Dr. Sara.  He complimented my short hair and said he likes it better than my long hair!  He did the usual exam, said everything looks good, then sent me into the waiting room.

I wasn't sure how the whole port thing would go down, but it's really very easy.  The nurse has a special needle that she sticks into the area between the three knobs - it's just a prick like any needle stick and then she can draw blood or hook it up to the IV pole.  I'm told after awhile I might not even feel this prick anymore at all.  I got the Herceptin as usual, and then came the Navelbine.  This is given as an IV push - it looks almost like a shot, and the nurse sits there and slowly "pushes" it - it only takes about 5 minutes or so.  After that, I get a saline flush for a few minutes and then I was on my way!

I was able to go to work afterwards and didn't have any side effects that afternoon or in the days following.  Whew!  This past Friday I had another chemo treatment - just the Navelbine this time, so it was even quicker.  Still no side effects to speak of, though I know with more treatments my blood counts might start to get affected and I might start to get the neuropathy (numbness and tingling in my fingers and toes).

During the past couple weeks, I also had a follow-up appointment with my radiation oncologist Dr. Evans.  During my exam, he remarked that Dr. Sara is watching me "like a hawk" - almost like a grandfather!  I said that I know he is, and that I'm very grateful.  It is really great to know that my doctors truly care.  Oh and then Dr. Evans said that everything looked great with my exam and I don't have to go back until February, when it gets a little closer to when my breast radiation will start.

I also had a follow-up with my breast surgeon Dr. Rosenbaum Smith, who also said after my exam that everything looks normal.  I will need a mammogram on my remaining left breast and another follow-up with her in January.  I also asked her about lymphedema risk.  She said that it's pretty rare - only about 3% - and that prevention is the best tactic, meaning no needle sticks in my right arm, no blood pressure cuffs, no cuticle cutting if I get a manicure, etc.  But she said that when she does see lymphedema, it's usually because someone had something drastic happen to their affected arm, like a broken bone, or a big bruise after falling on ice.  So that was good to hear - I will be mindful of it but I won't worry every time I have the slightest pain in my arm that I suddenly have lymphedema!

Now, I am "off" this week, then go back next Friday for my next Herceptin + Navelbine treatment.

Walking Pink

It's October, and that means Breast Cancer Awareness Month, and that means lots of walks and runs happening for the good ol' pink ribbon.

I've mentioned in past posts that two of my friends - Lori and Bernie (yes the same Bernie who came to my port placement with me) - had signed up for the Avon 2-Day Walk for Breast Cancer in New York this year.  This is a big commitment, not only because it's 39 miles over two days, but also because there is a pretty hefty fundraising minimum you have to meet in order to participate.  Lori and Bernie - who didn't know each other before they both decided to do this walk - signed up many months ago, forming the "Emily's Entourage" team, and have been busy with training and fundraising ever since.

Lori, who lives in Washington, DC, held a fundraising event a couple weeks ago at a bar in DC.  She made a deal with the bar to have it close one night for just this event. Everyone who came paid a cover charge for open bar AND FOOD, and then the proceeds from the evening all went to the Avon Walk.

I went down to DC for this special event and it was a great night!  Lori went all out with festive pink ribbon decorations, and there was a great turnout - with friends even traveling from out of town to attend.  And the best part of all is that Lori raised over $1,000 for the walk!

Here is a picture of me with my "Entourage" from that night (from left it's Erica, Sara, me, Kim and Lori):

The walk itself took place this past weekend.  Luckily NYC had great weather (expect for some windiness on Saturday) and Lori and Bernie did AMAZING! 

Sara, Kevin and their dog Snoop all visited from Maryland to help me cheer on Lori and Bernie on their walk.  On Saturday, we met them near the entrance to the Brooklyn Bridge and we walked with them over the bridge and then back over the Manhattan Bridge.

Here's a picture of Lori, me, Sara and Bernie just before we headed over the Brooklyn Bridge:

As you can see, I'm wearing a special shirt that Lori made for me - it says "I am Emily and this is my Entourage"!  How cool is that??

On Sunday, I headed over to the city to meet Lori and Bernie at the finish line.  Ok, turns out they are such super-awesome walkers that they finished ahead of schedule, so I missed seeing them actually walk across the finish line, but we still had fun with some celebratory beers!

They did an amazing job - 39 miles in all and combined they raised around $6,000!!! 

This same weekend, my friend Dana participated in the Philadelphia Susan G. Komen 3-day For The Cure, where she walked 60 miles over three days for breast cancer awareness.  Check out the sign she had on her back (not going to lie - I welled up a little when she texted this pic to me!):

My cousin Brianna and her husband Richard also did a walk for Breast Cancer Awareness this weekend, and I know there are many many people out there who have woken up early on a Saturday or Sunday (or both) to walk or run for the cause this month and throughout the year and I want to say congratulations and THANK YOU to all of them!

It means a lot to cancer patients and survivors  like myself that there are so many out there who are willing to give of themselves for this cause.