Big Day Tomorrow

The last song that I sang at Tula’s, for my winter voice class “final”, was a luscious, slow piece called “Small Day Tomorrow.” It’s about not having to go to work the next day, about being able to spend some time with a lover—just slowly and quietly, maybe get out of town for the day, relax and let the hours flow as they will. No worry, no rush—not have anything to do. I love the song, and I plan to add it to my repertoire (when I have one, sometime in the future).

Tomorrow, however, is not a small day. Tomorrow starts tonight, when I have my first Hibiclens shower to make sure my torso is spic-and-span and aseptic (using a clean towel to dry, and wearing a clean t-shirt to bed), then continues tomorrow morning about 6am when I take my second Hibiclens shower, and use my second clean towel, to make extra extra sure my torso is spic-and-span and aseptic. Of course, I have issues with all the water used to clean all these towels, so I’m planning to replace both our towels tonight and use Ian’s (before he gets his hands on it) before bed, then use mine in the morning. His should be dry by then.

I have to stop eating at midnight—not usually a problem—and I have to be at the UW hospital at either 7am or 9am or sometime else early. I think I’m going to go with 7am, because that’s what I’ve heard most. I then get prepped for my minor surgery (local anesthetic, Valium-type drug so I don’t care that they’re cutting me up), and probably get my port placed around 9am.

They access my port as part of the placement procedure, to take an X-ray and make sure that the tube is correctly seated, going up to the artery in my neck and down toward my heart. The reason for the port is at least two-fold—not only will I not get stuck in the arm once a week, but the chemotherapy drugs are so toxic that the small veins in the arm are just too little and will be burned by the poisons. Also, several years ago I had a surgery that removed 11 lymph nodes from under my right arm—before I even knew what lymph nodes were—and I can no longer have any blood draws or blood pressure tests on my right arm due to fear of lymphedema (a swelling from which I have never suffered).

Anyway, the main entry of the port—the “port” part of the full name, “port-o-cath”, will be implanted in my left chest, slightly above my left breast, in a little pocket made in the flesh. I’m hoping to have it in pretty much the same place as before, because 5 years of accessing it (thick, bent needle) killed off the nerves at the access point and I didn’t actually feel the entry anymore. There are some creams you can put on to numb the area . . . but that just got tedious. Then, moving up my chest from the port, there will be a thin, flexible tube. This tube will be just under the skin until my collar bone, then it will go under the collar bone and into an artery there at the neck. From what I understand, it goes slightly up into the artery, then the artery branches and the tube will be redirected to come back down toward my heart, where it will sit, quietly minding its own business, maybe an inch above the pumping and gushing. The artery is evidently about 1 inch in diameter there—much, much larger than the veins in the arm—and large enough to keep from being damaged by the beneficial toxins.

Then my port access will stay . . . and I will go and have some lunch . . . and then I’m due back at the SCCA at 1pm for my first chemo treatment.

This is a bigger deal than it was in the past, because of the amount of disease in my body, so a couple things have been added. First of all, I’ll be taking a pill to help my kidneys release toxins, which I will begin tomorrow morning. Then I’ll have my typical weekly infusion—Taxol, Navelbine, Herceptin, ovarian blockers, and another kidney support, and all the premeds so I don’t have a reaction to any of those things, then I’ll have several hours (3? 4?) of simple hydration—again to help my kidneys clear out the crap in my lungs. Cancer cells, when they die, are not good on the health of the body, and since I have a lot of them, Dr Specht is expecting a lot to die off pretty much immediately. This is actually really good news—I will probably be back to walking to the Essential Baking Company myself soon with all my added lung capacity—maybe even before my hair falls out—but the weekend could be rough. I’m a little worried about how sick I’ll feel, because I know (from the scans) that I’m much sicker now than I’ve even been before. But then, the huge network of friends and family and strangers who are supporting me through this, and all the people I’ve seen who’ve kept the rest of me so healthy for so long, are really doing amazing things to get me through, and so . . . on the other hand I’m not worried at all.

But tomorrow is a big day.