Blood Bath

Today was my second chemo treatment. Neil and I got there and waited a few minutes to go into the infusion room. They were going to use the port for my Chemo this time. Last time they just used an IV in my arm. The port allows for easier access and guarantees only one poke. Often later in your chemo treatments, your veins start to collapse and it gets harder and harder to get an IV in an arm or hand vein so the port can be really nice. I'm told it is the Cadillac of IV's. I'm not entirely convinced.

Two weeks ago, before I started my first Chemo session, I first needed to do bloodwork and then a breast MRI. They decided that rather than poke me in the arm for the bloodwork and then again later in the chest to access the port for Chemo, they'd just access the port in the morning to draw the blood and then leave it in for the chemo later in the day. They really did have good intentions.... It just didn't really work out.

First, they had given me a prescription for a topical numbing agent for me to put over the port an hour before they tried to access it. So being a good little Cancer patient, and more than happy to do whatever necessary to alleviate pain in any form, I applied the cream and put a little square of saran wrap over it. I couldn't figure out why they wanted me to do the saran wrap thing, but they did. So I did. When I got there all ready for them to access the port the nurse said, "Oh you didn't put nearly enough on there. You need to gob at least a good tablespoon on it and cup it in the saran wrap so it doesn't get all over your clothes."  Okay. That might have been good to know AN HOUR AGO!!!

So she proceeded to access the port. I have to stop and mention that over the last year and a half, I've gotten to be pretty good with needles. It's kind of ironic. I used to have to psyche myself up for weeks in order to get the nerve to go give blood. However, recent events have cured me of my fear of needles. I'm estimating that I've been given the poke for either blood tests, IVs, or injections of some sort around 35 to 40 times in the last 18 months. So the ironic thing is that now that I don't have issues with needles, I can't give blood. Ever again.  Okay so back to the port. The port needle is no ordinary needle. I got a good close look at it and it is about an inch long and FAT. I've gotten into the habit of watching them insert all the needles, but this one I couldn't. Not only because of how fat it is, but because where they were sticking it. In my chest. Almost directly over my heart.

I could tell that the nurse was a little nervous about accessing the port when I hadn't applied the numbing agent properly. She got everything ready, the area above the port all sterilized and needle needle poised and ready, and then the dialog went something like this:

NURSE: Are you ready?
ME: Yes.
NURSE: Okay, on the count of three. One. Two....  This might hurt a little.
ME: Okay.
NURSE: Alright, here we go.  One. Two.... Oh, wait let me get this guaze placed a little better. Is that better?
ME: Sure.
NURSE: Okay, hear it comes.
Nothing happens. Nothing happens.
ME: (Thinking: WOULD YOU JUST SHOVE IT IN ALREADY?!?!?!)

[POKE] (Honestly, that really just isn't an adequate word for the sensation of someone shoving, what felt like a metal spike into what could have very well been my heart)

ME: HOLY CRAP, THAT HURT!!! (That was outloud. Really outloud. She was very apologetic.)

It really did. It hurt like a bugger. And this is coming from someone that barely feels the needles anymore.

So, anyway. Once it was in, I didn't feel it. Until it was time for the breast MRI. It was a little uncomfortable because I had to lie on my stomach, putting pressure right on the port during the MRI. The radiologist was a little confused. Said he'd never done a breast MRI with a chest port that had been accessed. (Meaning, it had a big metal needle sticking out of it.) But, he went ahead and started. 20 minutes into a 45 minute MRI that was a little uncomfortable, to say the least, he pulls me out, tells me that the needle is throwing off all the images and they need to pull out the port IV and start over. Lovely. Needless to say, I was just a little bit cranky by the time we were done.

When the breast MRI was done and we went to the infusion room for my chemo, they got ready to access the port again. Not a chance. I told them to stick a needle in my arm. So they did.

So that was all two weeks ago at my first Chemo treatment. This morning, as I got ready for the second treatment, I squeezed out literally half of the tube of Lidocane onto a little square of saran wrap and slapped it on my chest over my port. When I first got the prescription for this cream, I was a little confused why the doctor gave me 12 refills for 8 Chemo treatments. Now I understand.

So this morning we get there, I sit down in my recliner and the little nurse comes over. This is the first of two nurses for this morning's session. The first nurse's job is to access my port and draw blood to be sent down to the lab. The lab does a rush job to check and see if my white and red blood cell counts have had a chance to recover since my last Chemo treatment. If they have, we go ahead with the next Chemo treatment. If they haven't, they consider putting it off for a few days.

So the blood-taking nurse wheeled over her little table of equipment and started unloading all sorts of gloves, needles, and other paraphernalia. She kept dropping things and Neil and another man across the room kept picking them up for her. Once she got everything ready, she wiped the goop off my chest and said, "On the count of three." I couldn't watch, "One, two, three. Okay, it's in." I didn't even feel the poke. Beautiful. I decided I really loved her. But then, we had a little problem. She couldn't get any blood out. Apparently a clot had formed over the catheter. That was fairly common she told me. So for the next 10 minutes she kept trying to flush the line to dislodge the clot, she asked me to cough, raise my arm, raise my other arm, lie down on my back, my left side, my right side. Still nothing. So then she said, "I think we need to put in a bigger needle."

I was a little annoyed, but considering I didn't feel anything the first time around, it didn't seem like a big deal. If the nurse two weeks ago had said that to me, I think I would have demanded a morphine drip before I let her near me again. But, this time around was different, so I told her to go ahead. She pulled out the first needle and got one out that looked like it was closer to two inches long. (I probably wasn't, but I feel I have the right to use a little creative license at this point.) After getting that one ready and dropping a lot more stuff on the floor (I think she was getting a little flustered by this time) she shoved the second one in. This one hurt a little. I think my numbing cream was wearing off. The second needle didn't work either. Now I was just annoyed. So after all that, she put a needle in my arm so they could draw the blood for the lab work.

This really should have been a Part I/Part II entry, because I'm only about halfway done, but hang in there. It gets even better.

Now remember, I have had my blood drawn a lot in the last year or so. In almost all of those cases, it has been beautifully done, takes about 45 seconds, needle in and out and I barely feel it. Didn't have the same experience with blood-taking nurse today. She prepped me to put the needle in my arm. I was watching this one very closely. First of all, the needle hurt going in. Those never hurt anymore. That was the first sign that there was going to be trouble. Normally, the needle goes in, they slide in the plastic catheter that goes into the vein, remove the needle, pop on a tube, and the blood goes into the tube. She slid in the catheter, pulled out the needle and didn't have a tube ready. I'm not really sure what she was waiting for. Well, of course, the blood started coming out of the catheter and pooling in the crook of my arm. She tried to stop the bloodflow by putting pressure on the vein just above the catheter, but it kept coming out. Within a couple seconds the blood was spilling over both sides of my arm and onto the arm of the chair and onto the floor. I start moving my jacket that was sitting in my lap so I don't get it all stained by my own blood that is now flowing freely from the catheter that she still hasn't capped with a plastic tube. Neil and I just keep looking at each other thinking, "Is anyone else seeing this?" Blood-taking nurse finally calls behind her casually for a wet cloth so she can start mopping up the blood. After that cloth is a mess, Neil walks over to the other nurse at the desk and says, "We're going to need a few more wet cloths." I think it was at this point that the other nurse began to get a little alarmed. So anyway, blood-taking nurse finally gets it capped off and my area cleaned up. She then goes back to my port and injects a solution that will dissolve the blood clot so they can use it for chemo. Why she didn't do that before she drained a pint of my blood on the floor just to fill a tiny little tube, I'll never know. Needless to say, during all this I made a mental note of her name. She won't be touching me again.

Well, I haven't even gotten to chemo and chemo-nurse and this is already probably a lot more information than you wanted for a simple update, and the sleepy drugs are starting to kick in. I have a new favorite drug. It's called Lorazepam.  I'll tell you all about it tomorrow.