Sunday, August 7, 2016

Graduation Day

Last week, I had a graduation of sorts. I had my chemo port removed. It hasn't been used for anything but blood draws for over two years. So, after being free of cancer for over 3 years, it was time to remove the port. My oncologist kept suggesting it. But, I kept dragging my feet, worried that it would need to be replaced.

About three months ago, I was rounding with residents and medical students. One asked about using a ventriculoatrial (from the ventricle of the brain to the atrium of the heart) shunt in a patient on our service. She had hydrocephalus with a history of shunt infections, so would not be a good candidate for a ventriculoatrial shunt due to the complications of renal failure or sudden death which may occur in the setting of shunt infection. A ventriculopleural (from the ventricle to the space around the lung) handles infection the best. Ventriculoperitoneal (from the ventricle to the abdomen) shunts are the most common type for managing hydrocephalus.

And, as we were walking down the hallway to the clinic discussing the risks, it hit me. I was living with a catheter in contact with my blood stream, like the distal catheter of a ventriculoatrial shunt. And, mine was violated to draw blood and flush it every 2 months, increasing the risk of infection. So, here I was, choosing to live with a catheter that had features in common with something I thought was too risky for my patient.

The next time I saw my oncologist, I told him that it did seem to be time to remove my port since it no longer seemed necessary. He put in the referral. And, this past week, I had the surgery. The pain has been minimal. I just notice when clothing rubs on the newly opened wound, or I move my arm a certain way. But, I feel that it is closing the chapter on this phase of my life.

Cancer will always remain part of my past medical history. I will need to have regular follow ups and imaging studies. But, it doesn't rule my life. Unfortunately, my patient will never be able to eliminate her device. She must live forever with a shunt. But, recently, she, too, had a turn for the best. Her spinal fluid was cleared of infection, a permanent shunt was again placed and she was discharged from the hospital.

So, we both have "graduated" from our recent problems. And, we are able to live more normally again. 

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