Skip to main content

IP chemo hits a bump in the road, lump in the belly

I'm sitting beside Amanda at the Victoria General Hospital. We're on the 11th floor. It's the chemo floor. She's reclining in a padded green armchair that looks like it's designed for people to sit in all day as they're hooked up to intravenous pumps. That's exactly what people in this big room do.

I count eleven of these chairs, plus one bed. There's a separate room at the end of this ward, behind a sliding glass door and a curtain. That room has a bed. She jokingly calls it the "VIP" room. It's for people who get intraperitoneal chemotherapy (IP). That's where we're supposed to be today.

IP chemotherapy delivers the cancer-killing chemicals right into the abdominal cavity via an implanted port and catheter. It bathes any remaining tumours or floating cancer cells in deadly fluids, rather than waiting for intravenous chemo to reach the bad guys through the bloodstream. Once she's filled up like an old waterbed, she's turned this way and that to get the killing juice into all the nooks and crannies.

Actual intraperitoneal chemotherapy port.
Not an iPhone charger - this is an implanted IP port.
Okay, it's not the size of a hockey puck, but when it's
INSIDE YOU, probably feels like it.
Study after study has been showing that each round of IP chemo can extend the life expectancy of a woman being treated for ovarian cancer. Amanda has been encouraged because she's been scheduled to be given the latest and greated IP chemo combos at aggressive doses.

But today, she's in that green chair with an IV in her knuckle (yuck! ouch! gross!), being given drugs that sound like wizards or TransFormers -- Zofran/Odansatron, Decadron. Later her veins will receive carboplatin and paclitaxel. That's not what she was expecting. She was devastated Friday to hear that she would be getting the IV, not the IP.

We were here a few weeks ago in that private room at the end of the ward as the nurses tried to poke a needle through her body, on the right side near her last ribs, into a self-sealing silicone membrane, and into a reservoir that should drain into her guts. They numbed her skin a little and pushed the needle in. They opened up a gravity feed of saline and it looked like things were going well.

Amanda told them it hurt. It burned. Something felt wrong. They said it was just the saline going in. But it kept feeling worse. The skin around the jab site started to puff up. They realized the needle hadn't made its way into the port, and the fluid was being poured right into her flesh. Docs said it was going into the interstitial space. As much as I've been obsessing over looking up every little part of this, I've not investigated that aspect. I'll just take her word for it that it was bad and hurt.

After the first mis-aimed flooding, they tried again to reach the port but came up short. Abandon ship. Day one of IP chemo was aborted and we were rescheduled for another shot the next day.

This time they brought in the surgeon who placed the port weeks earlier. She tried. No dice. Tried again. Nope. Another stab. Fail.

Imagine having a hockey puck buried a few inches deep in your belly, sewn to one of your ribs, and someone's grabbing and twisting it, trying to lance it with a long needle shaped like an Allen wrench from Ikea.

They did it again. Oops, no.

One final attempt to get the needle in the port with the guidance of an ultrasound machine was successful. From that point, I'm told it was fairly smooth. A bunch of saline, a bag of chemo, more saline. The equivalent of a whole big bottle of pop, right in her gut-bag. She came home distended and misshapen, but glad to be full of this cytotoxic cocktail.

She went back one week later for more IP, and it all seemed to go perfectly. They got the needle in with the help of a Doppler ultrasound, then filled her up, swished her around and sent her home. Things were looking good.

But in the past few weeks, there's been some kind of complication. It's a hard, swollen, very painful area somewhere near her port site. I wasn't at the appointment on Friday when the doctor told Amanda that she'd have to stop the IP treatments for now. She was devastated and was not able to interrogate the doctor to get a full understanding of what's going on. She heard enough to understand that the chemo is doing something bad to her good flesh, and that the worst scenario would lead to a surgeon going in and cutting out dead 'good' tissue, skin grafts, and an end to chemotherapy entirely -- bad bad bad.

Your first look at Amanda in Chemo Mode sans headscarf, with baby Gordon in Adorable Mode.
But if everything goes smoothly from this point on and the problem, whatever it is, corrects itself, she might, maybe, get one extra round of IP chemo. We'll see.

For now, we're hunkered down on the chemo floor for another of these all-day IV pumping sessions. The nurses are nice. It's one of the only air-conditioned places in this big, old hospital. I get to have pizza for lunch in the cafeteria. But as pleasant as they try to make all this, we'd both rather be at home right now playing with our baby.


  1. Thanks for your good post;We are giving qualified united states based service that is Zofran;We are providing treatment zofran attorney


Post a Comment

Popular posts from this blog

Gordon turns four and has questions

Gordon wanted to know where mommy went.

Not what happened to her body, but where SHE went.

We celebrated his fourth birthday this weekend with three gatherings. One at our house with his little friends. One at nana and grampa's house. One in Stratford with the Simpson clan.

The big party for the kids was a success. I'd never planned such an event. Thank goodness for the Internet, where I found a Martha Stewart article that laid out the basics. And thank goodness for Party City, which had a ton of Transformers party stuff ready to buy. I wasn't feeling well, but managed to pull it off. Thanks to sister Shannon and SIL Amy for being the Designated Adults who helped in wrangling and last-minute logistics. G thought the whole event was kind of loud, but he really enjoyed it. And I feel like a winner for making it happen -- some of the other parents even chimed in that they now know what goes into a kid's party, since they were as clueless as me! Great!

Great time at nana&#…

Things get much worse as tumours spread fast

Things crawl in the darkness
That imagination spins
Needles at your nerve ends
Crawl like spiders on your skin

Pounding in your temples
And a surge of adrenaline
Every muscle tense —
To fence
The enemy within - Rush, "The Enemy Within"
We don't know how or why, if there is a how or a why, but Amanda's cancer has woken up and is on the move, double-time. Things have become much worse in the time since the last update.

At that point, the docs had found a couple of spots on her ribs that were causing her pain. They zapped it with radiation to give her some relief.

Since then, things have progressed quickly.

Just after the hospital stay when they were trying to get Amanda's pain under control, docs found more bone metastases in her sacrum (large, triangular bone at the base of the spine) and iliac crest (the big wing-like bone on the pelvis where they harvest bone marrow). More radiation. This time, the radiation hasn't knocked the pain down.
Then she had headac…

The sweet smell of success (the opposite of that)

Let me lock in the system at warp 2 Push it into systematic overdrive - U know what 2 do - Ween, "Poop Ship Destroyer"
Pardon the juvenile humour off the top, but this journey has been so unreal that I can't help but fall back on laughing in the absence of appropriate things to say.

Amanda's headed for another big surgery this week.

Quick recap of how we got here: She went into hospital in late January to have her ovarian cancer tumours taken out. That surgery ended up taking a foot-long chunk of her colon, so they spliced what was left to her nature-given outlet. Well, that blew apart and she went for emergency colostomy surgery. THAT didn't work, either, as illustrated by our guiding light with the scalpel hand and the silver tongue, Dr. Sugimoto:

The business end of the remaining colon sloughed its way back into her insides and strictured itself off, creating a cul-de-sac with no escape for poop nor gas. They put her on TPN (full nutrition by IV) but let her …