07/23/2012

7:35: I wake up. Check the time but don’t want to get up just yet. I doze back off.

8:00: I wake up again, this time, time to get out the bed.  My appointment is at 9:00.  I wake up my wife, take Buster out, and page Debbie Schmitz.

8:04: Debbie calls me right back.  She explains to me the whole process I will be going through today and she tells me she will meet me in the waiting room when I get there.

8:07: I get ready to leave the house for chemo.

8:45: We leave the house. My wife is driving me today.

8:55: We arrive at the Yenni center and I checkin . The girl checking me in was my sister Katie’s class and recognized me.

9:00: We are upstairs in the oncology waiting room.

9:07: My buzzer they gave me goes off, and I ask a nurse and they direct me into the infusion room.

9:10:  I am getting my vitals taken.

9:15: I am led to the media room to watch an intro video on the chemo treatment, side affects, nutrition, etc.  Debbie Schmitz also comes and give a presentation and goes through the entire oncology binder that is for me to keep and take home and refer to as needed. During the video, my wife puts on the lidocaine cream onto my port area and covers it with serran wrap.  I start to eat a sandwich bag of cheerios to have some whole grain fiber in my stomach before my therapy.  At this time I also swallow an antianxiety pill just to play it safe, I don’t want to feel weak at anytime during treatment from anxiety.  We then finish watching the videos.

10:10: We are done with the videos and report back to the oncology infusion center.

10:15: They direct me to room 1, bed 2 for my infusion.  I believe I am in a bed for this round because they will be throwing test amounts of drugs at me to see if I have a bad reaction to them.  If I have a bad reaction, then they will have to make arrangements for a replacement drug.

10:25: The nurse comes in and accesses my port and tapes down the port.  He flushes it with no problems.  He has issues pulling blood back on it, but flushing and pushing liquids through the port is not a problem.

10:42:  I am just sitting around in the room waiting for additional directions/drugs.

The Test Dosage

11:05: The nurse comes back in and flushed the line some more saline flush and prepares me for the test dose of Bleomycin  He hooks up the IV and stats the saline drip.

11:10: I am started the test dose of Bleomycin into my IV Line to see if I have any reactions to it.  We will flush this for 30 minutes before the next step is taken.

11:17:  The nurse gives me a handout with the side effects of the Bleomycin.  The worst thing that can happen is long term lung problems hence causing breathing problems.  I should tell him if any of the following side effects happen while I am laying in the bed or my doctor if any of the side effects happen later.  Those side effects are if I am feeling dizzy, not thinking clearly, have fever, chills, or wheezing.

11:20:  Just sitting here waiting for my 30 minutes to be up, and for more drugs…

11:40:  My alarm goes off on my SignsSpectrum IV Dripper/Regulartor Device.  The nurse comes in ad ask if I have a rash anywhere, if I have any problems breathing, chills, wheezing, etc.  I say I am fine.  He says good.  So I ask him whats the next step.  He says its time for him to order my round of drugs and get my antinausea medicine, and other pretreatment drugs to feed into my line.

Pre Meds

11:50:  The Premeds – Zofran and another drug that I will find out.

12:35:  Emend – Anti nausea Medicine, this will last for 30 mins.

1:12:  The premeds are done flowing, now just back to the saline drip.

ABVD Time

ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma, supplanting the older MOPP protocol. It consists of concurrent treatment with the chemotherapy drugs:

• Adriamycin (doxorubicin/Hydroxydaunorubicin, the H in CHOP)
• bleomycin
• vinblastine
• dacarbazine (similar to Procarbazine, the P in MOPP)

1:17: First up Bleomycin.  10 minutes – 23 units, same dosage as the one test dosage, just more units.

1:24: I am just sitting here, not feeling anything special with this infusion just yet.

1:28: The alarm starts going off for my Bleomycin being done, a nurse comes in and sets the device to push more because there is still left hanging in the IV bag.

1:30:  My wife goes and gets me a chicken salad sandwich from the fridge in the infusion center.  I open up the tray, take a taste, and it tastes weird.  Also my Gatorade tastes weird too.  My wife says it taste like chicken salad, but that’s probably the chemo drugs taking over the taste side effects.

1:40: The alarm starts going off, the nurse comes in and checks it.  Bleomycin is done…

Next up is Adriamycin, the red stuff.

1:50:  The changing of the guards, I get a new nurse to start the Adriamycin.  The nurse comes in needing to pull some blood from the port to ensure that the catheter is in the vein before pushing the Adriamycin.  The Adriamycin can cause burning to surrounding tissue and skin if not delivered directly into a vein, therefore it must be verified that the catheter from my port it is in the vein before pushing the drug.

2:10: The nurse tried flushing the port with 2 more syringes of saline, even trying the pumping effect that the nurse achieved to get blood flow back on Friday, but she can still not pull back any blood.

2:45: The nurse came back and put some Cathflo into my line and port.

2:50: My mom gets here just doing of her job of being a mom, and worrying and making sure she is there for everything.  It’s her mom job that never stops.

2:55: Debbie Schmitz gets there and distracts my mom for a little bit giving her a full tour of the infusion room and kitchen area.

3:15: The Cathflo flushed out the port and the nurse was able to draw back blood, therefore everything is good to go and ready to start the Adriamycin.

3:23:  The Adriamycin is hooked up and started.  I should take the entire bag into me in 10 minutes.  Just pumping into me with no problems…  That is crazy look at how red this stuff flowing into me is.  Bright red.  It will make me sweat red, cry red, and even, yep, you right, pee red.

Crazy stuff, but cool stuff, Ill post another pic!

3:40: Adriamycin is all done, they pushed it at 774mL/hr.  They they push the the saline to clear the line out for 5 minutes at 774mL/hr.  Plenty of cold fluid.

3:51: The vinblastine is now being pushed into to me.  Its in a syringe, hooked up to the IV line and pushed in by the nurse.  She takes 2 minutes to push in this syringe of drugs.

4:03: Here comes the Dacarbazine!  YAY!  Last one!  30 minutes of this stuff, and then its time for me to go home.

4:13:  My dad gets here, yay, now its its a party!

4:17:  My wife shows my dad and my mom the video room for them to watch the chemo intro video.

4:30:  They still pumping me with the Decarbazine.  Not a problem here.  Just keep pushing these drugs into me, make me get better.  We’ll see how bad/good the rest of the week is, but me just sitting here right now, is no problem whatsoever for me 🙂  Kill The Cancer 😛

4:33: The Decarbazine is done with.  Now flushing me with saline again at 500 mL/hr.

Bad side affect today?  None so far.  I have been hot.  I had night sweats all last night, and some warmness, almost sweating the whole time I am here today, nothing drastic or sweating here during treatment but definitely a warm feeling, but I check in with my temp at 98.7.

4:44: The alarm goes off for my saline flush, and another nurse comes and turns the pump back on.

4:50:  The pump alarm sounds again, and the nurse that just turned it on for 5 minutes comes back in and changes my saline drip to 100 mL/hr.

4:58:  The same nurse comes back in with the cart.  She asks me a few questions about the next time I am doing blood work and the next time that I am coming in for Chemo.  I told her that the doctor told me that I would have blood work done the Thursday before my next chemo.

5:07:  The port is flushed with a syringe of saline to flush out any of the remaining fluid/chemicals in the port/catheter.  Then a 1/3 of a syringe of heparin is pushed in to prevent the port and catheter from clotting, the type of clotting that we saw today where they were unable to pull any blood back and had to use the cathflo to break up the clot that was preventing the back flow of blood. The silicone covering on top of the port prevents anything from leaking out of the port and seals back after the needle is removed.  This is the purpose of only using a non coring needle.  A coring needle would take out a portion of the silicone dome which would not allow the silicone dome to seal properly upon needle removal, therefore the type of needle to used to access the port is known as a huber needle. The huber needle is bent in a way that the opening of the needle does not slice out a section of the silicone hub.  It goes in on such an angle that the silicone is sliced with a very small pinhead then stretched around the rest of the needle, only coming in parallel contact with the needle hole therefore never destroying the way the silicone hub is made to close back up around the needle when removed.  However, great care must be taken that the needle is not moved back and forth while in the port as this could stretch/tear the silicone hub.  Also it is important not to spin the huber needle at any time.  The reasons for this is that if the wrong part of the needle is in silicone section, then it could stretch/tear on the bend, or it could core out a section of silicone if needle opening is even with the silicone section at the time of spinning.  Therefore it is strict regulation to just push the needle in and remove the needle out and not to move the needle in any other direction and to secure the needle with a clear adhesive circular patch to hold the huber needle in place.   Ok, Ok, enough about the huber needle and the port and it’s silicone hub, I just thought one may like a brief educational update.  My line is taken out and I am discharged from the Yenni Treatment Center.  I am heading home.

5:20:  I am headed out of the Yenni Treatment Center. Catch you when I get home.

5:45: We arrive home. My dad drove me home because he has the larger SUV.  My wife gets home right after us.

6:15: My mom gets home with some Kentucky Grilled Chicken. Time to eat! Yummy…

6:50: We are done eating, I go to the bathroom where I can close the door and take off the bandage in peace and in front of a big mirror.  This bandage is located on top of my port to prevent the skin from bleeding after they removed the needle.  I also need to be careful taking off the bandage because the nurse taped the tape on top of the sterri strips, and I don’t feel like ripping those off today.

7:30:  I am in my bed, and quickly fall asleep.

I wake up sweating, but turn over and go back to sleep.

10:30:  I wake up again in a sweat, I get out of bed and take another trip to the bathroom after all those fluids all day and drinking water and Gatorade all day.

10:55: My dad leaves for his weekly 11PM – Midnight Monday night adoration at church.

I then watch some TV with my sister, Sarah.  I want some different flavored Gatorade, so I ask my sister while she is up in the kitchen to see if there are any other flavors.  She says there is none, but asks which ones I usually like.  I tell her orange, yellow, and red.  She says she will go off to CVS and return with some.  I tell her not to worry about it, I will just continue to drink the blue that we have for now, she says its ok, and runs out to get some.  She returns with 6, 3.78 gallon bottles of Gatorade. 2 Orange, 2 Red, and 1 Yellow.  I have her mix half water and half orange to get me the electrolytes and other benefits of Gatorade with the extra water I need to drink to flush the chemo from my system and to keep my mouth moist and to prevent it from drying up.

Overall today went smooth!  I know the anti anxiety medicine helped me out greatly.  Usually I would not be able to watch the nurse insert needle into my skin, watching them pump the saline flush in and out, and try to aspirate blood from my port with no luck without feeling sick, first time at Dr. Veith’s office.  I felt a little sick before my bone marrow biopsy when that nurse was pumping the saline flush in and out trying to get no luck, then taking a break and trying once again with a little more force, and then was able to start pumping with some blood flow then flushing harder for better blood flow by aspiration.  I noticed it odd, but after taking the anti anxiety medicine I was able to just sit back and watch the chemo chemicals be pumped into to me.  I was able to watch 2 nurses try the pumping effect to flush the line so they could get blood pulling back by aspiration.  They were able to push and flush fluids, but they could not pull/aspirate blood from the line.  After the Cathflo, she was able to aspirate a half a needle of blood.  Funny enough I can’t watch them pull blood from me, nevertheless when I am giving blood for blood tests, or if they are pulling it back through an IV for blood work.  I can’t see my blood in any form with a needle in me without me feeling bad and woozy and just slipping to the floor.  I have found out that smelling salts do not work on me after seeing a bloody cyst removed from my back right after graduating high school. So yes, i want to say the anti anxiety medicine sure did help me today, and I am planning on using it for every upcoming treatment to put me at ease and help me through the situation.  I am sure it helped me accept the fact and have no worrying issue about the chemo chemicals/drugs they were putting into me today either.