Time for a Paracentesis...catheter to the belly!

I first want to say thanks to those of you who have donated to my cause.  Any little amount helps me out with my co-pays and medical expenses.  From the bottom of my heart, I truly thank you.

After my eventful week of a trip to the ER and having to visit Kaiser on Tuesday and Thursday for IV fluids and IV anti-nausea, I decided to also get a paracentesis done Thursday afternoon.  Paracentesis is very similar to the thoracentesis I have had to my pleural cavity except this is for my belly.  I have been able to manage the fluid build up in my belly by using Lasix but I was just so exhausted and afraid of taking any pills by mouth that I just gave in.  I was very afraid to have this done because I thought that they were going to pick the fattest part of my tummy and shove a catheter through it.  This is not the case at all.  I had asked my oncologist about how the procedure is performed at my last visit with her on July 31st and she told me that they usually go in on either the right or left lower quadrant of the belly.  I can usually tell when I have a lot of fluid build up by monitoring my weight. It's amazing how fast the belly fluid collects.  It was making me feel like I was walking around with a pregnant belly.  When I lay on my back, it also makes it hard for me to breathe.  And lastly, my clothes don't fit right.  Makes me feel like I should be shopping the maternity section.

My Thursday started at Kaiser at 10:45am when I had to go in for more fluids.  I had been throwing up the day before and so I had called just before closing to speak with nurse Jennifer about setting me up for fluids since I knew I was very dehydrated. It's nice that when I walk into the oncology department, the receptionists know my name and are already to register me in.  Nurse Elsie called me to the back and I asked her if I could hop on the scale real quick to see how my belly fluid was doing.  It was amazing that I was weighing more than I usually do when I had not eaten anything since Sunday.  Elsie led me to the back of the infusion center where there is a private room with two chairs.  Luckily, I was the only one in there.  I asked Elsie if I could speak with my oncologist, Dr. R, so I can let her know how I was doing.  Moments later she appeared.  I told her about how I was having major bouts of nausea, vomiting, and diarrhea.  The pain seemed to be control by the fentanyl patches but I was having more frequent break through pain.  She suggested that I take Decadron, which is a steroid I normally take during chemo only, for my nausea in addition to my Zofran or Compazine.  She told me it was ok to add one more fentanyl patch, and to make sure I was dating them so I wouldn't confuse them and would know exactly when to change them.  If I was still having break through pain, I could resort to taking the Dilaudid pills or liquid morphine.  I prefer Dilaudid because it's stronger and the liquid morphine tastes yucky.  Fortunately, when I have break through pain, which is about twice a day, it goes away within 15 minutes with the Dilaudid.  My pain is now managed very well.

Another round of fluids. Feeling like mush.

Elsie hooks my midline up to the IV and starts me on fluids and IV Zofran.  Because my potassium level is low, she double checks with Dr. R about giving me potassium through my IV.   Potassium infusion will take a few hours and I don't mind so they go ahead and give it to me.  It beats taking those darn horse pills that I was prescribed.  My sister decides to go do a bit of shopping and grab a bite to eat so I try to take a nap in the chair.  It's kinda noisy because I'm near the nurses station and they are discussing what they are going to have for lunch and who's going to go get it.  I don't mind though because I do enough sleeping as is and I adore the chemo nurses.  Dr. R had felt my belly earlier and said that while it felt soft, I could have a paracentesis if I was feeling uncomfortable.  I told her I was ready for it and she spoke to nurse Jennifer about having nurse practitioner Kelly do it for me.  I love Kelly.  She backs up my oncologist when she's not there and is a great woman.  By 2:30pm, I am all done with my fluids and since Jennifer is out at lunch, I'm not sure what time to come back for my paracentesis.  I tell Elsie that I'll be in the area and just have Jennifer call me.  My sister and I head on over to Costco to pick up my glasses.  We then decide to stop by Starbucks for a quick drink but Jennifer calls and asks me to head on over to radiology now for an ultrasound so that they can mark my belly with the site to where the catheter will go in.  Afterwards I am to head back to the oncology center.

My new, cool glasses!

My sister does a quick U-turn and we valeted the car.  I grab a wheelchair and have my sister push me to radiology.  I'm feeling exhausted.  We arrive at radiology, register and very quickly I'm called back.  The tech takes me into a dark lit room and I expose my belly.  She applies jelly on it and does her thing.  I'm watching the monitor and she tells me about how the dark spots are all fluid.  She finds two sites on my belly but goes ahead and calls a doctor back to double check her work.  They use a marker to draw two X's, one on my left side and one on my right.  I'm then let go and my sister wheels me on over to oncology.  I register and medical assistant Maria calls me on to the back procedure room.  She takes my vitals and has me sign a waiver acknowledging the procedure and risks.  I have my sister with me because I know I'll need to squeeze her hand once the needle goes in.  NP Kelly comes in and she starts getting ready.  She tells me about the risks but she's been doing these for 15 years so I know I'm in good hands. I show her the X's on my belly and she chooses the right side and has me lay down on the gurney.  She asks me if I want some Ativan and of course I do!  Nurse Elsie brings me some in and I stick them under my tongue, letting them dissolve.  I close my eyes to relax and my sister talks with Kelly, which is distracting me for the events about to happen.

At ultrasound marking the catheter site.

Medical Assistant taking my vitals

The set up!

Kelly is all set up, ready to go, and I am too.  She injects me with Lidocaine and the needle hurts.  Lidocaine stings.  I squeeze my sister's hand tightly.  Next, she takes a longer, thinner needle and injects me some more with Lidocaine.  I do some more hand torturing to my sister.  Somewhere along the line, she removes the needle and now I have this catheter in me.  Kelly hooks it up to the vacuum sealed jars waiting on the floor.  I'm fine now.  No pain.  No shock-like feeling like the thoracentesis made me feel before.  I'm ok.  I lay there relaxing and we just wait for the jars to fill up.  We all continue talking and soon I'm on the 3rd container.  I am amazed that I have that much belly fluid in me.  When I had my pleural cavity drained, that only filled about one and a third containers.  Obviously my belly is a much bigger cavity.  I can feel my belly slowly deflating and I take a peak down to where the catheter is sticking out of my body.  I don't freak out.  I look at my belly and I notice my pelvic tumor staring at me.  I give it a feel and I know it has grown.  It is definitely at least the size of a cantaloupe.  I fill up the 3 jars and a tiny bit of a fourth and Kelly tells me that we're going to stop.  I'm anxious as she pulls out the catheter but it doesn't hurt.  I made it! I survived!  There's no need to do cytology on the fluid since it's the same stuff as what was collected from my lung.  I just stare at the jars in amazement.  Paracenthesis isn't so bad.  It's actually quite easy and Kelly says I can have it done as often as I need to and like.  Before, it would take me a few days to pee all this fluid out.  Might have to rethink that now.  Kelly applies a glue to the catheter site to prevent any leaking and bandages me up.  I'm ready to go home.  I hop on the scale on the way out and see that I've lost 8 lbs, putting me back to my normal weight. Hooray!

Before: my water baby!

X marks the spot.

During.  Calm as a cucumber!

That is what came out of my belly! 3300 cc's!

By evening time, I'm feeling good.  I think it's a combination of the IV fluids and the draining of my belly.  I try to eat solids and I'm successful.  I don't vomit.  Huge victory for me.  The next morning, I'm feeling great.  There is no more nausea, vomiting, or pain.  I feel like having a solo dance party.  I can't believe how amazing I feel.  I'm so thankful for Dr. R, Kelly, and the nurses for helping me survive chemo #8.  My faith is restored that there is hope for me.  It was a horrible roller coaster ride, but I made it.  I take it easy that day as I do not want to overwhelm myself and have to put my Washington trip on hold.  I am to fly out on Tuesday and come back the following Sunday.  I lay low indoors.  At this rate, I will make my flight!  I also have my PET scan to look forward to when I return, on August 20th.  I am hoping and praying that my cancer is at the very least stable.  Better news would be that it is shrinking.  I know that sometimes it feels like chemo is about to very damn well kill me but I have to say that it is worth it.  I may have puked my guts out and felt the most excruciating pain I have ever felt, but I'm a warrior and that's part of the job.  A big hug and thank you to my sister for helping me through this roller coaster week. I know it wasn't easy watching me go through that but having her there for me really made it more manageable. I'm slowly letting her in more on my care as I realize that I can't do this by myself.  It's hard feeling like I'm losing my independence but I know that having someone else manage my care sure makes this journey a whole lot easier.

After: feeling deflated and good.

Although I am feeling good right now, I can't help but to think about the things that I won't get to do.  It seems like about every 4 weeks, my pleural cavity is filling up with fluid, causing me to be short of breath.  This means that I have to start pulling out my wheelchair whether I like it or not.  I think about the Cabo trip that I wanted to take with my sister's and how it probably won't happen just because my health is not that great.  I want to go to Disneyland so bad but I'm afraid to travel down there and wait in long lines.  I'll need my wheelchair to get me through that for sure.  But instead of focusing on the things that I feel like I'm being robbed of, I try to think of the things that I do have and what's really important.  I have my family and I have my fur babies.  I have my friends.  Really great friends.  Even if it's just a fashion show that I'm putting on for Molly and Dash, I try to make the most of my moments. I'm hoping and praying with all my heart that we find a cure.  Not just for my cancer, but for all cancers.  I won't lose that hope.  Not that easily.

Fashion show with Dash, who loved my dress.

Precious moments, playing hide n seek with the cats.