Tracie Fights Back

First I need to vent about my power port, which regular readers know has been an ongoing problem. Now we know why. It’s waaaay out of place.

At Stanford yesterday I learned that the tube that delivers the chemo to my heart to be pumped to the rest of my body has for some reason has moved 4 centimeters short of its target. As I work out the metric conversion in my head, I’m imaging that being about a yard.

It might as well be for all of the good it can do me now. The official medical opinion is that it cannot be used anymore to deliver chemo (or Herceptin, which I have to do for the next year) in its current position. The scary part is that it HAS been used for who knows how long while in this position. Everyone knows it hasn’t worked right, and that the infusion nurses have not been able to draw blood from it for as long as it has been in there. They theorize now the tip might have pushed against the vein wall, blocking the tube when they tried to suck blood out.

There is a chance that since it was used to deliver chemo all of these weeks, the chemo could have burned the vein near my heart where it has been dumping out. There is no way of knowing for sure. Yay me. And another reason for all of you to avoid this disease at all costs.

Though this is interventional radiology’s problem, Dr. Mollick, aka Dr. Nice, had to deliver the bad news while I was at Stanford to meet with my mastectomy surgeon. (Which is OK because I LOVE to see him, even on days like these when he has bad news. Oh, and apparently he got grief for giving me a ride to my emergency echocardiogram on his Segway the other day. He was supposed to call for a golf cart, like that would have been fun or made for a good story.).

He had many questions for me about how it could have come out of place, the most amusing being “Have you been standing on your head?” I assured him that ‘sitting on my ass,’ is all I can muster.

Now the bad news. We have to fix the placement. They can give me chemo in an arm vein for the last go-round on Sept. 21, but if they delivered the Herceptin that way every three weeks for the next year, my arm would end up with track marks like some crazed heroin addict.

So, as if having cancer isn’t bad enough, as if the chemo nausea and mouth blisters and hair loss and finger pain and bone ache and weight loss and smell and sound hypersensitivity and memory loss and income loss and fear aren’t enough to have to deal with, now I must have another procedure to “fix” it.

It will be like an angiogram, but through a vein in my groin instead of an artery. Doctors will thread a wire through the vein to my heart, “lasso” the wire and try to pull it back into place.

He said I would be awake. No way! I said I would only do it if they sedated me with the Michael Jackson drug. They would seriously have to tie me to the gurney if I were awake and knew this was going on. Somebody needs to cut me a break for once in all of this! Dr. Mollick said he would write that on the order.

Also, Dr. Mollick, if you are reading this I have another demand/request/demand: I want someone who has done this hundreds and hundreds of times to do it. No more students trying to learn, which I appreciate is a part of your mission there at Stanford. But since this is the department that misled me during the original installation (read previous entry Good Stanford, Bad Stanford), they owe me. I hope all of you at Stanford will see why this is important to me. I need to be able to trust the interventional radiologists as much as I trust my team in the Cancer Center.

Which brings me to my meeting with my surgeon, Dr. Fred Durbas. Nice man. And an excellent surgeon, I am told.

He was very impressed with my progress and the way my tumors have reacted to chemotherapy. I cried tears of relief when he said that that means the chemo would be equally as effective on any cells that might have escaped elsewhere. While the tumors are hard to detect, he said, it doesn’t mean the cancer cells inside have shrunk to nothing. He compared it to spraying herbicides on a field of weeds. Most of them would die, but there could be plants that survive scattered across the field. That’s why the entire breast has to go.

The tentative plan is this: remove my right breast on October 20, along with all of the lymph nodes in my right arm. We know the cancer had spread to a lymph node near my right breast, and that is the likely path along which it would have continued. It means I could have problems with swelling in my arm forever more, but Amy his PA says that with advances in medicine she hasn’t seen that in 10 years.

Then in spring when I have my breast reconstruction, Dr. Durbas will remove my left breast to all-but eliminate the risk of another breast cancer recurrence (of course it does nothing to reduce the risk it can pop up elsewhere in my body). It will also eliminate some fear that I have.

We’re waiting because it means my skin on that side will be preserved for the reconstruction surgery, meaning that less will have to be grafted.

So that brings you up to date on my Stanford visit yesterday. My friend Carol gave up her day to drive me over there – and get me back in time for a meeting in Fresno sponsored by Genetech, the maker of Herceptin, which I learned is a biologic agent that trains the gene that makes my HER2pos cancer reproduce to knock it off. Apparently it takes a year to make it stop, but more on that another day.

Meanwhile, it’s noon and I’m still in bed. It’s 10 days past chemo and I’m still sick. Sick and tired. And sick and tired of being sick and tired. I still can’t eat solid food, but the blisters in my mouth and throat seem to be subsiding. My stomach, which keeps spasming, feels like sumo wrestlers are going at it inside.

I guess this is all normal. I have had seven mega rounds of chemo discharged inside of me, and a lot of it is still in there working since I’m told it takes six months to leave.

Unfortunately, I had higher expectations for Taxatere, which I had been assured had lesser side effects than the Adryomiacin and Cytoxin that were my chemos for the first half of this trial.

But as the most frustrating new saying in my life goes: Everyone reacts differently. For some reason for me it has been particularly tough.

I also learned this week that some oncologists have a nickname for Taxatere that makes my current condition easier to understand.

They call it Toxic-tere. And it’s inside me.

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