Sent: October 15, 2013 8:19 AM
Subject: Quick Update: Tx#2
Treatment #2 was yesterday, and rather gory but you'll have to wait for details, b/c my hands are shaky today. Hopefully that will lessen over the course of the week.
Taking anti-nausea meds BEFORE I need them this time. It goes against my nature, so it's hard to remember to do it. I have a schedule written down, so that should help.
Planning a lot of rest today. Hope it works out that way ;)
Will update more later in the week.
Thank you for your prayers!
Five days after sending that message, I tried to show my friends and family what it was like for me in the clinic during the next chemo treatment:
Greetings!The treatment room was full on Monday. It is a large room, maybe 20-ft x 16-ft, with square stone tile on the floor, and windows on the two exterior walls. It is home to eight large, overstuffed leather recliners arranged around three sides of the room. Small folding tables placed between each chair provide a convenient place for nurses to set bandages, needles, meds, and all manner of equipment. Beside each chair is an I.V. pole with an attached infusion pump. The room opens onto a deep lab area where patients can watch as the pharmacy techs and the nurses go about their work.
When a patient brings a companion to the clinic, as I always did, the companion may use the recliner next to the patient, when one is available. Chemo infusions last several hours, so having a comfortable chair makes the long sessions more bearable. On Monday, there was only one empty recliner. I was patient number eight that morning. Most of the companions present, Patrick included, were relegated to low, backless stools placed behind the row of recliners and tables, next to the wall. Another companion, a young lady in her late-teens or early twenties, shared her mother's recliner, snuggling tight against her mother's side.
I sat in the one remaining available seat, which was halfway around the room, directly opposite the "cocktail bar" where the pharmacy tech stood bedecked in safety goggles, elbow-length purple nitrile gloves, and a disposable blue tie-back protective gown, eagerly awaiting the first chemo order to mix. He'd be busy that day, and he looked like he was up to the task.
One of the many things I never knew until I became a cancer patient myself is that "chemotherapy" is a generic term. The mix I would receive for my treatment would almost certainly be different than the one the patient in the next chair over received. Some meds were dosed based on the patient's surface area (I do wonder how they came up with that idea). Some were based on weight.
Not only were dosages different, but the meds used were different, depending on the type of cancer being treated. Not every chemo patient loses their hair, for example, because not every chemo patient receives, say irinotecan in their chemo "cocktail". To complicate matters even further, sometimes dosages are adjusted from treatment-to-treatment due to unacceptable levels of toxicity.
I didn't know it at the time this blast-o-gram was written, but my own "recipe" would be adjusted starting at treatment number three, due to my liver no longer tolerating (as evidenced by lab results) the amount of oxaliplatin in my mix.
Several nurses went about their routines, each assigned to multiple patients. They drew blood, hung meds, and offered blankets. The oncologist wove in and out among the staff, patients, and companions, ever-vigilant, checking charts and meds, answering questions, giving instructions, and ensuring that the day got off to a smooth start.
My nurse wheeled a many-drawered supply cart toward me noisily over the bumpy tile-and-grout floor. "You ready?" she smiled. I assured her that I was. But. I lied. I wasn't ready for what was ahead. She grabbed gloves, and selected a harpoon from one of the drawers to stab me with. She peeled away the sterile wrapping, then spied the spot where the medi-port waited.
The nurse carefully inspected the site, swabbed an antiseptic-soaked wipe across it, then jabbed the gigantic needle through my skin and into the port. Next, she used a saline-filled syringe to flush the port, and then tried to draw blood. No blood. "Hmmmm..." she said, "let's try that again." "Again?!" I thought. Thwack! out popped the harpoon from my chest, and she reached for another one from the supply cart. "Sorry," she whispered. She sprayed the spot with a smelly, non-effective numbing agent. She asked me to turn my head as far to the right as I could, and then to "take a deep breath". Doing this made me an unknowing participant in my own torture! As my lungs expanded, the harpoon dug in, pushing painfully against the back of the port. I screamed silently and clutched my thigh. Ow! Ow! Ow! Again the syringe. Again it pulled nothing.
"Oh no...," I thought. I couldn't look. Of course I couldn't look! My eyes squeezed shut.
Thwack! The nurse pulled out the second harpoon. Now my mind raced, "She's not going to do it AGAIN?!?" Yes. She was going to do it again. "Third time's the charm?" I croaked, hoping that if this attempt didn't work, I would pass out. I imagined myself sliding from the recliner to the cold, hard floor, unconscious. "She could try as many harpoons as she wanted then," I thought.
She unwrapped the third harpoon, and I was suddenly keenly aware of the other people in the room. They were all staring at us even though I swear the screaming was only in my head. Even the pharmacy guy was standing still, watching. Was three attempts unusual? I wouldn't know. "So, so sorry," the nurse whispered as she sprayed the aerosol again, then confidently came at me with the third harpoon. This time, it felt like she was trying to attach me to the chair with a nail gun. I clenched my fists, and my jaws, and guess what? Still no blood in the syringe.
Me: What am I, a zombie? Why is there no blood?
Nurse: Sometimes they're just stubborn. I'm sure you're not a zombie.
Me: Three tries is too many tries. Got any vodka? (Ha! No, I didn't mention booze...I wasn't nearly coherent enough to ask for anything useful at that point.)
The nurse was able to push fluids through the port (not that I was looking!), and so hung the meds as usual. She then drew blood the conventional way, using a needle in my arm. ("See? Not a zombie," she smiled, holding up the vial of blood.) She walked across the room and into the lab-slash-cocktail bar, while I attempted some deep "cleansing" breaths and tried hard to forget what just transpired.
That experience gave me nightmares, as in: more than one actual nightmare.
Note: If you are facing an infusion for the first time, don't worry! It almost never happens this way.
Part 2 to follow.