Port-O-Cath

As you know this week I had a new distribution system for chemo installed. Instead of a PICC line I now have a Port-O-Cath.
Not many images are available on the Internet but I found one that is OK.


As you can see it is a plastic box (mine is white) with a membrane and a central tube.


It's in the membrane that we insert the needle that brings the liquid flowing in the tube then to my right jugular vein. All this was inserted under my skin so when healing is complete I will not have to worry about a bandage or an opening in the skin (open door to infections). The needle going through the skin to distribute the chemo is like this.

The nurse takes the white part between the fingers of one hand. With the other hand she feels the skin to locate the valve and maintains it in position while the right hand pierces the skin. The attached tube stays outside on the chest so they can plug in pouches of chemotherapy or other treatments. My scars are still fresh but it should be less apparent with time. The Yellow or blue is a bruise, it will disappear eventually ;-)

The operation is done with local anesthesia. I am laying on my back with the head turned to the left. Nurses install surgical blankets leaving only the part where surgery will take place (neck, part of right shoulder and chest). Injections of anesthetic is what hurts most then you feel fingers pushing and pulling and lifting your skin but it don't feel pain. There are two incisions because they have to install the tube in the jugular (upper incision) and then adjust the length at the other end where they have inserted the valve (other incision). By the way the tube connection on the valve is similar to the fittings on a engine's carburetor.
When everything was installed I had to stay 3 hours on the back under observation. She was watching for bleeding but also the connection that I mentioned is quite fragile so I could not use strength from the right side (not lift my head, not lift my arm etc..) in case the tube wold dislodge and start floating in the jugular.

Anecdote: Toward the end of the operation, the doctor said: YIKES!. So I said, this is not the kind of sound a patient wants to hear from the doctor operating on him (do not forget that I do not see anything because the blanket covers my face). He hesitated and said, no no everything is fine is just the thread that came out of the needle. A little later he sighed and immediately said that this was perhaps not a good thing to do under the circumstances because I could interpret it negatively. We all laughed.

Discovery

I wanted to share a discovery on the web with you. It is an online database for books. I am in the process of entering our own collection. You can view it in the left column. I find it fascinating because we have a large collection of books (habit taken from my parents) and I like the fact that you can easily identify them with this online tool. By the way if you're interested in any of our books send me an email I will gladly lend it to you. The site is called Library Thing. It is available in several languages.

YES YES YES

Anyone who has attended a Tony Robbins conference understands the reference in my title. The reference is also used to its simplest expression, as a statement of acceptance. Dr Y agreed to opening up my belly and explore the possibilities.

Note that I did not say he will operate because he was very careful to tell me he does not know if he can operate. Clearly he needs to see for himself, with his eyes, the extent of cancer spread and the impact in my abdomen before he can decide if he can resect anything.



The various images (PET scan and others) do not give enough details to confirm the actions to be taken though they are specific enough to say that my liver is not affected. So it seems he will not have to touch it.

This is great news since the partial liver resection is a challenge and furthermore this support the thesis that my cancer has not spread through blood, but probably by contact (until now). If you remember this was one of the strikes against me in relation to the success of the operation so it's one less now.

The surgery will take place either May 25 or June 3. I hope it will be June 3 because it is MJ's birthday. I believe it would bring me good luck. Moreover, June 3rd 2009 marks the 25th anniversary of our relationship. We dated for the first time on that day in 1984. Christine and Marco will surely remember.


As you can imagine I am very happy (Marie-Josée also). Things are going as I had imagined even in the slightest details. I visualize every day and I saw the operation in late May early June... Huh! Huh!


Here is how I see what's coming.

I see myself sitting in my hospital bed with a big smile listening to the doctor telling me that things were not as bad as expected, he was able to remove all apparent traces of cancer and that I will recover quickly from the surgery. The recovery is not easy, but I see myself going through it with a smile surrounded by those I love.

My visualization continues a little more down the road. Once I returned I finally put the finishing touches to really start the company and also I am helping my friend Barry at the Colorectal Cancer Association of Canada. I even have a vision of me in 20 years surrounded by my wife and children.

Thank you to everyone for the support and encouragement.

Don't stop praying, sending positive thoughts, etc..

Ciao!

We're Back

Back to everyday life.
It is certainly a contrast to our two weeks in Dubai. The trip was fantastic.

Many of you have followed our activities through the photos. We celebrated the 12th anniversary of Tristan in a restaurant specializing in fish, The Seafood Market at the Meridien hotel. A memorable evening marked by the new tastings like shark.

Most of the things we see in Dubai are exceptional. It's big, it's expensive, it is clean, everything is new, but in unreal proportions.
In any case I can say I have re-energized. To a point where I wonder if there is cancer. I feel better than in the past 5 years. This is a good sign. I meet Dr Y. Thursday and I'll be set for the operation. I can not wait because I'm ready mentally. Inregards to the household organization, we will finalize the plans when we have more details.

Good day to all!

Dubai

News: It seems that even if youre not on Facebook you are able to see the photos publlihed there. So here are the links but tell me if it does not work
http://www.facebook.com/album.php?aid=2019344&id=1057565304&l=0693fd993c
and this one
http://www.facebook.com/album.php?aid=2019655&id=1057565304&l=6505ec4400

Here are pictures of our trip to Dubai for those not on facebook. http://picasaweb.google.ca/martinraymond.qc/Dubai?feat=directlink

Varia

A little note to let you know that things are going well.
The trip preparations are going well. MJ is taking care of everything.

The Pet scan is done and the other scan as well. I also received a letter telling me that Dr Y as ask to put me on the surgery waiting list. This does not confirm that he will operate but it gives me real hope that he will. Why would he go through the trouble if he did think lean towards a yes. If he really did not want to do it he would not bother filling out the paperwork. I stay grounded though, he can always say no but the script I have in mind is more on the positive side.

Wednesday I had my bottle unplugged and at the same time they took out the Piccline. I was told to keep the bandage for 2 days but I kept it for 3. I was a bit scared to see the hole not completely healed. By the way, the tube they took out was 45 cm long (about 14 inches).

I will post some pictures from Dubai as soon as I can.

PET scan

Positron Emission Tomography – Computed Tomography (PET/CT)

What is Positron Emission Tomography – Computed Tomography (PET/CT) Scanning?

Sample image obtained using a combination of PET and CT imaging technology.
Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging.
Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose or treat a variety of diseases, including many types of cancers, heart disease and certain other abnormalities within the body.
Nuclear medicine or radionuclide imaging procedures are noninvasive and usually painless medical tests that help physicians diagnose medical conditions. These imaging scans use radioactive materials called radiopharmaceuticals or radiotracers.
Depending on the type of nuclear medicine exam you are undergoing, the radiotracer is either injected into a vein, swallowed or inhaled as a gas and eventually accumulates in the organ or area of your body being examined, where it gives off energy in the form of gamma rays. This energy is detected by a device called a gamma camera, a (positron emission tomography) PET scanner and/or probe. These devices work together with a computer to measure the amount of radiotracer absorbed by your body and to produce special pictures offering details on both the structure and function of organs and tissues.
A PET scan measures important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning.

What are some common uses of the procedure?
PET and PET/CT scans are performed to:

• detect cancer
  
• determine whether a cancer has spread in the body
  
• assess the effectiveness of a treatment plan, such as cancer therapy
  
• determine if a cancer has returned after treatment
  
• determine blood flow to the heart muscle
  
• determine the effects of a heart attack, or myocardial infarction, on areas of the heart
  
• identify areas of the heart muscle that would benefit from a procedure such as angioplasty or coronary artery bypass surgery (in combination with a myocardial perfusion scan).
  
• evaluate brain abnormalities, such as tumors, memory disorders and seizures and other central nervous system disorders
  
• to map normal human brain and heart function

How should I prepare for a PET and PET/CT scan?
You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing.
You should inform your physician and the technologist performing your exam of any medications you are taking, including vitamins and herbal supplements. You should also inform them if you have any allergies and about recent illnesses or other medical conditions.
You will receive specific instructions based on the type of PET scan you are undergoing. Diabetic patients will receive special instructions to prepare for this exam.

Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work.
Generally, you will be asked not to eat or drink anything for several hours before a whole body PET/CT scan since eating may alter the distribution of the PET tracer in your body and can lead to a suboptimal scan. This could require the scan to be repeated on another day, so following instructions regarding eating are very important. You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast materials, iodine, or seafood.
You will be asked and checked for any conditions that you may have that may increase the risk of using intravenous contrast material.

How is the procedure performed?
Nuclear medicine imaging is usually performed on an outpatient basis, but is often performed on hospitalized patients as well.
You will be positioned on an examination table. If necessary, a nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm.
Depending on the type of nuclear medicine exam you are undergoing, the dose of radiotracer is then injected intravenously, swallowed or inhaled as a gas.
It will take approximately 90 minutes for the radiotracer to travel through your body and to be absorbed by the organ or tissue being studied. You will be asked to rest quietly, avoiding movement and talking.
You may be asked to drink some contrast material that will localize in the intestines and help the radiologist interpreting the study.
You will then be moved into the PET scanner and the imaging will begin. You will need to remain still during imaging. The PET scan takes 45 minutes.

What will I experience during and after the procedure?
Most nuclear medicine procedures are painless and are rarely associated with significant discomfort or side effects.
If the radiotracer is given intravenously, you will feel a slight pin prick when the needle is inserted into your vein for the intravenous line. When the radioactive material is injected into your arm, you may feel a cold sensation moving up your arm, but there are generally no other side effects.
It is important that you remain still while the images are being recorded. Though nuclear imaging itself causes no pain, there may be some discomfort from having to remain still or to stay in one particular position during imaging.