Emily is out of surgery and things went well. They didn't actually start her procedure until after 4:00 so she spent most of today hungry and bored in her hospital room. Her surgeon told us that she did find an infection around her port and wished she had done the surgery on Sunday. Either way, the port is out and we can begin moving forward again. She gets a week to recover before she has her next chemo appointment, which puts her one week behind her original schedule.
Speedy recovery, Em!
Thursday, July 24, 2008
Wednesday, July 23, 2008
Surgery Required
Emily went back to her surgeon this morning for a checkup. The swelling and irritation had been getting progressively worse since Sunday and she was supposed to have chemo Thursday morning. Her surgeon took another look and was concerned that the condition seemed to be worsening, so she decided to do an ultrasound. The ultrasound showed that she has something called Thrombophlebitis, which means she has a blood clot in her vein and the vein is swollen and irritated. Right now, it is not dangerous to her, but if not treated could cause some real problems. So instead of having chemo tomorrow, she is having surgery! They will be removing her port tomorrow (Thursday) at 2 pm. She is thrilled to be getting the port out of her body, especially since it has caused so many problems thus far.
Regarding the last two rounds of chemo, we don't know exactly what will happen. After surgery, the doctors will determine if and when she can continue. They will have to administer it through a vein in her arm or hand from here on out. I will post a surgery update late tomorrow afternoon.
Regarding the last two rounds of chemo, we don't know exactly what will happen. After surgery, the doctors will determine if and when she can continue. They will have to administer it through a vein in her arm or hand from here on out. I will post a surgery update late tomorrow afternoon.
Sunday, July 20, 2008
Unexpected Setback
We've all seen the medical dramas on TV where the patient comes in with a mysterious ailment and all of the staff work together to figure out the problem and decide on the appropriate treatment. This week, Emily had a vastly different experience in which she was met with apathy and a C.Y.A. approach to medicine. Let me start at the beginning....
On Thursday, Emily had some discomfort around the port that is used to administer her chemo drugs. The port is implanted in her chest about 3 inches below her collar bone and is attached to a catheter which is threaded through a vein. The area around the port was sore and tender with an area of skin about the size of a postage stamp that was bright red and inflamed. Suspecting an infection, she immediately she called her oncologist and was told to come in right away. The doctor looked at it and could not identify the problem so he called in his nurse and asked her (?) and she didn't know either, but they both agreed it did not look like an infection. They decided to order a "dye study" in which dye in injected into the port and an x-ray is taken in order to determine if the port could be leaking. They prepped her for the dye study and prepared to send her down to radiology for the x-ray. As soon as they had her all prepped, which entails inserting a 1 inch needle connected to a long tube into her chest, they notified her that no one was available in radiology, and since it wasn't an emergency, she would have to come back in the morning. They decided to leave the needle in her chest and simply taped her up and sent her home. So, she had to leave the hospital with a mysterious, painful infection AND a needle and tubing sticking out of her chest.
She went back in on Friday to finish the test and it was determined that her port was not leaking. The doctor said he still didn't think it was an infection, but since he couldn't come up with another explanation, decided to put her on antibiotics anyway. Meanwhile, the affected area was getting redder, more swollen and more tender by the minute and had doubled in size. His lack of desire to get to the root of the problem really concerned us all, but Emily dutifully took her antibiotic and hoped for the best.
By Saturday morning, the postage stamp sized redness had grown to the size of a baseball and was swollen at least an inch above the rest of her skin and extremely painful. Since she wasn't getting much help from her oncologist and his team, she decided to call her surgeon at home to see if she could help. That was the best decision she could have made. Her surgeon immediately recognized the symptoms as being the result of extravasation, which is a fancy way to say that the chemo drugs had, in fact, leaked outside of her port and into her chest.
Though her surgeon suspected extravasation immediately, she wanted to run some tests to rule out infection once and for all, so Em and our parents spent most of Saturday at the hospital. Why her oncologist didn't run these tests before arbitrarily prescribing antibiotics, we'll never know. The results of the tests won't be in until Monday, but her surgeon asked her to come back in Sunday morning so she could take a look at the area and see if the redness and swelling had spread. Had it shown signs of spreading, they were going to go straight to the Operating Room and remove her port. Luckily, it did not spread overnight, and her surgeon concluded that it was, in fact, extravasation.
Extravasation is typically caused by a break in sterile technique, not a leaky port. So in other words, the nurse that gave Em her chemo last week didn't follow proper protocol when administering the drugs and caused Emily a pretty serious injury. There are two things that can happen when chemo leaks into the tissue and it all depends on what type of drug is involved. With certain drugs, it causes severe tissue necrosis (tissue death), whereas with others, it simply causes terrible irritation of the skin and underlying tissue that can take weeks to dissipate. Fortunately, Emily is not on the drugs that cause instant tissue death. Unfortunately, she will have to endure the horrible pain for quite a while.
Needless to say, she had decided to leave her current oncologist.
Her surgeon is setting her up with a new oncologist at a new clinic that is closer to home. Hopefully she will have more luck with these folks! Em, I know this has been a painful and stressful weekend for you and I hope that you feel better soon!
On Thursday, Emily had some discomfort around the port that is used to administer her chemo drugs. The port is implanted in her chest about 3 inches below her collar bone and is attached to a catheter which is threaded through a vein. The area around the port was sore and tender with an area of skin about the size of a postage stamp that was bright red and inflamed. Suspecting an infection, she immediately she called her oncologist and was told to come in right away. The doctor looked at it and could not identify the problem so he called in his nurse and asked her (?) and she didn't know either, but they both agreed it did not look like an infection. They decided to order a "dye study" in which dye in injected into the port and an x-ray is taken in order to determine if the port could be leaking. They prepped her for the dye study and prepared to send her down to radiology for the x-ray. As soon as they had her all prepped, which entails inserting a 1 inch needle connected to a long tube into her chest, they notified her that no one was available in radiology, and since it wasn't an emergency, she would have to come back in the morning. They decided to leave the needle in her chest and simply taped her up and sent her home. So, she had to leave the hospital with a mysterious, painful infection AND a needle and tubing sticking out of her chest.
She went back in on Friday to finish the test and it was determined that her port was not leaking. The doctor said he still didn't think it was an infection, but since he couldn't come up with another explanation, decided to put her on antibiotics anyway. Meanwhile, the affected area was getting redder, more swollen and more tender by the minute and had doubled in size. His lack of desire to get to the root of the problem really concerned us all, but Emily dutifully took her antibiotic and hoped for the best.
By Saturday morning, the postage stamp sized redness had grown to the size of a baseball and was swollen at least an inch above the rest of her skin and extremely painful. Since she wasn't getting much help from her oncologist and his team, she decided to call her surgeon at home to see if she could help. That was the best decision she could have made. Her surgeon immediately recognized the symptoms as being the result of extravasation, which is a fancy way to say that the chemo drugs had, in fact, leaked outside of her port and into her chest.
Though her surgeon suspected extravasation immediately, she wanted to run some tests to rule out infection once and for all, so Em and our parents spent most of Saturday at the hospital. Why her oncologist didn't run these tests before arbitrarily prescribing antibiotics, we'll never know. The results of the tests won't be in until Monday, but her surgeon asked her to come back in Sunday morning so she could take a look at the area and see if the redness and swelling had spread. Had it shown signs of spreading, they were going to go straight to the Operating Room and remove her port. Luckily, it did not spread overnight, and her surgeon concluded that it was, in fact, extravasation.
Extravasation is typically caused by a break in sterile technique, not a leaky port. So in other words, the nurse that gave Em her chemo last week didn't follow proper protocol when administering the drugs and caused Emily a pretty serious injury. There are two things that can happen when chemo leaks into the tissue and it all depends on what type of drug is involved. With certain drugs, it causes severe tissue necrosis (tissue death), whereas with others, it simply causes terrible irritation of the skin and underlying tissue that can take weeks to dissipate. Fortunately, Emily is not on the drugs that cause instant tissue death. Unfortunately, she will have to endure the horrible pain for quite a while.
Needless to say, she had decided to leave her current oncologist.
Her surgeon is setting her up with a new oncologist at a new clinic that is closer to home. Hopefully she will have more luck with these folks! Em, I know this has been a painful and stressful weekend for you and I hope that you feel better soon!
Tuesday, July 15, 2008
Relay For Life
Our dad is participating in an event called Relay for Life, which is being held in Vancouver on July 26th. It is a 24 hour event in which teams of people gather and takes turns walking or running laps to raise money for the American Cancer Society. According to their website, the events are held overnight to represent the fact that cancer never sleeps. My dad's company, Cemex USA, has put together a team and my dad is planning to be there for the full 24 hour walk.
If you would like to contribute to this worthy cause, please click this link to be directed to John Porter's personal web page for the Relay for Life.
http://main.acsevents.org/site/TR/RelayForLife/RelayForLifeGreatWestDivision?pg=personal&fr_id=6369&fr_id=6369&px=7385362&JServSessionIdr009=d33w4vgm01.app315a
Good luck on your fundraising effort, Dad! We are all rooting for you. :)
If you would like to contribute to this worthy cause, please click this link to be directed to John Porter's personal web page for the Relay for Life.
http://main.acsevents.org/site/TR/RelayForLife/RelayForLifeGreatWestDivision?pg=personal&fr_id=6369&fr_id=6369&px=7385362&JServSessionIdr009=d33w4vgm01.app315a
Good luck on your fundraising effort, Dad! We are all rooting for you. :)
Sunday, July 13, 2008
Her Best Friend's Wedding
Emily embarked on her first major outing since last fall. Her friend Angie was getting married in Utah and she was going to make it to that wedding no matter what. When she first found out she was going to have to start chemo all over again, she mapped out her treatment schedule. She wanted to make sure that on the weekend of July 4th, she would be feeling good enough to travel. Armed with this information, she chose her start date. Sure enough, she was on the upswing and felt fine for the trip. She was gone for less than 48 hours and she was exhausted when she got home, but it was worth every minute to be with her best friend on her wedding day. Congratulations, Angie and Dave! Best wishes for a long and happy life together!
It was right back to reality this week, however. Emily had her 4th chemo treatment and she commented that this one has hit her harder than the first three. Hopefully by Wednesday she will be feeling normal again so she can get back to work with ease. Two more treatments to go!
It was right back to reality this week, however. Emily had her 4th chemo treatment and she commented that this one has hit her harder than the first three. Hopefully by Wednesday she will be feeling normal again so she can get back to work with ease. Two more treatments to go!
Tuesday, June 24, 2008
Acupuncture and Accessories
Emily has taken a new naturopathic course in her cancer recovery. She visited an acupuncturist last week and had a treatment that has really helped her feel better physically and mentally. They put three pins in her wrists and ankles and one in the middle of her forehead. The acupuncturist said that some people start to feel relaxed right away but Em was too concerned about the reality of having needles sticking out of her body to relax immediately. By that evening, she was bright and cheerful and feeling good. They also gave her suggestions on supplements to take that would ease some of her other woes. Among other things, they suggested drinking about 4 cups of green tea each day. She has been following all of the recommendations and really notices a difference in how she feels.
Another bit of good news comes in the form of vanity. Emily's hair is starting to grow back! She even had enough hair to clip in one of our beautiful barrettes. It took a few tries but she managed to get it in her hair to stay. Unfortunately, when she tried to unclip it, she lost one of her precious new hairs! The doctors told her that there was a possibility she wouldn't lose her hair with this new chemo drug and so far, that seems to be the case. Let's all cross our fingers that her beautiful hair continues to grow and flourish!
Thursday marks her third chemo treatment, leaving only three more to go. Once again, we find ourselves at the halfway point. Yay!
Tuesday, June 10, 2008
A little bit of normalcy
Emily has decided to go back to work! Her company is allowing her to work 15 hours per week so she can get back into the swing of things during this round of chemo. She will take 6 days to recuperate from her treatment, then work 3 days, have the weekend off and work another 3 days before she has another round. It seems like a very reasonable schedule to jump back into her regular routine. Monday was her first day back and things went smoothly, though she felt unbearably tired when she got home.
The side effects of this particular regimen are a little different than the first time but no matter how we look at it, it still sucks. She describes the feeling as more flu-like this time around, with nausea, fatigue and body aches. She finds that she feels nearly normal a week after treatment. Her next treatment is Thursday and she will be 2 down and 4 to go!
The side effects of this particular regimen are a little different than the first time but no matter how we look at it, it still sucks. She describes the feeling as more flu-like this time around, with nausea, fatigue and body aches. She finds that she feels nearly normal a week after treatment. Her next treatment is Thursday and she will be 2 down and 4 to go!
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