The chemo drugs were much more of a fear for me than what the radiation was. After the few hours of watching TV and chatting thru the IVs, I just had to go to the end of a hallway to the radiation department.
Once again I meet the nicest people. Primarily I dealt with Faye and Melissa over the next five weeks of five treatments per week. This was simply a matter of my laying on a table while an X ray machine's head basically rotated around me to four different positions, all aiming at my upper left shoulder. And best of all, no needles!
As the weeks went on I did develop a little patch of dry and sensitive patch of skin on the front of my shoulder, much like a bit of sunburn. This I treated with some aloe lotions and some carved up "Flashdance T Shirts". Much more a discomfort than pain.
I did notice that general pain from my shoulder caused by the tumor did increase over time. This was treated with some Oxycoton as high as 40mg twice a day and a bunch of Ibuprofen. The pain did decrease as the treatments ended and during my "cool down" period of the few weeks pre surgery allowing my body to heal a bit from the radiation and the chemo. As I look at surgery mid November, I was off of all pain killers before Halloween. Dr. Landrenaeau did say i would notice symptoms decrease through the treatments, and that sure came true.
As the tumor was in a place close to aqn artery, a nerve, and behind my collar bone, the surgery was, or could be tricky. Dr Landreneau decided to consult with Dr. Rhee, a vascular surgeon and Dr El Kahid, a neurological surgeon. They were going to use the MRI and CT scans they had compiled to make a computer model of what the surgery area would look like. I would have to do one more MRI/PET scan and another CT Scan to help clarify the images. I look at this as the more the merrier. No one is taking any chances or leaving anything overlooked.
The MRI was going to be of my spine and shoulder area, like all of the others, except longer. There was no problem until I may have fallen asleep. Ever wake up and not know if you were out for five minutes or five hours? Welp, that's where I was. I was pretty well encompassed by the MRI machine's walls, and this time I had a kind of headgear on to keep me from moving.
For the first time ever the fear of claustraphobia kicked in. I could not see out and all I could hear was the constant noise from the MRI. I actually caught myself breathing faster. I knew that I had the "panic" button in my hand that would bring everything to a screaching halt and technologists to the rescue.....but what if we then would have to start all over again????? Oh God, this is horrible!
"Ok Mark, we're all done, everything went well and we'll be in there in a second to get you out" The voice over the intercom was like a voice from heaven! As I was coming off the table I asked how long I had been in there and it indeed was a long time...just under two hours! Wow, what a weird feeling that time distortion was.
A few days later I got a call from Maria that I was to do a CT scan at another UPMC location only fifetten minutes away from home. They needed more detail than the MRI just gave them. This was going to be a CT scan with contrast, which meant the IV machine again (Did I mention I hated needles?).
This test went well, even with the IV as technologist Bob was excellent with the needle. He had me sit down in the hall while he had a Dr. review the images. About 10-15 minutes passed and Bob came out and sat down beside me.
"Mark, it looks like you have blood clots in your lungs and the Drs. want to admitt you. We called your Drs. at Passavant and they think you should go there (about 10 minutes away)." Oh no. I got that big warm rush of fear that starts in your neck and goes right up through the top of your head. Now I could die instantly from a blood clot.
Bob told me that I had to leave my car here and an ambulance was on the way. Great. Just Great. I had to get ahold of Kim. She had been returning from a corporate meeting in Oklahoma and missed her connection in Memphis. She had to stay overnight and was on the plane at this moment. All I could do was call her parents and text Kim's phone.
Meanwhile, Bob would not even let me walk the ten feet to a water fountain. I must be in really bad shape is all I could think. It was 9:30 am and Kim would not be at Greater Pitt airport till noon. Little did I know that the ambulance would not be there for me for about three more hours!!!!
With that delay I was able to talk with Kim. Her parents would pick up her up and take her to our car and meet me at the hospital. I got to Passavant and into my room around 1:30pm. Soon after Kim's sister found me, she had rushed to the hospital around 10am so I would not be alone but got lost in the system as no one really knew where I was going. Kim showed up about 2pm and decided she would go home, take care of Bailey, and get me some comfort items like sweats to wear, a real pillow, my laptop, and the like. I still had no medical information and only a blood draw (did I say I hated Needles?) and some vitals.
Kim returned with all my gear and I set up camp. It was now about 6pm and still nothing from the Drs.. I told Kim tohead home as she was working on about 4 hours sleep in the last two days. No sooner did she leave than a new Dr. arrived. Dr Schaubel was a delightfully pleasant man that just brightened a room with his presence. A pulmonary specialist, Dr Landreneau had asked him to check on me as he was out of town.
Dr. Schaubel explained that blood clots were not uncommon with lung tumors and other disorders and they were easy to treat with medication. I was going to get Lovenox injections in my belly twice a day(Did I mention that I hate needles?) and take Warfarin, a cumidin blood thinner. This would manage the clotting problem. I would do the injections for 3-4 days and then have blood work (Did I say how much I hate needles?)check my clotting level. Once I was at the right number, I could quit the injections.
But there was a problem......
In that I was less than 3 weeks away from surgery, I could not be on blood thinners within a few days of the operation because of bleeding issues. So I would have to quit the pills three days or so before surgery, and the shots the day before. To protect me from the blood clots, Dr. Schaubel told me that they could put a "blood filter" in the vein just below my heart and that would protect me thru the surgery(Did I mention I hate having metal filter devices put into my veins?) I guess the look on my face must have denoted some concern, or maybe even panic....
"Don't worry Mark, we do these things every day, it's realy quite simple. They'll just numb you up in your groin, and insert a catheter with the filter up to where it needs to be aqnd that's it, just a minute or two. And then it will come out after surgery. We just have to decide when to do it."
"Dr", I said, "the words injection, insertion, and groin don't belong in the same sentence. That's just wrong..." He laughed and told me not to worry. He was going to keep me here overnight, give me some injections and the blood thinning pills, do some blood work in the morning and send me home...if they did not decide to do the filter.
A few more Drs. and assitants came by to check on me and reassure me of how simple the filter thing would be. They thought that it would be better done as close to the surgery as they could, but they had to work out the time frame with the drugs as well.
Next in was my nurse Barbie with my first belly shot. Turns out that I had had one of these during my first stay and for a shot, it was OK. She was so much fun and we laughed so hard as I told her the filter plan... A few hours later I got the pill and was able to go to sleep.
The next morning I awoke to vital signs, another Lovenox injection with my nurse asking me to watch how it was done in case I had to do it on my own (Did I mention that I hated needles). One of the Drs. from the night before that had been reviewing the filter procedure stopped by an hour or so later and said they thought that they would wait on the filter deal for a week or two. "Here's the deal," he said. "If you think you can give yourself these shots twice a day for a while, then we'll send you home." I responded, "I'll give myself shots in my eyes to get to go home!"
Sure enough, I was on my way home in an hour or two with my $3000 two week supply of preloaded syringes.
Within a week of my going home with the PE (medical speak for pulmonary embolism), Dr Schaubels' office (The Pulmonary Specialists) called to schedule the filter implant. It seems that they were trying to find a window that would cooperate with the blood thinner medications, but stay within the 6-8 week lifespan of the "temporary filter". The filter was designed for a short life and primarily going to be there to protect me from clotting during the surgery.
If my blood was too thin, it may become an issue if the work on my artery reconstruction as bleeding close to my spinal column could lead to paralysis, if it wasn't thin enough, then I ran the risk of the PE dangers in my lung.
Dr. Schaubel explained a quite simple procedure. They would enter a vein in my groin with about a 2+ foot long catheter. The springy self size adjusting filter screen, much like two umbrella frames connected together, would be placed in my vein just below my heart and the pulmonary veins. This would allow any clots to be caught in the filter and then dissolved by the meds in my system and the natural ability of blood cleaning we all have.
Personally, he kind of lost me with the sentence containing the words groin, injection (did I mention I hate injections?) and insertion. Hey so be it.... The procedure would happen after three days on no blood thinning pills.
I arrived a little early that morning and got to meet Alleryck (please excuse the slaughter of your name my friend---I tried to go phonetic). He was a very affable, very reassuring technologist that would be with me start to finish. We struck it off great right off the bat and our senses of humor kind of matched up which spelled disaster for all others involved. May as well have a good time when facing something as impossible as this!
Alleryck explained that I would be getting quite a strong local in my groin, then I would have the vein punctured and the catheter would be inserted to the base of my chest using a floroscope like everyone you have ever seen in a A Bugs Bunny cartoon. He then asked me if I had any issues with shaving. I said "Hell no, I just shaved myself pretty close this morning!", rubbing my chin.... He smiled and reminded me that he was talking about the "insertion site". "I could do it for you, or maybe you would prefer if one of the female nurses or doctors would do it, or we could have the women leave the room if you'd like"
I could barely keep a straight face as I looked at Kim as I raised my trumpet blowing hand to my mouth and giving out a quick "Ta Da Da Da Da Da". I then raised my other hand proclaiming "Let the indignities begin!!!" "I should of warned you Alleryck" said Kim. He just laughed and laughed, it was such a great stress breaker.
We spent an hour delay that popped up because of the surgeon's schedule delay, talking about flying and how i thought he would do really well as a flight student (something I did in the early 80's). Finally it was time and the Dr. came in to check me and order a little extra pain killer via my IV (good for him!). I kissed Kim goodbye and was rolled across the hall to a waiting surgery suite.
As the crew of about 8-10 staff member buzzed about the suite unwrapping things, Alleryck took a moment to show me the actual filter that they would be using. This way bordered too much info. Problem is, Alleryck was so excellent at what he did and he was by nature a "comfort through knowledge" type. I on the other hand always found myself fighting my techno-geek tendencies of wanting to see and touch everything.
The filter looked like it was about 3" in diameter and maybe equally as long. Ok, That was enough.
After about 10 minutes of prepping, cleaning and wrapping, oh and yes, ten seconds of shaving me, the Dr. proclaimed, "Ok Mark, we're ready...first the big pinch of the needle (OUCH! but not that bad) and now for a bit of the burn." He then changed tha angle of the needle and repeated the fist little procedure. Weirdly, and though he was working on my right leg, my left leg started to uncontrollably tremble. He asked if that was my doing and I told him it was quite involuntary. He then asked the anesthesiologist to increase my dosage of my IV sedation. "I'm up for that!"
A few seconds later the Dr. said "OK Mark, now we're going to set the filter.....Ok.....That's good right there." He opened the filter and removed the catheter....all done in about 30-45 seconds---no pain or discomfort. Now Alleryck just had to put pressure on the "puncture site" on my upper leg for about ten minutes.
I was smile city....this was about the least painful procedure I had done so far. I also can now say that if one would ever have to have any kind of cathertization, go into it head held high as it is really a lot less grueling or painful than it sounds. The Dr. then told me, "See Mark, that wasn't all that bad. And remember, it comes out even easier and faster since we pull it up through your neck."
Did he just say neck? NECK?
I rested for a few hours to be sure there was no bleeding and followed up with an X Ray before Kim and I headed home.
We were now less than 10 days from surgery....
The Thursday prior to Monday's surgery had me back at UPMC for some Pulmonary tests, some blood work, (Did I mention that I really am starting to hate needles alot?) and some Arterial Blood Gas test (This was a blood test that was drawn from an artery in your wrist or forearm --it hurts if they miss, and I mean a lot. When they get it right it's virtually painless. Go figure. All these tests came out in great shape. Surgery was set for 8-830am on this coming Monday, the 16th. Be here at 6am.
I did not mention much to Kim over the weekend as a blind person could read the tension on our faces as Monday grew closer. I really did have a lot of faith in Dr. Landreneau, he had earned a level of respect reserved for very few people I had pass through my life. His ability and the ability of the other three surgeons gathering for Monday's procedure was exponentially above what I had seen throughout my family's medical life. Talking with my best friend Don that I work with at Noritsu fixing the photolabs, he put it all in some really decent perspective.
"You know, if these Doctors would come into a Giant Eagle Supermarket photo lab while we were in the middle of a printing laser replacement and saw all of the circuit boards, wiring cables, parts from the laser, on and on just laying around the lab as we were replacing a new one, I can't help but think that they would have the passing thought, 'Man, this will never work again..'" "To you and I Mark, It's just Giant Eagle #67, first of 2-3 calls that day...That's what you are going to be for them on Monday...just the first patient of three for that day, You'll be fine...."
Monday came quick after a very sleepless Sunday night. Kim and I were there right on the dot at 6am. The ride to the hospital was kinda of quiet, broken by quite a few "Remember when we...." or "Kim, you do realize how much I love you don't you? You've been my very best friend for the last twenty years..."
I found myself wiping away quite a few quiet little tears over the half hour drive. I did really well I had thought. The only somewhat negative thing I had mentioned was along the lines of "You know Kim, I've stayed away from this subject, but in case things don't go right, I really want to be with you and Darby....do you know what I mean?" As Darby, our first Golden Retriever that had died about a year ago, lay cremated in his little box in our dining room hutch, That was as clear as I wanted to make my request. "I know Mark..." Kim took my hand as a little tear tumbled down across both of our faces about the same time. Biting a trembling bottom lip brought back a bittersweet smile.
At surgurey registration, family member are greeted with "Flight Info Panels" much like you would see at airports. Kim could follow my progress from pre-op, through surgery and post op recovery, and then ICU after that. For now, I was being taken to one of my little cubicle to get my gown and my IVs started.(did I mention......).
This all took about 30 minutes and Kim rejoined me in my little room with about 45 minutes to go.
The parade of Drs. and assistants, Anesthesia Drs, and OR Nurses would start soon. At one point I think I had about 5-6 Dr. types in my cubicle, so I took the moment to proclaim "You guys do know what today is don't you?". A bit puzzled they looked at me waiting for an answer "Blue Cross of California called me on the way over and wanted me to let you all know that it was free Corvette Day today!!" I got a couple laughs, a couple snickers, and a general break in the tension.
The time had passed quickly and it was time for me to go. I took Kim's hand and looked so deeply into her eyes as if I was trying to communicate a lifetime of feelings, loves, regrets, and hopes all without saying s word. I got out "Kim, I love you with all my heart and I always have and always will." Kim came back with "I love you to Mark, it's all going to be OK....I'll see you when you wake up in the ICU in a few hours..." My vision of her faded to a blur as my eyes filled with tears. The Anesthesia Dr. slipped me a kleenex from her sleeve and patted my shoulder telling me that it all would be OK. What a sweet touch by her. I told her that I really wasn't all that scared for myself as I was so scared for Kim as she had been trying to deal with this all these months. I wish there was a way to relieve some of this burden from her shoulders..
I was wheeled into the operating suite and the geek in me kicked in. I made a quick study of all the equipment around me, which surprisingly seemed to be very little. I did see a literal MOUNTAIN of hemostats (clamps) off to the side. I asked Frank, one of my nurses, "Are those all for me" He laughed and said, "...don't worry, we have a couple hundred more right there in that outer little room."
"Welp," I said, I hope everyone had a great weekend, got lot's of sleep last night, and all that." I'm not sure if it was Dr. Landreneau, but one of the Drs. said, "Nothing as good as the sleep you are going to get right now" as they winked at the Anesthesiologist. "Sleep" I said....sure could use some...." Darkness again.