Well today was more than a tad interesting. My wife and I went to Medstar Montgomery Hospital today so I could have a mediport inserted for use in receiving my chemo treatment tomorrow. I had opted to have the surgery performed under local anesthesia as it was only supposed to be a 35 minute procedure. “Supposed to be” being the catch phrase. Dr. Field first went into my neck on the right side but couldn’t get the guide wire to thread through the veins in my neck to the main artery. Although I was awake I couldn’t see the images they were looking at but one of the nurses said it (my veins) looked like a clover leaf. So, plan B. Prep left side of neck and upper chest and shift all the equipment to the other side of the surgical table.
Note to self: DO NOT drink a cup of coffee before going in to have a “ahem” 35 minute procedure done.
Numb up the left side and try this again. Since I have what they refer to as a tent draped over my head all I can do is listen to the doctors grumbling comments. Left side is no better than the right side. We’re done. Plan C requires further consultation. They get me out from under wraps and I sit up on the operating table so they can go over the images they’ve been taking. The doctor points out where the artery into the heart, he’s wanting to access, is supposed to be but there is nothing on the x-ray. He then points out all the other veins in my shoulders and chest and says, “Think of it as I-95 being shut down and everyone is having to use the surface streets.” He also pointed out this is why my face is always red and why bending over causes me to get dizzy and feel like my head is blowing up like a balloon. Things just aren’t flowing like they are supposed to.
Further consultation (Plan C) requires going to meet another interventional radiologist back down at Georgetown – can I be there at 2:00? Yup. Run home, get some lunch, take care of the 4 legged beasty, kiss the wife goodbye and I’m off to Georgetown. I met with Dr. Cardella who went over, in great detail, why things failed this morning. Pulling up a recent CT Scan he could show me what the x-ray couldn’t. When Dr. Field had pointed out where the artery was supposed to be for the mediport catheter – the reason I couldn’t see it is because it’s so collapsed that none of the contrast fluid (used to highlight the veins for the x-ray) could go thru it. Looking at the same area with the CT Scan the collapsed section of the superior vena cava “SVC” was quite obvious. To say 95 is shut down is a great analogy.
The solution is to have balloon dilation of the SVC and then have a 90mm stent put in to keep it from collapsing again. He then wants to allow things to heal up for two weeks before he’ll try to insert a mediport again. The two weeks is to allow the stent to better bond with the walls of the artery. I’m slated to have this procedure performed next Tuesday at Georgetown.
In the mean time I still need to get my chemotherapy started. After meeting with Dr. Cardella he sent me over to have a PICC line put in my arm. Since a PICC line is supposed to also thread into the SVC they put in a modified “shortened” PICC that only goes in as far as my shoulder. Oh I was of course awake for this one but the operating room at Georgetown had a monitor that was close to 3′ x 6′ in size so I got to watch as he threaded the guide wire into my arm. Very cool!
Tomorrow I head back to Georgetown first thing to get a chest x-ray and get lab work done. Dr. Pishvaian wants to see if there’s any fluid building up in my lung again and talk to me about everything else that’s transpired. Then I head back to Medstar Montgomery to their infusion clinic to get my chemo. It’s a very nice clinic and being only 15 minutes from my house, it’s much more convenient.
While I could have been very frustrated over today instead I feel very blessed. I had incredibly kind and caring professionals around me all day who went out of their way to make sure I can stay on schedule to receive my treatments. I don’t know what the ethos is like at other hospitals but I’ve been working specifically with doctors who are all part of Medstar Health and I can’t sing praise loud enough for the wonderful way I’ve been taken care of.