Time to catch up on some cancer news…

Let’s get caught up on the cancer part of this merry little good-news blog. The last little essay was one that I had been asked about and I enjoyed sharing my life philosophy by telling the story that way. Although there were many other negative consequences stories I could have told.

There have been many items I need to update regarding blood clots in my right leg and some serious news on the metastatic cancer situation. And because the last part of this little look-back is potentially the funnest, I’ll tell it first.

Allowing I was an ‘In-Patient’, Room 527, and they had me on a heparin drip, they scheduled a blood clot procedure on June 5th and lung biopsy on the 6th. I’ll delve into the blood clot procedure when I am in a much darker mood as it was the most painful and frightening experience I think I have ever survived. The outcome of the lung biopsy had a more mixed ending, meaning that it was difficult, very painful, anger inducing, and, in the end, funny.

From early in our evaluation and treatment with the great professionals at Johns Hopkins Kimmel Cancer Center, we’ve known the large sarcoma tumor growing on the outside of my bladder had metastasized, or spread to other organs. A CT scan of the lungs found a nodule in the bottom of both lower lobes. A high definition MRI of the brain showed there was no spread there, and the liver proved clear as well. Dr. B was confident that this was a sign the cancer was in my bloodstream, and if that were the case, my prognosis was grim. It is near impossible to go chasing cancer cells that are having a loaded bicycle tour(Northern Tier, Southern Tier, Pacific Coast, Atlantic Coast & last but not least, Trans-Am!)  throughout your entire body. So, a biopsy of the 2 lung spots was ordered. They do this by putting you on the table on your belly, punching a hole in your back, shoving a flexible metal catheter, guided by a live feed CT scanner, they fish around in your body until they hit paydirt, then they punch, punch, punch, until they have a large pile of tissue to look at WITHOUT a damn microscope. The department that performs these type of image guided procedures is called Interventional Radiology (IR), and with the limited number of cases they might do in a given day, there are not enough, perhaps, to warrant a PACU (Post-Anesthesia Care Unit). Back in the day, this was always listed as ‘recovery room’. I have been in the PACU, as a sales rep, of just about every hospital in a five state region of the southeastern United States and the care by these professionals has always been exemplary. I’ve been a patient in PACU’s in the past as well, however I may never be allowed into a PACU ever again. In my particular case, they punch a hole in your back, through the back chest wall, creating, essentially a pneumothorax. Or in other terms, a loss of the vacuum surrounding the lung sacs (lobes). Then, after they are in the lung lobe targeted, they rip out tissue samples of the cancer nodules, creating bleeding. Since I was on a heparin drip they can turn that off 6 hours pre-procedure and the blood thinning and bleeding is more easily controlled. So…

While they did numb the area where the catheter, entered with lidocaine, once they got deeper there was no additional lidocaine administered. The great nurse that has cared for me in all the IR procedures kept chatting with me while administering Fentanyl for pain, well, it may be addictive and deadly, but for a straight up pain killer, it SUCKS! She also would suction up the large foamy blood luggies that kept finding their way into the back of my mouth. I would spit them out on to the sheet covering a foam pad that was all of 2” thick, she would swoop in with the Yankauer (Thanks Sidney!)  Tip and it disappears from my line of sight, although I would have liked to look at, poke at & play with those big red piles of goo. (Is Tommy Otey my son or WHAT?)

They got 8 tumor tissue samples, much more than they needed, slapped on a bandaid and wheeled me upstairs on a Transport Stretcher to the Outpatient & Endoscopy PACU. Rachel, (my angel) told me they would watch me for 2 hours, looking for evidence of pneumothorax, coughing up blood was normal and I did hock up some huge bloody luggies. Wayne & Garth were in awe. She was going off shift and I had been properly handed off to the PACU. The problem was the patient platform upon which I rested. Working for Hill-Rom for 10 years, I know a Transport Stretcher is used to move a patient from point A to point B and transfer them to another surface (bed, procedure stretcher, electric stretcher. They were NEVER DESIGNED TO KEEP A PATIENT ON FOR HOURS, AD INFINITUM! Granted, I’m obese, 63 years old, so I contributed some to the situation. The main thing that needed to happen before I left the PACU was that I needed to have a chest x-ray to make sure there was no pneumothorax, and no additional bleeding from the sample site. They do this with a portable digital x-ray machine that runs about $850K, the digital image plates for those things run about $250-300K. I had seen the rad-tech wheeling his machine around the PACU when I first go there, so I knew he was close. After 1.5 hours my PACU nurse calls the radiology dispatch, no return call, at 2.0 hours another call, again no answer, no return call. At 2.5 hours, they answer and inform him, due to staffing issues (On a Wednesday!!) it will be another hour before they can get to me. I ask my nurse to close the curtain of the cubicle I’m in.

Slipping off the pulse oximeter probe I reach up and switch off the Philips Intellivue MP5 monitor, sit still, & listen, no central monitoring alarms go off. I peel the ECG electrode pads from my wooly abdomen, but now that I am into the break-out, I make no noise. The small saline IV bag I am still connected to is empty, I unhook it from the IV pole and wrap the bag & tubing around my neck. Taking the sheet from the HARD AS A FUCKING ROCK transport stretcher, I wrap it over my shoulders and drop down from the stretcher to the floor. (Sidebar: as a FALL RISK, they had that stretcher jacked up pretty high)

Quietly I slip through the cubicle curtain and walk for what I think is the exit door. Now I have their attention. My PACU nurse, Jeremiah or Jeremy, hurries to my side and gently pulls my shoulder. “Sir, you can’t be up like this!, you have to get back on the bed!” I refrain from detailing for him the difference between a bed and that damn plank he had me lying on. I walk on, through the doors that say exit but immediately realize this is a fire egress door, not connected to any other departments or main corridors. So, I let him turn me around, we walk back into the PACU, he peels off to the nurse’s station to call Radiology again. Continuing back towards the cubicle where the Steve McQueen Great Escape began, I walk right past it, through the main doors to the OP Surgery area. Seeing a set of doors on the opposite side of that room that look promising, I head towards them. A woman that I am sure has been the PACU Head Nurse for >20years comes out of her office and we almost collide. “Sir, (they’re so polite) you can’t be here, where are you going?” Finally, a question I can answer, “I’m going to my room, number 527, if they need to take an x-ray, I’ll be there.” She replies, “But sir you can’t just walk out of here, I need to call security…” She says a lot more but I have stopped listening because I have just calculated that the doors I just hit are like the fence Steve knew he could jump on the motorcycle he’s just stolen. Over my shoulder I throw her my last comment, “If security needs to speak with me, I’m in Room 527.” Mr. McQueen never told his captors where he was headed, and unlike my hero, Mr. McQueen, I know I am going to clear this fence with a great deal to spare. Through 2 more sets of doors, I find myself in the main atrium next to the Starbucks Kiosk, (which needs to be pointed out…doesn’t open until 7:30

AM ARE YOU KIDDING, HAVE YOU NO SELF RESPECT!!) I’m turning left, I know where I am! I walk across the main atrium to Elevator Group B, take the next one up to the 5th floor, walk down the hallway to my room. My sweet daughter Leigh is waiting for her favorite Daddy’s return, she tries to include me on the FaceTime call she is on with her hubby, but they both soon realize it not a ‘shareable’ moment. They hang up. My nurse Della, from Jamaica, she’s the greatest. Comes in to ask why the Transport Dept didn’t bring me back. “they were short staffed”, I told her.

30 minutes later, the x-ray guys shows up, quietly and efficiently shoots one image, sends it to the radiologist on their wireless PACS, one hour after that, my discharge orders have been written, my sweet daughter gets to take me home, and listen to me regale her with my big prison break story. I was a good bit angrier when she heard it, and she makes clear that if Mom is going to hear ANY of this story, I will have to tell it, the intuition of children stands up again, and makes the correct call about getting in the middle of something she knows Mom will be pissed about…

In summation, the tissue samples harvested from my lungs are the same cancer that they harvested from the large sarcoma in my abdomen’s midline. So that is the best news out of the shit I am swimming in.