First off, thank you all for not hounding me to post new info. I know it’s been almost two weeks since the last post, but I’ve been busy. Well, as busy as a guy can be without going to work. Alright, I haven’t been that busy. But I was without convenient internet access for a week while we were out of town, so that counts for something. Moving on…
I returned to Stanford on August 10 for lab work (the usual blood tests), another bone marrow biopsy (#6!), and to meet with Dr. Miklos regarding future treatment options. The previous week’s CMV test came back negative, so the foscarnet was discontinued. My central venous catheter was removed, too. That was an interesting procedure. You may recall that the catheter was placed in my upper chest, about 3 inches below my collar bone. There’s about 12-14 inches of tubing hanging out of my chest. On the inside, the line goes into a major vein/artery (which one goes toward the heart?) and stops just above my heart. There’s at least 8 inches of catheter line inside, and there’s a cuff around the tubing under the skin near the insertion point. Think of this cuff as a hollow cylinder with the fuzzy part of velcro around the outside. It’s about 1/2″ long. Karen the NP warned me beforehand that sometimes the cuff doesn’t come out with the catheter. This is because after the catheter is installed, scar tissue forms around it and gets entwined in the fuzzy material on the cuff, functioning very much like velcro. This is part of what keeps the catheter in place for months at a time.
The procedure for removing the catheter is much simpler than that for installing it. Two shots of lidocaine are administered around the site to numb it. Karen the NP wraps the outside tubing around her hand to get a good grip and instructs me to take a deep breath. I do, and she gives a solid pull like she’s starting a lawnmower. Out comes the catheter, without the cuff. Surprisingly, I felt very little. She then tried to get the cuff out because it was so close to the insertion point. This effort consisted of grasping the cuff with clamps (see photo below) and cutting the scar tissue around the cuff with scissors. I should note that this is all done on the inside–the clamps and scissors are inserted in the hole. Alas, the removal was unsuccessful because the lidocaine failed to numb the area effectively, and Karen was uncomfortable with my wincing movements as she tried to cut away the scar tissue. So, I have a little souvenir in my chest for now. It can be removed easily when I get the next catheter installed (whenever that is), or I can schedule a minor surgery if it becomes a problem before then. All it takes is conscious sedation (not quite a general anesthetic, but stronger than a local), a quick slice with a scalpel, and some stitches. The ITA isn’t set up to do that kind of procedure.
Here’s a picture of the clamps, already clamped on the cuff.
The bone marrow biopsy went off equally well. (Hint: that’s sarcasm.) Stanford is a research and teaching hospital, so the doc performing the biopsy brought a BMT program fellow with him to observe the procedure. Since this was Biopsy #6, I feel I’m at a point where I can evaluate and rank methods of the docs. Right now, it’s a close call between Dr. Sayegh (my oncologist at SCHMO) and Dr. George Chen (the doc who did #5 at Stanford). I have to give Dr. Chen the gold medal for a relatively low amount of pain. He has a nice touch, even though it took two tries to get the core sample. I should have remembered the joystick technique he used (remember that, Jim?), and shared that helpful tidbit with the doc who did #6. After the first two attempts at getting the core sample, he tried something different and my blood ended up squirting on the wall and ceiling. Unfortunately, I wasn’t able to get a picture of that. After the third try, he called another doc in, and that doc used the joystick technique with success. Needless to say, my lower back/hip is still a little tender. I guess I shouldn’t complain too much, because I have good bones.
After the biopsy, we had some time to kill before meeting with Dr. Miklos. We went out to the car and watched a few episodes of the first season of “24” on the laptop. Yes, we’re new to the show. We’re now about 5 episodes into the second season, and I’m not sure if I can make it all the way to the current season. I like a good action show or movie just as much as the next guy, but some of this stuff is absurd. For example, consider the bombing of CTU-LA. There’s a big explosion, the place nearly collapses, yet there’s still a functional, secure network and camera monitoring system for them to interrogate Nina and continue working on the database to stop the nuke, and George Mason’s glass office door is still intact? And the dialogue? I can’t count how many times I’ve heard practically the same line: “You have to trust me, (insert character name here, any character, just pick one.).” Must be tough to remember those lines….
Back to reality…Dr. Miklos had some interesting things to say. I have a busy day ahead of me (no, seriously, I have some errands to run), so I’ll save that for another post. After our meeting, we drove down to the Santa Cruz area for a week. We hit the usual highlights–the beach, the boardwalk, Marianne’s Ice Cream (mud pie…mmmmm), and I had my first deep-fried twinkie. I’d eat one again, for sure. We managed to polish off two packages of brownie bites during our stay between all of us (not just Jen and I!), complete with whole milk in a frosty glass fresh out of the freezer. Fortunately, there’s no trans fat in brownie bites, so it’s all guilt free! Thanks to you guys who were there–we had a great time, despite the runny noses and coughs and vomiting and….I’ll stop there. And thanks to Christina B. for hooking us up with your grandma–it helped us out tons!
I must now start my day, even though I’ve been up for 2.5 hours already.