Well, it's finally winding down - the first day of chemo-therapy is nearly finished. I am sitting in my "office" (the brown recliner in the front room), listening to the 5-FU pump cycle through its 3 ml/hour song (whzzzsht) and trying to relax enough to try some sleeping. We are already wondering if the pump sound, once every couple of minutes, will allow a decent night's sleep for anyone in the master bedroom... if it keeps the cat awake, then no one will sleep!
We started out by sending the darling daughter over to a friend's house so we could drive up to the cancer clinic. Traffic is unpredictable, and we wanted to be on-time the first day. We ended up arriving five minutes early, after stopping for gas, but it didn't really matter. They "checked" me in, but we didn't get called back to the chemotherapy area until after 9:30. I was weighed in - 166 lbs! - and then taken to my personal Naugahyde recliner for the duration of the day. The PowerPort was flushed with a saline solution, and then we withdrew a small amount of blood through it (about a teaspoon) for the blood tests. The doctors/nurses are particularly interested in the physical counts (white blood cells, red blood cells, platelets, hemoglobin, etc.), which measure my susceptibility to anemia, neutropenia, and excessive bleeding, as well as the components that indicate proper liver and kidney functions and glucose levels.
Once those data are declared to be within safe parameters for a person my size and weight, they "order" the drugs to be prepared. Ordering means that they fax the prescription across the room to the clinic pharmacy. :) Have they heard of paper reduction? Whatever. Then my prescription is placed in the queue to be mixed, and I am given some anti-emetic/anti-nausea meds both orally and intravenously. Those take an hour to take effect, so the timing seems OK. Then the paperwork arrives! I spent at least an hour filling out surveys related to my medical history (as well as my immediate family's history), my diet (for the anti-emetic clinical trial that I am in), and one other one that I didn't know about (but it was a one-pager, and it's all about the science, right?) And the staff were all very helpful and friendly - but that means plenty introduction conversation of the "hi, nice to meet you" variety.
The chemo- drugs didn't all arrive until nearly 1pm. !!! We finally got them dripping by 1:20pm, after a second nurse had to come by to verify (along with my main nurse for the day): (a) who the patient is - by asking me my name and birthdate and comparing it against my wristband, (b) the prescription - by looking at the original form that was faxed to the pharmacy, and (c) the drugs themselves - by comparing the IV bag labels to the prescription. It is a good safety policy... but it adds time as nurses aren't twiddling their collective thumbs in the clinic, you know. :)
Drip... drip... drip... and two plus hours slowly melt away. We got hungry and got sandwiches from the cafeteria (not bad, really). We drank cran-apple juice and water, and then I would wander to the bathroom every 45 minutes. Between the drinks to quench my thirst, and the liter-plus volume of fluids dripping into me, I kept my bladder plenty busy. The nurse from the portable pump service taught us all about the pump that I now wear for 48 hours. And after the Oxaliplatin and Leucovorin were finished, I got another 20 minutes of anti-emetic-helping glucose/saline IV. We finally left the clinic at 4:30pm for the drive home... arriving there at 5:50pm. 10 hours and 20 minutes after we left. They think that we will only need 5 hours in the clinic next time (which could mean that the day would only be 7.5 to 8 hours long). Yippee.
Next time I hope to remember to bring cards and backgammon. I was able to work for a couple of hours, but the interruptions were too often to get on a roll. There is also a lot of beeping and conversation in the clinic's sound-space, which I found to be hard to ignore today. Maybe I'll get better at that in the future? And there are so many other topics that I feel compelled, and ready, to write about... but now I go to sleep. :)