Friday, December 6, 2019

12/6/19: Chemo Cycle #10 of 12 + (3.5 Months Post-DMX) Physical Therapy Appointment #9 + Nurse Removed Port Incision Stitches

Warning: This post contains photos of my unhealed port incision.

Today I drove myself to chemo. I think it went fine! I'll plan to drive myself for the last two treatments.

I had a 10:45 appointment to get my port accessed, but the port nurse was running about 30 minutes behind schedule. The Cancer Center was super busy today, even the parking area was full. The port nurse said it's because the flu is going around early this year; patients are supposed to call their oncologist if they get a fever during chemo.

After getting my port acccessed, I was 30 minutes late for my physical therapy appointment. Luckily my physical therapist didn't have another appointment immediately after my original time, so she could still see me without much disruption to her schedule. She purposely scheduled this appointment before my infusion appointment so that we could meet in her exam room, making it easier to take measurements of my range of motion. It was very satisfying to see objective evidence of improvement!

Meeting in her exam room also gave us more privacy for her to look at my DMX incisions. She massaged them to help break down the scar tissue. The area is still numb, and tingly when touched, so it felt weird, but not in a ticklish way. She said I've healed really well; my incisions are nice and smooth, no bumpiness or puckering, which can sometimes happen. (There's a bit of extra skin at the outer end of each incision... They bother me, but I'm working on accepting them.)

I told her I was still feeling a kind of tightness in my right arm. She took a look and said it's cording again. She massaged the area, and it did feel a lot better afterward. She said she'd schedule me for another physical therapy visit next Friday, while I'm in the infusion room, to work on the cording some more.

I got to the infusion room around 12:00. My usual nurse had told me she'd be out, and I had the same substitute nurse I had once before.

I started my pre-meds around 12:15. Started Herceptin just after 12:45, and then Taxol at 1:30.

After the Taxol finished around 2:30, the nurse took out the port incision stitches. It took a while because the nurse said the stitches were really tight, she had a hard time cutting them. I figured that was a good sign that the stitches were done well, but when I finally had a chance to look at the incision at home (no mirror in the infusion bay), I was disappointed. The bottom half, maybe 2/3, looks closed. But a portion at the top is still open.

At this point, maybe a series of photos would be helpful. Here's what the incision looked like over time:

6 weeks after port placement.
Not healing, 2 spots not closed.
Started using antibiotic ointment.

8 weeks after port placement.
Entire incision not closed.
Stopped using antibiotic ointment.

9 weeks after port placement.
Incision closed tightly with stitches.

10 weeks after port placement.
Stitches removed after 9 days.
Inside circle, not closed.
Left of circle, a scab spans opening.
Left of scab, skin is closed.

I guess when I compare the little opening after stitches to the big opening before stitches, it's definitely an improvement. It's just kind of ironic how the two giant DMX incisions healed so smoothly, and this 1-inch incision is having so much trouble.

I wonder if the stitches were taken out too soon. From what I can gather, stitches on the chest area are generally removed in 7-14 days; mine were removed in 9 days, clearly within the range, but on the early side. I did some Googling, and I guess wounds opening up after stitches are removed is not uncommon. It sounds like, if "too much time" has passed, the opening won't be re-stitched, and the person just has to wait patiently for the wound to heal across the gap, which takes a long time (could be months) and results in a more prominent scar. In my case, these stitches are already the re-stitch, so a re-re-stitch seems unlikely. The re-stitch was a solid 2 months after the original surgery, too, so maybe it was already "too late", but they tried.

I was lamenting the potential scar, and my son said, "No, it's good to have battle scars! They prove that you've gone through hardships. You're badass!" (Reminds me of the meme I posted about my DMX incisions.)

I assume I will get another incision in essentially the same spot when my port comes out in about a year. However it heals now, it is what it is. The port removal procedure will leave me with the final scar, and there's still a chance to get a better result then. It's just unfortunate, and annoying, that it's not healing smoothly.

Anyway, circling back, I left around 3:00, so my visit today was over 4 hours, one of the longest. Thankfully, lunch was included.

Oh, there was something new on my blood test results. I had a value very slightly out of range on the high side for Phos (phosphate). As far as I can tell, phosphate is one measure related to kidney function. I guess it's weird that I want to look at my numbers when I don't understand them. But I like to check just in case some numbers go way out of whack. It's reassuring when they are mostly within or very near normal ranges.

12/7/19 Update: Spoke too soon. Woke up this morning to find the bottom part of the incision has opened up. Not as much as the top part, but it's definitely not closed, there's a gap. OH, WELL. 

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