Tuesday, June 28, 2011

Head to AF Hospital--again!--just about 8:30 a.m. This time, we're headed for radiology.

Yes, they're expecting me, but the front desk doesn't know about the bone marrow biopsy or have any orders for it. Good thing I asked. We get that straightened out.

Hurry up and wait again. Okay, I ask to have Dale come back with us and he does.

Oh good. You already have an IV. That's great. We're going to access it and give you some sleepy medication. Really? This again? Can I get this dialogue pre-recorded so that I can just press a button and have it all work out? No sedation. Yes, I'm sure.

Here's the pathologist to do the biopsy. He seems way nervous--especially when he realizes I'll be conscious. Sorry to be so intimidating. It goes fairly smoothly. A sharp stab, some warm stinging in my right hip. I'm good. "I'm making a small incision now" as a small trail of warm fluid runs down my body. Yep. Got that.

"Trish, I'm sitting on your bone, about to drill through." Yep. I can feel it. Bone's never get completely numb. Go for it. This part isn't that fun, but it's not that difficult either. Nurse asks how I'm doing, then laughs out loud, "She says she's fine as she quints her eyes close." But I don't yell or move or do anything else, so she takes me at my word.

Then they ask Dale how he's doing. Can't have him passing out in the corner. Are you kidding? He's a former funeral director, I inform them. If embalming bodies didn't bother him, do you really think a little biopsy will?

Okay, large jolt--almost like a strong electric current--runs down my leg. Almost finished and we need only two samples and no aspirations. Great. Done. Some pressure. A band aid. We're done with the first part of the day.

Move to an adjoining room with a large X-ray or CT machine. Transfer to the gurney. How are we ever going to access the top right side of my chest? I volunteer, "Last time they had to use duct tape to secure my chest down. When they removed the port, they kept me partially sitting up. Whatever works for you." Time for more duct tape. They apologize over and over again for having to use so much tape.

Are you sure you don't want any sedation? Yes, I'm positive. Thanks, for asking. Well, we are accessing your IV to give you an antibiotic. Great.

Lots of draping, even over my head, but they cut away a large hole so I don't feel quite so claustrophobic. Radiologist asks for calm music. Phantom of the Opera springs up, followed by Jessica's Theme from Man From Snowy River. Ahhh, perfect.

Brief stab and more lidocaine warming. I have the perfect captive audience, but I forget to ask them why there are two incisions required. One probably hooks to a vein, but I might never find out if I don't remember to ask. Exact same port--a purple, triangular PowerPort--as before.

Decides not to go with his originally intended placement, next to my old one. This one will go out a little from the last one, which should provide better access. Plus, the veins were twisted on the last port, which probably provided some positioning problems. I'm amazed that he can tell all of this from live scans he's taking throughout.

Some pushing and tugging as they clear a pocket for the port to go in. Then, more waiting.

The radiologist isn't intimidated that I'm not asleep and there's some bantering back and forth. I learn about his weekend plans with his family and listen to other fun chitchat.

How many ports do you place a week? "Used to be 3-4, but now it's not that common." What changed? "Well, surgeons realized they could place them so they steal all of the cases they can. However, if there's any kind of risk, like a suspicious history or second port placement, they send them to us radiologists, which is how you ended up here." Interesting.

After about thirty minutes, there's a phone call in the room. Matt, a technician, answers. "Hey, have we ever given sedation for a xxx shot? No? I didn't think so. Maybe we can talk her out of it when it's time." Wait, I harass him, let me get this straight. For the patients who don't want any sedation, you try to talk them into it. For the patients that do want sedation, you try to talk them out of it. I see how you are. Whatever the patient wants, you're not into. It's kind of funny. "No, you're just strange, Trish. Most people beg to be put out for a 45-minute procedure. She's having a 5-minute injection and wants to sleep through it."

Time to access the port, but it's being very stubborn. I count three, four, five attempts. Finally! What was the difficulty, I ask a bit later as I'm being undraped, untaped, and unhooked? Does that mean we're going to have positional problems with this port too? It's just all the swelling and irration from a newly placed port. Oh good. They leave the port accessed so I can go next door and receive more chemo.

I'm dressed and ready to leave less than five minutes later. Oh wait. I've been fasting so that everyone else would be comfortable, and now I'm facing about four hours of chemo? We've got to get something to eat first.

Head downstairs to the cafeteria. It's opening in five minutes for lunch. I'm a little dizzy and tired, so I sit in a chair up a nearby hallway. I'm ravenous as soon as I smell food. My ham and baked potato is almost finished before Dale's hamburger is off the grill and before we've paid for anything. Oh well. I still have grapefruit juice to go.

After we sit down, Matt from Radiology comes in. Hey. Did you talk your next patient out of the sedation? "Actually, I guess we kind of did because she ended up not having the injection."

Finally, we're ready for the third part of the day--more chemo--and head next doors.

Back into the Circle of Trust. There's already two other patients there. It's pretty common to have at least two or three people getting chemo together. I'm not sure what the drug regimen is today. I'll have to find out and detail it later. It's considered the long day of the three. Between three and a half hours and four hours passes with more poisons dripping into my body. This time Dale and I are prepared, and we spend the time playing multiple rounds of Cribbage. Dr. Wendy comes in to watch us play for a while.

Finished! But not quite complete. Now, I'm hooked up to a pump that disappears into a black bag with my name written on tape on the inside of it. Lovely! I'm so excited to take another friend home tonight, and two days in a row also. One of the chemo drugs is so irritating that they diffuse it as much as they can over a 24-hour period to alleviate its caustic side effects. The bag is almost bursting but will gradually shrink. It's not too heavy, but it's going to take some getting used to--especially when it beeps and clicks every two minutes or so to load the next increment of medicine. "Bury it under a pillow at night," the nurse advises.

Finally! I get to leave the hospital and cancer clinic at around 4:30 that day. I'm exhausted!