Posted by: Jenn | March 25, 2009

Chemo, round 4

I had my fourth round of chemo on Monday, 3/23.  The treatment itself went OK, but it started 2 hours late because they couldn’t find my orders.  The paper orders hadn’t been scanned into the computer, so the nurse had to hunt them down.  It frightens me that President Obama and his administration seem to think that electronic medical records are going to save the world.  I guess I should be glad, because as long as people think that, I’ll have a job, right?

Infusion bedSo let me show you a little bit of what happens during a chemo treatment.  First I am escorted from the waiting room to either an infusion bed (shown in the picture) or an infusion chair (no picture, but imagine a huge purplish recliner).  I like the bed, because the Benadryl makes me really sleepy, but I’m more productive in the chair.  As you can see, I get a little table to keep all of my junk on (usually my computer, phone, coffee, water, a book).  Once I’m tethered to the pump, the last thing I want to be doing is trying to move around the room looking for something.

Infusion pumpThis is the previously mentioned pump.  The one in the photograph is a dual pump, but I only get one drug at a time, so they either use one side of this pump or use a single pump.  The reason they use a pump instead of letting the meds infuse via gravity is because the rate of infusion needs to be controlled to minimize side effects.  For example, if the Rituxan is infused too fast, it can cause allergy symptoms (itching, wheezing, rash, fever) because it’s an antibody.  If the Cytoxan is infused to fast, it can cause sinus pressure and a stuffy nose.

IV setupThis is the IV setup.  It’s funny how every nurse does it a little differently.  The place where the catheter enters my skin is always visible (sorry if it grosses anyone out) because the doxorubicin and the vincristine are vesicants (they are irritating to the veins).  The nurse and I both keep an eye on the site because if the catheter becomes displaced and the drugs are administered into the tissue by mistake, it would be a nightmare.  The catheter is then secured to my arm (and usually my shirt) with either tape or the stretchy bandage in the picture above.  The objective here is to try to eliminate the risk of becoming disconnected from the IV solution.  It’s not that hard to disconnect yourself from an IV (although I’ve never personally done it).  The treatments are so long that at some point (usually multiple points) I have to visit the restroom, go get a cup of coffee or something to eat, and it’s really easy to get the tubing caught on things if you’re not paying attention.  Normally it’s not a terribly big deal if your IV becomes disconnected, but in the case of chemotherapy, you run the risk of exposing other people (nurses, janitors, other patients) to these horribly toxic drugs if you become disconnected and leak.  Needless to say, we do everything possible to prevent a chemo spill.

My cocktailHere are my drugs.  Everything has special connectors at the ends of the syringes and the tubing to prevent accidental exposure for the nursing and pharmacy staff.  It might not seem like a big deal, but tiny exposures to these kinds of drugs every day for many years can cause problems for people who handle them.  My whole professional career I have handled these drugs with a figurative 10 foot pole, and now I’m infusing them into my body.  It’s a VERY strange position to be in.

DoxorubicinIn this picture, I’m getting the doxorubicin.  Because it’s a vesicant, it’s infused into an IV line that already has normal saline running in it.  They infuse a couple of milliliters, let it run down the line into me, then pinch the line closed (you can see her fingers in the right side of the picture) and draw back on the syringe to make sure blood flows freely into the line.  The purpose of this is to make sure the vein is still open.  If the drug irritates the vein to the point where it closes down, any additional drug infused would end up in the surrounding tissues, causing BIG problems.  This part takes a while (I get 3 syringes of doxorubicin plus the vincrisine) and it’s kind of like getting your hair cut – some of the nurses are really chatty and some of them don’t talk very much and I suck at small talk. 

When I’m done, they take the IV out and send me home.  I think the whole process is really interesting, but I apologize to those of you might be bored with this lengthy and slightly technical post.  On a more exciting note, I am scheduled for a CT/PET scan on Friday, April 3rd, to evaluate my response to treatment and see if I’ll do 6 cycles or 8 cycles of chemotherapy. 

Thanks for all the comments.  I haven’t been able to respond to every single one, and I feel horrible about that.  Unfortunately my need to sleep right now outweighs my need not to feel horrible about it.  😉  But that doesn’t mean I don’t love you and appreciate your support more than you know.

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Responses

  1. Wow, very interesting. I never knew what went into this. Hope you are getting better!
    Dammy

  2. Jenn, I have always thought that you were an exceptional woman, but, I must say, you continue to amaze me. Not only is this technical post very interesting and articulate, but it’s presented in a way that allows those of us who do not have your background (and, in my case, are overwhelmingly humanities and fine artsy!) to easily follow the explanation.

    I’m sending wellness vibrations and lots of love,
    Nikki

  3. Wow thanks for posting this-I never knew the process of chemo.

    I am amazed at your positive attitude! Sending good karma your way!

    Love,
    Beth

  4. What a process! I have never been told exactly what a chemo treatment is. Very interesting. You are in our daily thoughts and prayers.

    Love you,
    Joe & Kris

  5. Jenn,
    That’s along day! That rest is well deserved. Thanks for giving us insight into what you go through. You are certainly an incredibly strong woman. Get some rest, hug all those boys of yours, and keep up the good fight!

    Our prayers are with you all.
    God bless you,
    Jenny
    Thanks for the pictures too!

  6. Hang in there sweetheart! You are stronger than this illness. . .and all the good wishes sent your way must make a difference! We love you very much!

    Aunt Polly

  7. WOW what an ordeal. I’m learning so much from you not only about your treatment but how to march forward and be positive no matter what life throws your way! You are my rock in so many ways. Keep us posted on the PET scan.

    Teresa

  8. Jenn, Keep up the great work! You’re doing great & have a ton of support. Your posts remind us of just how strong you really are…not that we didn’t know it already 🙂

    Love, Brian, Tree, & Katie

  9. Thanks for the great insight into the process.

    Stay strong Jenn.

    I love you soooooooooo much!

    love dad

  10. Debi updated me on what’s going on in your life! You are such a strong person and I’ve always had the greatest admiration for you ever since Needham days!

    What a beautiful family! You are so blessed – and I’m sure you know that – but what an unfair burden for a new mother to also have to deal with lymphoma at the same time!

    I know that such a good person as you can keep up your courage and fight this off! I’ll follow your blogs with great interest and will stay in touch.

    Love,

    Tom Wharton

  11. Jen-What can I say. You are just amazing. Your info on chemo has certainly given me an education I never knew existed. I loved your Easter picture. I’m glad your Dad got to be with you. What a special Easter for all of you. You are always in my prayers. We send our love and hugs
    Uncle Eddie and Aunt June


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