Chemo Port is Out!

On Monday, I had my chemo port removed.  It was fairly straight-forward.  The nurse had me take off my shirts and lay down on the surgical bed.  She shaved my chest above the port.  The doctor came in and shot lidocaine into my chest.  It was similar to having the dentist numb your mouth.  He then cut me open and removed the port.  There wasn't any pain, just a slight sense of movement.  The weirdest part was when he sewed me back up.  He leaned hard on my chest and I could feel him stitch me up.  There was also a pert where it felt like two zip ties were being tied up.  I asked him if I could keep the port since I couldn't keep any souvenirs from the first surgery when they took something out of me.  I asked him if that was freaky of me and he said a lot of patients ask for their ports.  Who knew?  So, another step towards "normalcy"!

Quick Update

We met with the oncologist and I am officially in remission and will start the surveillance portion.  This means that for the first year or so I will have my blood taken and a chest x-ray done every two months to make sure that there is no sign of the cancer returning.  Then every 3-6 months, I will have a CT scan done as well. This will become less frequent each year until year 5 when they cut me loose.  I see it as an insurance policy to make sure that I won't be caught off guard again.

I am feeling really well and the hair is coming back in.  Not a huge afro like I was hoping for and it could be a bit thinker up on top, but no complaints here.  I will report back the test results in May, but I hoping to have nothing to report!

The Accidental Hero

In the summer of 1967, Rocco Morabito, a photographer for the Jacksonville Journal, had finished a photo shoot of striking train workers.  He had some film to use up and headed downtown to see if there was anything else of interest worth shooting.  Driving around, he saw a group of agitated people who were yelling and pointing at something above.  Morabito parked his car and saw that there were some linemen working on electrical lines.  One of them, a young man of 29, was hanging upside-down, apparently unconscious. Randall Champion had been performing routine repair work and had been shocked by over 4,000 volts, enough to stop his heart. Morabito returned to his car, radioed for an ambulance, and then ran back to take some shots.

Meanwhile, another lineman, J.D. Thompson, heard the commotion and raced to the pole where his colleague dangled from above.  Thompson immediately shimmied up the pole and began mouth-to-mouth resuscitation. He couldn't seem to manage to get any air into the other man's lungs.  So he moved Champion's body slightly, cradled his head in his arms, and finally got some air into Champion. At that moment, Morabito returned and snapped some frames.  Champion jerked, hiccuped, and then began to breathe again.

The ambulance Morabito called arrived, Champion was taken to the hospital and Thompson quietly returned to work.  Morabito radioed into the newspaper to proverbially hold the press, processed the film himself and took it to his editor.  The editor ran the picture on the front page with the caption, "The Kiss of Life."  It was picked up by papers around the country and then the world.  The term, "kiss of life" stuck to this CPR method and the following year Morabito won a Pulitzer Prize for his photo.

The Kiss of Life

Champion fully recovered from the shock and Thompson was hailed as a hero and presented with several awards.  Thompson seemed perplexed by the attention, however, and insisted that he was just doing his job, just following the training he received, no big deal.

I used to wonder about the sincerity of persons such as Thompson who displayed such dramatic acts of heroism and downplayed their role afterwards.  Did they really think that their acts were "no big deal." I understand now, that their sincerity is real.  Not to compare myself with people such as Thompson, I didn't try to save another's life, just my own.  Many people have called my act of fighting cancer "heroic."  I appreciate their kindness and sincerity, but I just don't see it.  Never once in the past four months did I feel anything remotely close to heroism.  I just did what I had to do and tried to make the best of a crappy situation.  

If anything, the heroism I saw came from those around me.  From far-away nieces who drew get-well cards, neighbors who brought food, co-workers who dimmed the office lights so I could rest better during my daily naps, family and friends who would visit with me in the chemo spa and chat to pass the time or call or email at random times to check in and show their support. Therein seems to lie the source of heroism.  It is a quality that resides within and shows itself instantly, without thought, in the moment of crisis.  The moments I got emotional were not when I received the diagnosis, nor after the surgery or even thinking about the implications of chemotherapy.  It was when someone would come up and offer me a hug of support with tears of sympathy in their eyes.  That to me was heroism and my kiss of life.

CT Scan and Results are In...

I had the CT scan this morning.  So much less stressful the second time around when you know what to expect.  The technician didn't even bother to have me change out of my pants (trousers for my British friends, I kept those pair of pants on, thank you very much).  Instead, she just laid a blanket over me and I pulled my pants down to my thighs.

I just got a voice mail from the oncologist and he already has the results of the CT scan.  Apparently the masses have either completely disappeared or left scar tissue a few millimeters in length.  Therefore, it looks like no "chicken dinner" surgery will be necessary and instead I will just have surveillance for the next five years to make sure nothing returns.

I have to admit, I have listened to the voice mail 3 or 4 times trying to make sense of it.  It appears the race has been finished.  Chemo is done.  No additional surgery is required (well except to remove the port which is still chillin in my chest). The blood results are all clear.  Do I dare to say it?  It appears I am cancer free and can declare this adventure over.  It's really a surreal experience.  I feel as if I should get something tangible at the end, you know? Like how a pregnant woman gets a baby after all her work and toil.  In this case you get nothing, which is exactly what you want, but it's odd to celebrate the negative.  "Look at me!  I am back to where I was 5 months ago!"  Odd.  But, oh so invigorating.  It feels as if my life has been on pause for 4 months and suddenly the possibilities of wonderful things from birthdays and holidays to the mundane things such as oil changes and clogged-up toilets are in view again.

Forgive the stream of consciousness, I haven't had time to process it all yet.

I do want to thank everyone again for their support.  I know I haven't answered everyone who has sent their best and those to whom I have gotten back have had to wait longer than they should.  There are truly no words though to thank you.

Update with Nothing New to Report

We met with the oncologist again.  Blood work is still fine: blood tumor levels are all normal and everything is working fine.  Another example of the joys of normalcy.  We had questions galore for him about what long-term surveillance might consist of or what the regime might be if, heaven forbid, the cancer returned, but he really didn't want to discuss any details until the CT scan is performed.  We heard today that insurance has approved the CT scan and it is scheduled for Thursday morning. 

I am hoping the masses have puffed away into nothingness, like something out of a Disney movie!  Although I have to admit that it is nice being in the pre-CT scan timeframe where ignorance is a bit of bliss...

Chemo is over.

Well, today was it.  Wrapped up the fourth and final round of chemo today.  I think the third round was harder somehow.  Feeling tired and like I've been pumped through of poisons all week, but it's OVER!  If feels like fifteen Fridays and the end of the school year all wrapped up into one.  We celebrated by eating my sister's homemade lasagna and watching the Olympics.

An Average Day of Chemo

So before this whole adventure began, I admit I was terribly ignorant as to what "chemo" actually was, how it was administered and all that good stuff.  I had a vague notion that it might be given via a shot, pills or IV, but that was about it.  Oh yeah, and it seemed to make people go bald.  So I thought it might be helpful to share how I get my chemotherapy.

Now each cancer type has its own regime.  Some testicular cancer is seminoma and can be treated with radiation in addition to or without chemotherapy.  I have non-seminoma, the more aggressive type and type has different options based on staging and what risk class you fall into.  Despite having the highest stage for this cancer, because I feel into the "good risk" assessment group, I could choose either three rounds of a combo of three chemo drugs or four rounds of a combo of two chemo drugs.  The statistical results of curing the disease are essentially the same, but you can avoid some of the potentially nasty side-effects of the additional drug, Bleomycin.  I chose the longer regime of four rounds.  So today is day three of round four.    Here's what it looks like.

I arrive at the cancer center at the hospital at 11:00 and check in.  Most of the receptionists and nurses know me well by now and we talk throughout the day.  It takes about 20 minutes or so before I get seated in one of the chairs.  I have my favorite, which is tucked away in this little corner with a large window behind it and looks like this:

There is always a pillow on and IV stand next to each chair.  The chair is a recliner complete with footrest and can recline almost all the way back.  Lucky me, today my favorite chair is available and I claim it for my own.  I have to wear a button-down shirt and either a v-neck under shirt or none at all, so that they nurses can access the chest port. I've seen other men who have forgotten and they've had to remove their shirts altogether.  The women, for some reason, never seem to forget to wear appropriate clothing.

First the nurses prepare to insert the IV needle into my chest through my port (see previous post "Because Inquiring Minds (seem) to Want to Know" for more on the port.)  They swab the port site and then spray a coolant on to try and numb the skin.  In the needle goes (barely hurts) and they make sure that the port isn't blocked by testing for a blood return in a syringe.

The first thing I get is 45 minutes of saline hydration. The hydration is important because the chemo drugs are so hard on the kidneys.  Then I get the "pre-meds" which consist of two anti-nausea medicines on Monday (only 1 the rest of the week) and a steroid to help my body not reject the poisonous chemo drugs.  This only takes 20 minutes or so.  Then I get the first chemo drug, Cisplatin.  This takes 45 minutes and is the wonder drug saving my life.  It is a platinum-salt drug; nothing like pumping heavy metals into your veins.  The introduction of this drug in the late 70s is what caused survival rates for testicular cancer to skyrocket from 10% to 70%-80%.  Additional drugs increased the survival rate to 90-100% in the 80s.

My IV bag collection

Then I get the second chemo drug, Etopside, for 90 minutes.  Etopside is a plant-based drug that stops the cancer cells from reproducing by disrupting their DNA.  After that's done, I get another 30-45 minutes of hydration of saline solution. After that the party is over and the nurse removes the needle from the port.  In theory, they could leave the needle in with a little valve attached.  I did this for all of round 1 because the port was still healing.  I haven't opted to do it since because 1) you can't shower with the valve dangling from you; and 2) I have small children who love to have pillow fights, piggyback rides, wrestling competitions, etc on a daily basis and it just gets in the way.  So out goes the needle and a little gauze gets slapped on my chest for me to yank off at night.  The whole process takes about five to six hours, five days a week followed by two weeks off for good behavior so that my body can recuperate.

I typically go to work for two to three hours before chemo and back again for 2 hours to wrap stuff up.  It helps mentally to keep up the work routine, plus it keeps the stress level down by preventing a huge backlog of work from piling up.  At the start of a chemo week, I am feeling pretty good and get a lot done.  By the end of the week, especially round three, I was fatigued and slept/rested during most of the day. For an A-type personality who has to be constantly going, I thought that being in a chair for five-six hours straight would be tantamount to torture, but it actually goes by relatively quickly.  I always eat lunch, nothing too smelly I hope. The dear wife has sat with me almost every day and my parents, siblings and religious leaders have been great about visiting.

Other TC patients have mentioned that the sight of the cancer center or the sound of the pump eventually become associated with the nausea of the medicines and make them sick.  I haven't had that problem myself. Sometimes the sound of the pump can make sleeping a bit more difficult, but I try to associate it with the tick of a clock which I find relaxing.

So that's what my experience has been like.  Just two more days to go.