Getting Ready for Battle

Prioritizing my medical care, meeting my team and learning about the technology happened next. My weight loss was accelerating and by the first weeks of May I had lost over 30 pounds and would eventually loose almost 50 pounds. So stopping the weight loss and getting chemotherapy going were priorities.

During April I met my radiation oncologist, who was also a Boise High graduate, and my medical oncologist Dr. Krishna Alluri at MSTI along with his his RN Sharon. I also met Dr. Ciara Huntington, my surgeon, my dietician Valerie. and several members of the MSTI triage team. Over the course of April and May I would have nearly 2 dozen appointments for scans, tests and surgeries.

Dr. Jensen ordered a CT Scan and a PET Scan to determine the extent to which the cancer had progressed in and around the tumor at the junction between the stomach and esophagus – the gastroesophageal or GE junction for short.

Next up was my appointments with MSTI Oncology and Drs. Smith and Alluri followed by power port surgery then an appointment with Dr. Huntington about the plan for my J-tube surgery.

The end result of these surgeries would be better nutrition through the feeding tube and the start of chemo, but they’d also be the beginning of what I have to think of as Dave the science experiment.

My Power Port

The first piece of technology was my chemotherapy power port. This was the most enjoyable surgery of the bunch. My surgery nurse wore camo and the rest of the surgical and anesthesia team were guys rocking out as I went under. The device itself is a very cool technology and my recovery was quick.

Power ports are implantable intravenous connection ports that includes a thin, soft, silicone tube with a small reservoir (the port part) attached to it. My port is a hard lump in my upper right chest area. The tube extends up and over my collar bone into my jugular vein they said. The surgery itself was pretty easy and the recovery time was short. The incision area got pretty red but not infected.

This benefit is extremely important because chemo drugs compromise the immune system of oncology patients. Additionally, it reduces the pain that would otherwise be experienced with countless needle pokes for IVs, and there are so many, since the skin over a port hub becomes thicker and desensitized.

Another consideration is chemotherapy can be toxic and erosive to tissues in the body. By infusing chemotherapy through a strong vein via a power port, the medication has a lower chance of leaking into tissues and causing problems like irritation. 

My J-Tube

Since eating by mouth was very limited, a jejunostomy tube or J-tube was surgically placed. The surgery was hard. It was supposed to be an outpatient procedure. I have dubbed these catch and release surgeries. But this one was a bit more than advertised. I expect it to be like the endoscopy or port implant but I ended up struggling with the anesthesia and CO2 used during laparoscopy.

Laparoscopic surgery is a more surgery than an endoscopy or an implant for sure. Dr. Huntington and her dad, Dr. Huntington, better know as the Drs. Huntington, are excellent at what they do. They spent extra time inside me to take a biopsy and do a “peritoneal wash” to check for the spread of the cancer. None was found than goodness.

A j-tube is a soft, plastic tube placed through the skin of the abdomen into the midsection of the small intestine. Basically a j-tube was used because the viability of my stomach was questionable. I need a tube to deliver food and, if needed, medicine until I was able to eat more by mouth.  It wasn’t clear if the tumor would continue to close off my esophagus or recede as chemo kicked in. My food is an Ensure product that’s loaded with carbohydrates mostly in the form of corn syrup. I was programmed to take in 2400 calories a day feeding around 18 hours a day including while I slept.

Feeding Tube and Charlie

The feeding tube had its own challenges. Not only was I beginning to feel weak and listless, my cat Charlie was in open revolt. Charlie is a bit of a case. She’s a declawed feral cat. I didn’t declaw her but I did take her in as a kitten. She has always been a bit standoffish, but now she was stressed to boot. And a stressed cat does weird things. The feeding regimen involved a machine that would pump food from a bag into my intestine via the J-tube. It isn’t too noisy, but it is loud enough to disturb sleep and bother Charlie.

She started acting up more and more with each surgery to the point she was beginning to act like she didn’t know who I was. Little did I know this would only get worse with time and the onslaught of chemo and her heightened stress level.

Part 4: One Word – Chemo

Now that I’ve been though four cycles that make a complete course of my chemo treatment, I can tell you it is as gruesome as it gets. As I write this it has been 10 weeks since my last chemo treatment. I have a little hair growing back in just in time for my “big surgery”, my appetite has been great and not a hint of nausea. I do have other side effects hanging in around. More here.