First Night

With cancer, many people are prone to believe that the cure may be worse than the disease. With Hodgkin’s, though, that’s hardly the case. Given that even the most advanced forms of the disease have a very high cure rate (my doctor told me that some patients take up to a year to be properly diagnosed), it seems like a rather agonizing and perhaps even awakward way to pass given the option of life-prolonging treatment. Still, the drugs needed to whip this thing entirely aren’t exactly a delightful cocktail, and the days of testing can make things all the more trying.

The day started off with a knock at my door at about 7:30. My parents told me they would call me at the top of Afton Mountain, but they decided to “let me sleep.” This was rather inconsequential, though, as I really didn’t sleep all that much. I’ve decided last night was my last go with the vicodin. One, I don’t really need it, and two, for some bizarre reason the stuff just kept me tweaked. I wasn’t able to sleep until 3 a.m. And you know what was distracting me? VH-1’s biopic of MC Hammer. That alone sounds like the perfect sedative, but no.

Anyways, I slowly got around and at about 8:30 we arrived at the hospital (again, I’m reveling in the fact that I live a mere six blocks from the hospital. If it weren’t for the treatment’s effects, I’d walk.) When I arrived all I knew was that I had a “heart scan” scheduled. In my conversation with the receptionist she told me I was to undergo a stress test (which despite the fact that this would require me jogging was still preferable to being scanned ad nauseum). However, when the tech took me back I was told that I’d get to revisit my old friends, the radioactive isotopes, for a photo shoot of my heart.

So far I haven’t had a very hard time getting over my aversion to needles. I simply came to accept it as a fact of how to get better. Today might have changed all that. First off, the tech had quite a time getting my IV in. He said the veins kept moving away in my hand. He then put an IV in my left elbow. This may seem rather innocuous, but it becomes a key part of the story later. Take notes; there might be a quiz.

Anyways, the heart scan went without incident. They did it in a rather dilapidated part of the hospital that is being transferred from radiology to another department. For some reason, though, there’s still a few cameras there. So after laying still for around twenty-eight minutes I got to see the results of my scans. I have absolutely no medical imaging training, and I even opted out of college biology. Still, it was pretty awesome seeing my heart beat, and, though perhaps overwhelmed by man’s medical progress over the last century, everything looked ok. You know, thump thump thump.

So after that we took a brief detour to the hospital cafeteria, where I had a bag of pretzels and a caffeine boost. We also discovered a fun fact; for a major hospital, the University of Virginia Medical Center has an alarming lack of bathrooms. Perhaps they abound on the upper floors, but in the lobby they are far and few between. In addition, the ones they do have are woefully small; we’re talking one toilet and one urinal. Certainly this is little more than an amusing side-note, but at the time it was an issue of major dispute.

At about 10:45 we headed to the Cancer Center for my appointment. When we arrived, however, we ran into an immediate backlog. I had been told that my bloodwork would start at 11; I didn’t get into the back until 11:45. And that was the beginning of the vein fiasco.

I was almost immediately informed that the IV that had been put in for the imaging was not going to work for my treatment. One of the drugs, adriamycin, is renowned for, amongst other side effects, causing great damage if it comes into contact with the muscles around the vein it is injected to. We’re talking the sort of damage requiring plastic surgery. This would explain why the techs all put on thick rubber gloves before getting anywhere near a used bag of the stuff.

So at this point my right arm was wrapped with a warm towel. This apparently helps the veins contract. Every tech has something different. Some simply ask for a fist, others use a squeeze ball. This technique, however, was a welcome diversion. However, it didn’t seem to help very much. My tech got “really close” on his first go around (I’m reminded of the old adage that close only counts in horseshoes and hand-grenades), but he then informed us of his “one poke” policy. This means he only tries once; if he fails, he calls in “the master.” I’ll admit, the master knows his stuff and was relatively gentle, but it still took him two swings. The port (which would be a line inserted into my chest) is looking better all the time. Anyways, after all this I finally had a line in and we were getting close to starting treatment at about 1:30. It was about time; had he not made it the second time, I probably would’ve left that chair. I’m not sure where I would’ve gone, but some place other than that room. The tension was too much. So I was quite glad to finally be on the cusp of getting what I was there for and perhaps settling in for a nap. However, this was complicated by the fact that, since my elbow line was still viable, they would leave that in in case they needed to pump me full of Demerol if there was a reaction. Oh well. I had a sandwich (which although I really wasn’t all that hungry I couldn’t really resist, given the persistence of the volunteers) and settled down after a nice mix of Tylenol, benadryl, and zofran (an anti-nausea drug that is supposedly one of the best there is). They put me on the premeds (steroids to help with the other drugs), and I tried to take a nap while my parents left to get a bite. All the while I thought we were getting somewhere.

By the time my parents got back it was time to start the actual chemo drugs. The first one was a test dose of bleomycin; they start with this one because it has the greatest chance of a reaction (in the form of chills and shakes) but the reaction comes on comparatively slowly. After that they moved on to Adriamycin, which I mentioned before. This little wonder is affectionately known as “the red devil.” For a drug, it really has quite a range of side-effects. Just take a look!

-hair loss (not just on top, either. We’re talking about all of it)
-the strongest chance of nausea
-the greatest infection risk
-and just for kicks, red urine!

For some darned reason (perhaps psychosomatic), this one hit me hard. It’s a simple injection rather than a drip, but for some reason as soon as the first drop hit my veins I went FLUSH, like every muscle in my body simultaneously released. My tech was busy and only my dad saw the look, but apparently it was close enough to the look of nausea to warrant the introduction of a pan. I wouldn’t know what that was for. They also tried a wash cloth on my head, but I quickly vetoed that. It was a little much, as I bounced back rather quickly.

Relatively speaking, I felt nothing from the other drugs, which took about another hour and a half. Finally, with no major side-effects appearing, it was time for the bleomycin. The “pitch” for this drug was enough to warrant my mom spending the night with me. However, this all went without incident, and by 5:40 I was safely at home. I was tired but not particularly weak. I did feel nauseated, but I felt an odd gastric sensation. Not quite gas, but just a “full” feeling without being full. If that makes any sense.

Some friends visited, and I was find, though I refused to yield my perch on the futon except to open the door. By this time the fatigue really kicked in. I just didn’t want to move. I was, however, able to manage a bowl of soup and two slices of pizza. Quite impressive given the fact that I didn’t really feel all that hungry.

Anyways, that brings me to now. Still tired, but now a little queasy. I don’t feel the urge, but it’s unsettling. I can take my nausea drugs again, though.

So what did I learn today?
-Ports can be a good option for all sorts of patients, even when the doctor is convinced you have good veins
-Bring something to do; it’s rather tedious just sitting there, and you run out of casual conversation after about 20 minutes with the tech. If you have parents, though, they’ll be fine. Talking to the tech and other patients , that is.
-Expect the unexpected. Those side-effects are really a bag of tricks.

One last take away, and one that may be painfully obvious. Still, I found it intriguing. Cancer is truly an equal opportunity disease. With that brings people of all races, creeds, genders, and classes together in one place. Chemo truly is the great equalizer. Although everyone takes it a little differently, rarely is there a person that gets off the hook. But truly interesting is how many different mindsets there are. For some, this is a big deal that needs to be attacked with positive imagery. Apparently, these are the same sort of people that are into evolutionary science and time travel. But I digress. For some older people, it’s just another thing. Same goes for people who are on there second or third go-around, or trying a different hospital. There almost seems an air of resignation. Then there are those people that are calmly serene, despite what complications they have. They take advantage of the relative peace of the clinic, and even though their life may be threatened they are keenly aware it isn’t over. These are probably the people who will be found, no matter the eventual cause of their demise, with a pencil and pad in hand or with a book dropped by the bedside.

Anyways, I’m getting a little tired and now’s a good time to cash in on my drug timing. I probably won’t have a big update tomororw, given my relatively lengthy narrative of the day’s events, but I’ll try to check back in with some report.

Until then, best wishes.

OH! The quiz!

1) Which chemotherapy drug is affectionately known as “the red devil”?
2) How many times was I stuck today (not including in traffic or the waiting room)?
3) Which drug turned out to be the underachiever of my cocktail?

You have ten minutes. Black or blue ink only. Good luck.

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