September 07, 2010

Adriamycin #2

Today's chemo adventure was more complicated than ever before.

It started at 3:30 PM when I arrived at the Swedish Cancer Institute. Dr G had written the orders for yesterday. The Ca Institute doesn't give chemo on holiday Mondays. We knew this a week ago, and had scheduled an appointment for Tuesday. But did anyone suggest Dr G change the date of the orders? No. (Personally, it never occurred to me that orders were dated.)

After waiting for more than an hour and a half, Dr G amended the orders in the online system. I went downstairs to the lab for a blood draw. The nurse could not get blood return from my port. I raised my arm, I coughed, I turned from side to side -- nothing.

She took me back to a spot where I could lie down. Same thing -- cough, raise arm, turn to left side, turn to right side. Nothing. At this point I suggested the nurse remove this needle and try accessing my port a second time. The same nothing happened again.

However, they have a back up plan. A phlebotomist can draw blood from my elbow to test, then I can receive alteplase to remove a suspected fibrin sheath. (The nurse explains this is when a catheter, such as my port-o-cath, becomes encased in a fibrotic sheath, which may harbor bacteria and make it difficult to draw blood from the line). The alteplase is a good thing, since it will clear out my port and Adriamycin can only be given through a port and not through an IV line. However, it takes at least 30 minutes for the alteplase to be effective. The tech is able to get blood on the first poke (and I only allow one).

At 5:30 I go back upstairs to get the alteplase. My friend S and I take a break and I buy us dinner (Japanese-style crepes at Crepan; mine spicy tuna, hard-boiled egg and lettuce, hers mushrooms, basil and cheese). By 6:15 we are back in the Ca Institute.

We wait for the nurse to test the port. Voila! She can get blood return. The nurse gives me the IV Emend, Aloxi and Decadron over 45 minutes. Then she uses the IV push technique to give me the Adriamycin (takes about 10 minutes). I am sucking on ice to prevent mouth sores and talking a mile a minute from the Decadron. We leave the Ca Institute at 7:45 PM. I've been there more than four hours altogether.

I am hopped up on Decadron, would still be talking a mile a minute if I wasn't typing so speedily. I think I will suck on a popsicle to help prevent more mouth sores, put on my jammies, turn on the tube and try to relax. Maybe I will be able to sleep tonight. Maybe.

1 comment:

  1. That is a surprise about orders for chemo...who knew they were dated. The fibrin sheathe stuff is a new concept as well. I often had problems with getting blood from my port. Usually, standing me on my head for a time fixed it, although it was kind of disconcerting. I guess this post can easily be summed up. 'Just when you think you've got it all figured out...' Sounds like a rough day. Glad you're home.