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September 29, 2009 - Day 162

Posted Oct 04 2009 11:12pm
Today, it was back to the Velcade/Dexamethasone regimen.
We are starting all over from square one, so this is the first week of 4 consecutive weeks before a chemo vacation.
We are using 80% of the normal therapeutic Velcade dose to try and avoid the side effects that I experienced on the last go around and 12mg in lieu of 20mg of Dexamethasone to try and control the edema.
I also received 40mg of Furosemide (diuretic) IV in an attempt to clear the edema and my "Bag o' Mag", so I have plenty of crazy compounds coursing through me at the moment.
This was the first time that we used my port since its installation and I can see why they pushed so hard for me to get one installed.
It can be used not only to give me the infusions of poison that will hopefully save me, but it is also used to draw the blood for my testing.
No more needles in the arm, no more big ugly bruises all up and down my forearms.
The use of the port is relatively simple.
This is what it looks like when installed:


The tube leading from the port is connected to the superior vena cava located above the right ventricle of my heart.
The first step is for me to prepare the skin above the port septum by applying a lidocaine/prilocaine cream on the skin about one hour before Jo takes me to The Cancer Center of South Florida to see Doctor Abe.
It is covered with a small square of Saran-Wrap to protect it in preparation for the drive.
Once my drugs are mixed and ready for infusion, Jill who is one of Dr. Abe's infusion nurses, puts on sterile gloves and mask and then swabs the area to sterilize it before the needle is inserted.
She had the rig ready, told me to take a deep breath, counted to three and pushed that sucker (literally) home into the port.
I felt absolutely no pain, just the pressure of her pushing through the skin and the silicone cover of the port.
This shows the components to give you some idea of how it all works together:


Not all of the external components shown above are actually used as you can see in this picture of my chest.

(The incision directly above the needle is the opening that was made to shove the port under my skin last week by Dr. Shapiro).
Once the needle is in place, it is used just like any catheter installed in an arm vein.
Blood comes out and drugs go in, quite simple really.
The IV bag is then connected and we are off to the races.
About half way through the bag, Jill gives me a bolus injection (A bolus injection is one delivered directly to the veins through an intravenous drip allowing a much faster delivery which quickly raises the concentration of the substance in the blood to an effective level) of whatever drug is required.
This is accomplished by connecting a syringe of the drug to an adapter inline with the IV line ahead of the needle.
The bag of saline then continues its drip until finished and I am almost done.
After I have received the meds for the day, lines are disconnected and flushed with a saline solution and I get one last injection of Heparin which is a powerful blood thinner that prevents clots from forming from the blood in the port.
The whole thing is then bandaged up and I am on my way.
Very simple, very easy.
Comparing my port to needles in my arms, I wouldn't trade it now for all the tea in China.
Yes, it was a hassle having the surgery to install the port, but I may need 40 or 50 treatments and I can't imagine going into my veins that many times.
Strange thing, a year ago I wouldn't have traded my 9" Klein high leverage linesman pliers or my Titleist ProV golf balls for all that tea and now here I am letting you keep the tea for a port in my chest to deliver life saving chemotherapy.
What changes a year can bring.
So, that is my port story and I'm sticking to it.
Now we just wait and see how I tolerate the meds and how effective they are in fighting AMY.
If the karma of today holds, I am looking forward to smooth sailing.

P.S. If you have any fears or concerns about having a port installed (which apparently many people do), talk to your doctor, he's the expert. If I can help from the perspective of a patient, feel free to write ( dougvsamy@gmail.com ) and I will answer questions about my experience and how pleased I am with it.

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