Since I had a long day ahead of me, Dad decided to drive us down to Mayo on Sunday afternoon so I could rest and be ready for round 2 day 1 of my chemo treatment.
My friend Sumana was on her way to visit her family in very exotic Dubai, but I get to enjoy sunny Rochester MN! Because my hemoglobin has been low, dad agreed that I could get my steak again and boy was it delicious.
We got to Mayo’s blood lab at 7:50 this morning. As expected, it was completely packed with people.
I walked up to the front desk to check in and enjoyed the conversation I had with the front desk lady.
Me: Came to get my blood taken from me
Lady: Ahh here to see the vampires huh?
Me: Yup, that’s why you guys are in the basement right? No sunlight down here.
The wait was about 50 minutes to do a 3 minute blood draw. Not complaining, just that there were a lot of people for the lab to suck dry.
We were only 5 minutes late to my chest x ray appointment which was fine. They led me to a changing room and gave me a paper poncho to put on which I wasn’t used to. I jokingly asked the x ray technician if I could wear it for the rest of the day and she said “Only if you really want to”.
The x ray only took a few minutes as well. It’s the waiting today that kills you.
Joanna drove down from the city and was right on time to meet my dad and me for my PICC line placement procedure.
As a reminder, I was having complications during my first round of chemo using IVs. They placed 5 IVs in 5 days because they were getting clogged and I got phlebitis, which is vein inflammation, in both my arms due to the chemo medication backing up and giving me a sunburn under my skin. The PICC line is inserted into my arm and follows my vein up into my heart so that the medication can be sent to my larger veins and directly to my heart. Another advantage is that the nurses can use it to draw blood so I don’t have to be stuck over and over again.
While the benefits are definitely there, the disadvantages are a bit more serious than the IV as well. I could develop blood clots near the catheter in the vein or develop an infection which is problematic when my white blood cell count dips low again.
I have to admit that I was definitely nervous for this procedure. I intentionally didn’t look into it because i didn’t want to freak myself out beforehand. I already don’t like the thought of getting stuck with an IV. In fact, I’m just starting to get used to getting it done. However getting stuck with a long tube that goes up to my heart is just a little scary to me.
Nurse Emily was the one that would perform the procedure. She lead Joanna, my dad, and me into a room and checked my vitals.
She explained what to expect from the procedure and we got started. First, I laid down and she put lube on my left arm so that the ultrasound machine could look for a large vein she could use to place the PICC line.
The top part of the ultrasound screen is the top of my skin, each green dot represents 1mm deeper under my skin. She said that she was surprised to see the majority of my veins to be so shallow, not a bad thing, just an observation.
The black circles were what she was looking for. She would press down with the ultrasound wand. If the black circle collapses, it’s a vein. If it collapses but pulses, it’s the brachial artery which is what she needed.
She also tested my right arm and found a larger brachial artery but since my tumor is on my right side, she didn’t want to take any chances.
Once we were ready to get started, dad and Joanna were asked to leave the room as the two nurses that were going to perform the procedure needed to scrub down and clean up. Unfortunately, I wasn’t allowed to have my phone with me since it would risk infection so I’ll have to use my carefully written words to paint a picture in your mind :p
They placed a blue cloth across my arm, chest, and other arm with a little opening on my left arm. I was given a mask to wear during the procedure. They also placed electrodes on my left hip, and right pec along with a large grey plastic box on top of my chest which was connected to the previous ultrasound machine.
Nurse Emily said that I’ll feel a pinch and a slight burn from the lidociane shot but then my arm should feel numb. Just for good measure, she used an extra shot of it on my arm a few minutes later because I could feel her test pokes.
I told both nurses that I was nervous and immediately the other nurse who I didn’t catch her name started talking about her kids, asked me about Joanna and how long we’ve been dating for, and about my cancer journey. I immediately picked up on what she was trying to do and it actually worked to distract me.
I did feel the pressure of an incision and from the corner of my eye. I saw nurse Emily pull out a long tube from some packaging but didn’t see or feel her place it in my arm. The procedure took about 10 or 15 minutes. At the end, they took what looked like a thin metal wire and pushed it through the tubing. The grey box on my chest helped indicate how far the tube was to my heart and if they needed to push it closer or pull it back.
They were happy with the placement, taped my arm up, and wrapped it in gauze. We were all done. From beginning to end, it took about an hour and a half to look for the artery and place the line in my arm.
They told me that as long as the PICC line was in my arm, I would need to avoid lifting anything over 10 lbs for risk of bleeding and that I should expect it to be sore for the next 2 days.
By this time, it was a little after noon. I needed to pee really badly and was ready to have some lunch. I met dad and Joanna in the lobby and I was feeling pretty good.
I went to the bathroom and noticed my leg started shaking. I went back to the lobby and needed to sit down. At first, I thought I was having an emotional break down similar to when I was getting poked and prodded a few weeks ago. I did what I could to keep it together but my body decided otherwise and go crazy for a little bit. I told Joanna that I was starting to feel nauseous. She suggested that maybe my blood sugar was running a bit low and gave me a hard candy to suck on while we went to get lunch.
Hard to believe how fast things change from this picture and the picture taken just a few minutes before.
I asked dad for a wheelchair because I wasn’t feeling strong enough to walk to the cafeteria. In the matter of minutes, I sweat through my shirt, needed to force myself to breathe deeply and slowly because my body wanted to do short quick breaths, my face got really pale, my vision went blurry and I lost about 80% of it due to static and darkness, and I just wanted to lay on the hospital ground and pass out.
This is the best representation of what I saw while riding in the wheelchair.
Dad turned us around and went back to where they did the procedure. The nurses brought me back to the room where I was allowed to lay down in the bed. They checked my vitals. My blood pressure went down a little bit. Blood oxygen level was at 97%. The most alarming part was that my heart rate was at 57, when I first came in at 119.
The best the nurse could describe my situation was that I was experiencing vasovagal syncope or just a fainting spell: A sudden drop in heart rate and blood pressure leading to fainting, often in reaction to a stressful trigger.
I think considering the length of time to insert the PICC line and the episode I just had. I’m going to ask if I can keep it in my arm for the duration of my chemo. I need to be at Mayo once a week so they can schedule a dressing change of the bandages around the line. This isn’t an issue since I have chemo every week at Mayo anyway. Not having to be poked anymore is just really tempting.
After about 15 min of laying down, I felt much better and we were on our way to get some lunch. I still had to be in the wheelchair though. Just in case.
After lunch, I checked into the cancer center and was glad to wait only about 15 min for an empty chemo chair to sit in. Unfortunately, after settling down, you have to wait for the pharmacy to mix your delicious cocktail of medications which takes a while to do.
I may have explained this earlier but the pharmacy needs to custom mix my medications as the intensity is specific to my treatment plan and body size and weight. I noticed on the Etoposide, one of the chemo meds, that it only has a 1 day shelf life. I heard that each of my 3 meds cost about $500-$700 each but I haven’t confirmed that yet.
All the medication was delivered within 40 minutes of me sitting down in my comfy chair and pre-warmed blanket.
The pre-chemo medications were delivered within 40 min and the chemo meds soon after.
Dr. Wiisanen came by to check in on how I was doing after the PICC line situation and wanted to share some good news with me.
The x ray on the left was the first one taken at urgent care on June 4th when I first discovered Derek my tumor. The one of the right was taken this morning. As you can see, it’s significantly smaller which is great news because I’ve only had one round of chemo and considering I skipped the last week of round 1 as well.
He also reviewed my blood tests from this morning and said that my neutrophil count was at 3.91, an increase from 2.46 from just a few days earlier.
This is very promising news and it makes me look forward to continuing the treatment to get this bastard out of me.
Dr. Wiisanen also wanted to discuss the use of Neulasta, a shot that I would receive on Saturday after my chemo to encourage my body to create more white blood cells when we expect those counts to go down. I have my reservations about using this treatment which I’ll discuss in tomorrow’s blog post.
Towards the end of my chemo treatment, I started getting really tired and started to doze off during my chat with Joanna. My fingers started getting numb, the metal taste came back to my mouth, and it felt like the moisture in my hands were sucked dry.
We wrapped up chemo at 6pm, total of about 4 hours but it was more than a 10 hour day and I was really tired.
The three of us grabbed a quick dinner in the hospital cafeteria. Joanna left to drive back up to the city as she has to work early tomorrow morning. Dad and I went back to the hotel which was only about 8 minutes away.
I passed out on the bed and just couldn’t wake up until 10:30pm because my body was so tired. I’ve been slightly worried to go back to sleep because I don’t want to start feeling nauseous since it usually hits right before bedtime. The only reasonable thing to do is blog about my day.
Today was tough and kind of scary. I’m glad my dad and Joanna were there to literally catch me during the rough periods of my day.
I have a bunch of stuff I want to cover this week so I’m glad I have a lot of chemo down time to write about them. Stay tuned!
