Monthly Archives: March 2009

March 31, 2009

Mallard Drake

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March 27, 2009

Streeeetch

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explaining what a port is

I mentioned in my last post that I was over at the cancer center go get my port flushed. Had a commenter ask what is a port flush -- which is actually a very good question because like everything else (running included -- I mean think of how many non-runners can say "fartlek" without giggling -- not many!) cancer has its own vocabulary.

I guess a good place to start explaining what a port flush involves is to explain what a port is.

Port is short for "mediport." This is me and this is my mediport -- you can see a little what it looks like and where it is located on the upper part of my chest right below my collar bone.  Oh yeah, and definitely GO NAVY!  (The shirt was a gift and I love it.)  Anyway, a mediport is a vascular access device -- a surgically implanted little object (mine is about the size of a dime) that resides usually in the chest on the right side to avoid driver side seat belt issues. Mine happens to be on the left because my chest masses were so large there wasn’t room on the left side.  (And yes, I do have seat belt problems sometimes from the shoulder belt rubbing against the port).  The raised slightly discolored area on my chest is the port reservoir. An attached lead runs up to the large vein in my neck. You can actually see the lead if you know where to look -- it makes the vein sort of stick out more on that side of my neck.

By the way, I had this really awesome vascular surgeon implant my port.  He let me stay awake during the surgery and we talked about triathalons (he's a triathlete, I would sink like a rock to the bottom of the ocean, so no tris for Jenny).  The whole thing felt just really weird.  It didn't hurt very much.  Actually compared to the bone marrow biopsy my oncologist did the next day, the port surgery barely hurt at all.

This is what the port looks like accessed. (Like that rocking red sports bra?)  So now you know what a port is and what it looks like.

A port is useful for a cancer patient for three main reasons. First, it saves you from multiple needle sticks. The nurse “accesses” the port with a needle, but it is hard for them to miss, unlike with arm veins.  You should see the bruises I sport when I get CT scans.  Second, it saves your veins from the chemo itself. Chemo can actually sometimes burn your veins inside out. Finally, the port allows chemo to be given at a much faster rate. I guess you can think of it as just an easier, more efficient way of delivering poisons to tumors.

Anyway, a port can be pretty easily removed after chemotherapy is completed. I know a lot of Hodgkin’s patients get them pulled out right away given the high cure rate Hodgkin’s Disease generally boasts. Being a shot from out around half court rather than the typical slam dunk Hodgkin’s case, I still have mine and haven’t worked up the courage to ask my oncologist whether I can have it removed.

As a consequence of still having my port, every eight weeks, I have to traipse over to the cancer center and get the port flushed. A flush is about a two minute procedure where the nurse accesses the port and flushes it with some heparin to make sure it works properly and won’t form any blood clots (obviously that would be very bad). It’s really not a big deal, it just means another appointment, another trip to the doctor, another needle poke … You get the idea.

Anyway, if anyone has any questions about what I write about, I’ll try to answer them as long as they aren’t TOO personal.

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March 22, 2009

Spending Sunday with the Squirrels

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Attitude.

I had to go over to the cancer center today to get my port flushed. Walked in and greeted the receptionist. Spied a new bulletin on how you can apparently now request a translator -- even one, apparently, who speaks Swahili (but strangely enough not Italian or German). Cleveland Clinic is going all cosmopolitan apparently. Of course, I politely requested a Swahili translator for the sole purposes of getting the receptionist to laugh. I then walked around the corner to sign the port board and find a seat.

I’d like to say it was screaming yellow race shirt that attracted the stares, but every time I walk in to the cancer center and walk over to the waiting room for oncology, people stare at me. I don’t blame them, I look completely out of place. Fit, young 20-something year olds wearing marathon shirts don’t belong in an oncology waiting room. Everyone sitting there was at least thirty years my senior. I could have passed for someone picking up a grandparent or something except they make you wear this white paper wrist band that identifies you as one of the stricken, one of the victims. I like the nurses, like my oncologist, like the staff, but I hate how people look at me like I’m a victim. Every time I go into the waiting room I just want to slouch down in my seat and hide. (And actually I sometimes hide out in the corner by the fish tank so as not to be seen.)

I guess part of what bothers me most about the whole cancer things is … why me? I’m a runner. I eat a pretty healthy diet. And my life was just getting started. Why did this happen to me? Was this some sort of test? Did it happen for a reason? Or was it just a totally meaningless thing, just a random bad luck event?

There don’t seem to be any answers. None. No meaning, no reason, no logic. This always bothers me, but it really disturbed me today. I have seen cancer claim two bright young people in the last two weeks. I desperately want to understand why that happened. And try as hard I can, I can’t make any sense of it.

The first time I walked into this waiting room in February 2007, I took note of two things. One was the fish tank (no surprise there as I love fish) and the second was the Attitude poster. I was badly in need of the Attitude poster.

“The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than successes, than what other people think or say I do. It is more important than appearance, giftedness or skill. It will make or break a company…a church…a home. The remarkable thing is that we have a choice every day regarding the attitude we will embrace for the day. We cannot change our past. We cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is play on the one string we have, and that is our attitude. I am convinced that life is 10% what happens to me and 90% of how I react to it.”

I like that poster. I like it because it reminds me that I do have control: I control how I react to what happens to me, even if I can’t control what happens to me.

It is really hard not to have control over cancer. With Hodgkin’s Disease, there isn’t much you can do to lower your chance for reoccurrence -- we don’t even know what causes Hodgkin’s Disease in the first place. No one knows whether running or exercise does anything. What happens to me is decided by something far more powerful than I -- be it God or the utter randomness that guides the universe -- and that is something I have to accept.

And I understand the cynics ... a good attitude isn’t going to change whether my cancer comes back or not. One of my friends who died last week was one of the best, upbeat people I knew. Fought the good fight, ran the race, kept the faith. All the while with grace and dignity and a good sense of humor. And he’s now gone anyway. None of that seemed to matter.

Or did it? I've slowly puzzled it out and what I think is really key about keeping a good attitude is not that it makes your prognosis better, it makes your life better. You can’t control how many days you have left here, but you can control how you live the days you have. You can choose to be miserable, or you can choose something else. The poster up there on the cancer center wall is right; no matter what happens, I don’t have to accept feeling down about it, or accept giving up hope. I control how I react. That’s why I run. Running is my hope. And hope is the best possession we have. As Victor Hugo put it, it is best to “be like the bird that, passing on her flight awhile on boughs too slight, feels them give way beneath her, and yet sings, knowing that she hath wings.”

I haven’t been running well the last few days because my shoulder has been hurting and I seriously considered just not running today. But when I left the cancer center, I decided I wasn’t going to feel sorry for myself. So I took control. And went for a run. And refused to feel sorry for myself. Instead, I took note of how spring is approaching -- how the tips of the crocuses are starting to poke up through the ground, how there are buds swelling with new life on the trees, how you can now hear the call of the newly arrived red winged black birds, the rustle of a robin in the underbrush, the angle of the sun in the sky, the glint off the water. Spring is coming. It is inevitable.

I sure am glad someone decided to hang up that poster. I needed the reminder today about attitude and hope. Your attitude really does have the power to shape your life.

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