Sunday, September 23, 2007

Any Given Wednesday III

The final installment of this three part series is the simplest. Every time I go to the hospital, before anything else can be done, they must send blood samples to the lab to make sure my levels of white, red, and purple blood cells, magnesium, potassium, myassium, protein, preteen, calcium, ABC, XYZ, CRS, etc are all either good or "expected under the circumstances". This photo flipbook show them accessing my portacath, taking blood and then administering the intravenous chemotherapy into the same port.

This is a Port-a-Cath or as we lovingly call it, a port. There is one just like it implanted in my chest as I type. It grosses me out still sometimes to think about its plastic invasiveness, but it's really quite a convenient little gadget. There are two pin-cushion pads where a special needle has lots of room for error. We all have our horror stories about difficulty finding veins in our arms and hands to access for blood collection/donation, right? Well, when my veins were just about to walk out of the factory in protest, the union renegotiated their contracts and got them vacation time. Technology was brought in via a surgical procedure last spring to implant this mechanism. The tube winds around my collar bone giving it special access to all that fresh blood pumping out of mi corazon- and front row seats to deliver all the poison throughout the body as well.

This is Kecia removing the bandage I had put on at home. When I remember, I put a topical anesthetic cream on the port one hour before show time. Everybody's different, but this seems to help me avoid a good deal of the pain.

I think I've blogged about nature's gift of outward perspective before, but it applies to my port as well as to my general looks over the past year and a half. It's really such a great feature of being human that we can't look at ourselves, save by aid of mirror. Therefore, my self-consciousness about being bald, enfeebled or even having strange lumpy protrusions in my chest has been limited. There are some fashions I will not sport (strapless tops shout: Stare at my weird pectoral tumor!) but mostly the summer found me donning tank-tops and bikinis just like everybody else. Few people mention the port and so I forget about it.

She's using alcohol to clean the site.

That's the fancy needle. Considering it's length, it's remarkable that the pain is insubstantial and the success rate of first-time access nearly 100%.

My nurse verifies a blood return, or, makes sure that the port is functioning well both in and out. She'll take several vials of blood, flush the tubes inward with saline and heparin (an anti-coagulant), and then pinch the tubes shut while we wait for my results from the lab. This waiting period is usually the bulk of the time I spend at the hospital each week- approximately two hours. During this time, I usually eat something from either the hospital cafeteria or the food court. I always plan to study or work, but rarely actually do. Hospital time gets sucked into the black hole of all wasted hours plotted with the best intentions.

I think there has only been one time when I was too sick to get my weekly chemo and it hasn't happened for a looooong time, thank goodness. So, next, the nurse will suit up in a thick protective gown and pull on special heavy-duty gloves. Can you imagine? The crap that they inject INTO MY HEART is so toxic and terrible that those who administer it must dress for a walk on the moon lest it splatter or drip a drop on their skin. I love that.

Another saline and heparin on the rocks, bartender.

The nifty needle has a spring-loaded release mechanism to immediately self-sheath the point upon removal.

By the way, these pictures were taken in July, so your eyes aren't playing tricks on you- my skin does look terrible. One of the things they are always telling me is that my skin on chemo is very sensitive to the sun, but I would scoff and insist that they didn't know MY skin. MY skin rarely burns and always tans. Well, score another one for the medical establishment. In Costa Rica, I got very burned and some of these pictures show the healing process. Still today, the remnants of the sunburn are faintly visible on my legs. Oops.

Et voila! All of that blood, water, and chemical exchange and all I get to show for it is an unnecessary band-aid. They should at least give out suckers. Or toothbrushes.

Signing off Sunday.
T minus 3 days until this is repeated.
And twenty-eight more times after that.


Sara Jennings said...

This blog brings back memories of my portable catheter. The pain was excruciating for me when they accessed it and I used to rub an ice cube on it to try and numb the area. I had mine removed in 2004 but I get alot of questions about the "hickey" on my chest. When I tell people it's a scar that I'm fond of because it helped save my life, they get a bit embarassed. Hang in there, you're in my prayers!
Sara Jennings (Bendele)

Anna said...

Hi luv!

Your series has been fascinating, although I clench and grind my teeth and stop breathing a little in some parts. I just love to read your writing. I hope you are feeling good lately. Miss you much.

Greg Genco said...

Hey Erica,
Hisahiburi! Sorry for dropping out of touch.

Well, I cant reciprocate any personal encounters with catheters or needles but as a very pasty white guy I can relay that I have survived many nasty sunburns over the years.

Like Anna mentioned in her post, my teeth were clenched as I read about your chemo treatments.
You are an excellent writer and a very courageous and special individual.
Keep getting better and hope you are feeling well.

Kio tsu kete,
Greg Genco

Anonymous said...

Thanks again for sharing. It's kind of wonderfully fascinating (clinically) and amazingly human what you bring to these procedures.

As someone who lives in LA, I'm thinking after this post, Port-a-Cath's will be all the rage. I might get one installed before I get new boobs. ;)