Monday, 2016/05/16 – New Poison and a Balloon

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what the modern zombie fighter wears to battle

They don’t give me stickers or lollipops for behaving well at my chemo appointments, but today I got a balloon.  I don’t want to seem ungrateful, but I really was disappointed.  I had discussed getting chemo delivered by a portacath (portable catheter) with a fellow pilgrim on the Linac Limo. I’d seen his port and pump, and thought mine would be similar.  Nope; I got the “new, improved” version.  His port was covered with a 2” x 3” clear adhesive dressing, and had one tiny clear tube leading to a little blue pump.  I remember the device, which contained the meds, was no more than about 1” x 3” x 4” max.  I think it was smaller.  It had some LED’s and switches on it, and he kept it in a little pouch on his belt.  What my medonc told me I would get was something very similar, very small and precise, and unobtrusive. Here is what I got:

BalloonKludgeNot quite the same.  It’s a plastic ampoule, 2½” in diameter, by 7½” long; 8½’’ to the tip of the hanging clip. The business at the port is much bigger, more complex, and nasty-looking than what I remember my fellow pilgrim having, as well. It is what I would call a kludge: an unfortunate assemblage of mismatched parts forming a distressing whole.  It’s almost comically simple, in reality.  Instead of an electronically-regulated precision pump, metering out the toxic 5-FU (Fluorouracil) and monitoring its own progress, I get a balloon. Inside the clear plastic shell is a balloon full of poison. It wants to shrink. It will shrink until it has squeezed the poison into my vein (right at the atrium of my heart) through a filter and a regulator. The round blue filter is to stop any particles that form in the 5-FU from getting into my blood. Wow. The yellow plastic rectangle is designed to let exactly 1.9mL of 5FU into my heart each hour until I have 250mL in me, if it is kept at about 90°F, then quit.  There will still be about 15mL left in the balloon at that point, and the walls of the balloon will be parallel to one another.  I hope.  If the temperature varies by more than 10° F, hotter will make it faster, and cooler will make it slower.  So I’m sitting in the sun. I want this contraption off me ASAP.

MY POWER PORT
Yes. Really.  That is what they call it.

PowerPort

I was feeling pretty good about the “Power Port” being able to handle high-pressure IV feeds, and not having any plastic sticking out of my skin.  It turns out that my port is a central line, meaning that the catheter tube goes from the port, up to a handy spot to enter my vein, then down to the atrium of my heart. That is a particularly good place to deliver meds, because it gets mixed thoroughly and distributed evenly through the whole body.  When they want to get stuff into me now, they just poke through my skin with a short needle, into the port, and no hunting for veins and long tubes to thread and thread again.  I like that.  Then came the balloon.  Oh, well.

One pleasant surprise. I misunderstood which meds would be given which way. The medication for which I have the greatest hope, Cetuximab, was a relatively quick infusion. It took only 2 hours today, perhaps as little as 1 hour from here on) rather than requiring the “pump” as I had thought.  It’s the nasty, unpleasant 5-FU that is in the pump, and after two cycles of that, I probably won’t need any more. Carboplatin is a lot like Cisplatin (what I had before) but more stable and less toxic. The plan is for me to get two courses of all three, then quit the 5-FU and Carboplatin (the two most dangerous and bothersome of the three) and continue with just the Cetuximab, until I am in remission. The next 42 days may be tough, but I doubt they can be any worse for me than October and November. Maybe we can make them difficult for the cancer instead.

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