Without a Port

Dr. Broderick removed my port today. <giggle> Yay! It was weird and really cool.

Frank and I were ushered into one of the examination rooms at the offices of First Surgical Consultants (I tend to hate generic sounding names like that, but I love Dr. Broderick, so I guess I'll let it slide) and I put on one of those lovely paper gowns (Frank said I looked like something out of "Forbidden Planet"). Dr. Broderick showed up and got right to work (and Frank left the room soon thereafter. I mean, there's a reason he's a lawyer...)

Dr. B cleaned the area and shot the area up with Lidocaine (pinch burn, pinch burn, pinch burn, pinch burn..... numb, yay!) He cut the skin above where the port was sitting and explained that the body creates a sac of scar tissue around the port. So he massaged and pushed and massaged and pushed to loosen the sac around the port and eventually it came out. That five minutes or so of massaging (probably less than that, but in these instances, it feels like such a long time, you know?) took up most of the time for the procedure and felt really weird. My skin was being pulled taut and so while nothing was happening at that moment, probably, it just felt weird. Like something was imminent.

And then, voila! I felt the tubing that led from the port to the Subclavian being pulled out. Kinda freaky and kinda neat.

He applied pressure to the spot where the tube had left the vein and I asked him how it healed. He said that the blood flow would prefer to just follow the path nature made for it, through the vein, rather than fight with other tissue and find a path through my body. So, it heals itself.

The human body. Just amazing. (When it's not being a total PITA.)

I can't see where the sutures are now--they're under a bandage--so I'm not sure if this scar just eradicates the one remaining from the insertion of the port, or there are two side-by-side. But given Dr. B's consideration and expert work on the two previous occasions, I'm not too worried.

I brought the port home with me (Dr. Broderick: "Um, you might want to wash that with bleach or something") and I smell a bit like a surgery (that blood and antiseptic smell). But no more foreign bodies in my body! Yay me!

When we left the office I was seriously jittery from an adrenalin rush, but we've been home for about an hour now and my head hurts a bit, and feels tired, so I'm already crashing. I expect to sleep well tonight.

(I go back next week to get the stitches removed.)

Goings On

I've got my port removal scheduled for next Monday (July 21). Yay! Dr. Broderick (who I love, btw) said he can do it as an outpatient service in his office, and I admit I am intrigued.

See, while the hard silicone thing (into which they put the needles to draw blood and infuse toxic chemicals) is supposed to be near the surface of the skin, mine appears to be somewhat deep (much commented upon during treatment and subsequent blood draws). Also? It's connected to a tube that goes up to the Subclavian vein. Can they just pull that out? They don't need to suture it or anything? Finally, mine is much farther down on my chest than the one in the diagram in the link--Dr. Broderick very kindly placed it within a reasonable line of decolletage, so, um.... Well, I guess we'll just see, won't we?

This Weekend
In other news, Emily is doing the AIDS Walk next Sunday, with team I Love This World. Feel free to sponsor Emily and donate by going here.

While Emily is doing that, Maggie and I will less helpful to society at large by going to the Giants v. Brewers game. Frank shares in season tickets with several other people, so we get about 10 or 11 games a year. And I love the seats. They're on the third baseline, in the Club section. Which means if it's too hot, we can go up to the glass-enclosed food/drink section, which also is air conditioned, and still see the game.

Oh, and Friday night, we're all going in to the city to see the Chihuly exhibit at the DeYoung, along with Jackie (and maybe Becky?) whose husbands will be at the annual golf "debacle" with Frank and five other fine gentlemen, up in Graeagle this weekend.

Last Weekend
This past weekend we saw "Ironman" at the Cerrito--way fun, we'd all recommend it. It was fun and over the top in a good way. And yesterday we saw "An Ideal Husband" at CalShakes* in Orinda. The sets and costumes were lovely, the direction was fine, and the acting was fairly solid. It's the play itself, I fear, that doesn't quite stand up. The play drags a bit in the middle (the plot bogs it down just a bit) and the wonderfully sexist point of view at the end is a bit hard to take. But you can't beat the venue--amphitheater, set in the hills, on EBMUD watershed property, so you really feel like you're away from everything else. "Ideal Husband" is on for a couple more weeks and then next up on their calendar is "Uncle Vanya". They did a super job with "The Seagull" a couple years ago, so I'm looking forward to this next one.

*Dinking around on their site, I found this terrific video from CalShakes' Artistic Director, Jon Moscone (yes, son of George Moscone) showing the site of the Bruns Amphitheater. Actually the video on their site didn't work, so I tracked it down on youtube. Check it out:

Surgery: Double Check

....and just be grateful it won't be a "triple check".

There was some doubt as to whether or not we'd get approval for the port to placed during this surgery and I was starting to feel a bit pouty about the prospect of a third surgery. But, yay!, someone pulled a rabbit out of a hat, and they put the port in place yesterday, during the recision.

The recision doesn't hurt much, but the area where they put the port is pretty sore. I gather they had to move some muscles around to get everything in place.

But, all in all? Things went swimmingly. Surgery started a bit late (I was wheeled in to the OR a bit after noon, rather than at 11:30), but I was home before 5 p.m. and I got to sleep in my own bed (much more restful than sleeping in the hospital).

Thanks to Joanie, Karen, and Dorothy for cleaning our house again yesterday, while Frank and I were in the hospital all day. "Thank you" to Becky for a wonderful dinner. And thanks to my co-workers for the most fabulous box of chocolates (a box made out of chocolate, filled with chocolate), accompanied by the loveliest sentiments.

I will be meeting my oncologist next week to schedule chemotherapy. And in the meantime, we'll be getting Emily packed up and then settled at UCSB.

2B or not 2B?

Frank and I saw Dr. Kuan today, to go over the pathology report and to discuss chemotherapy. What a long appointment.

First, the details. The CT scan showed the breast lump and the rather large lymph node in my armpit, but that's it. So, yay, we get a zero on the M(etastisis) for the TNM staging for breast cancer. We told Dr. Kuan that Dr. Broderick had said I was staged at 3A (67% survival rate) and she looked confused. She said, no, a T(umor)2 and N(odes)1 meant a 2B. She looked through the pathology report and we talked about lymph nodes that are "matted," which can move a stage 2B to a 3A, but she said the pathology report showed no indication of this, so we're going to take that 2B with no further argument, thank you very much. All in all, given the TNM "score" combined with the fact that the tumor was "high grade" (i.e. aggressive), gives me a 75% survival rate. (But as my oncologist friend, Carla, reminds us, "these statistics refer to large numbers of people, not to individuals.")

After clarifying those details, Dr. Kuan let me know that the cancer center is doing a clinical test on Taxol infusions. If I sign up for the test, my chemotherapy would consist of 4 bi-weekly infusions of Doxorubicin (Adriamycin) and cyclophosphamide [abbreviated AC], and then either 12 weekly infusions or 6 bi-weekly infusions of paclitaxel (Taxol). The benefit of taking part in a clinical trial, of course, is that you have even more doctors watching your condition. So, despite the fact that weekly infusions would be a drag from the perspective of getting on with life, we are considering it.

We got to meet the nurse for Dr. Kuan's practice, Lisa Mune, who showed us how the "port" works for the chemo infusions. You can go here for an image of where the port goes. This port, which is surgically inserted under the skin, enables the nurses to give me my chemo meds and to draw blood without having to find a vein every other week. We're hoping that Dr. Broderick can put in the port when he's doing the recision to get more of the margins (still no word on when that will occur, yet).

But, if you look at the image, you'll note that meds go right into the vena cava, which leads right to the heart. So, to make sure my heart can handle all this (the Adriamycin, the "A" part of the AC, is hard on the heart) I'm having a heart scan (MUGA) on Thursday morning.

Whew. What a day.

On a positive note--I went camping this past weekend with the moms and daughters in Maggie's girl scout troop. There were four girls and four moms in Marin and it was lovely. I came home on Sunday utterly exhausted. But I'm figuring I won't be doing much of that kind of thing for at least the next six to nine months, and I wanted the Maggie time.