Thursday, June 28, 2012

Another Punch to the Gut

It's now Wednesday, June 27th, the day I have been waiting for.  I get my port today.  I am super excited for no more needle sticks!  I wake up at 8am and take my anti nausea and Xeloda.  My sister and her boyfriend are at my apartment ready to take me to my appointment.  I realize that I never received any pre op instructions from interventional radiology.  Strange.  Usually anytime I have a procedure done, they email me instructions on what I need to do.  I post a question on Facebook about whether or not I can eat and one of my friends who is a nurse confirms that I shouldn't.  I just really want a smoothie but I can wait. I dress in some comfy pajamas and my Superman sweatshirt.

We headed on in to Kaiser in South San Francisco where the procedure is going to take place.  My sister's boyfriend drops us off curbside and we tell him to meet us at the lab.  We pass by the cafe inside the hospital and I point this out to my sister and tell her that's where I want her to buy my raspberry smoothie when I'm done with surgery.  I get to the lab and there's no line.  When I had called radiology on Monday to ask them when to stop my Lovenox shots, they told me to get an INR test at 9am Wednesday.  I tell the tech sitting at the desk that I need an INR and that I'm having surgery today.  People with same day surgery get priority.  He checks me in and tells me to wait in the chairs.  I dread this lab.  They are always busy and this day was no different.  I barely found an empty chair for me and my sister had to stand by the wall.  In a couple of minutes they call my name.  Score!  I was so happy I didn't have to wait.  My sister comes in to the lab with me and she tells me how she heard the other patients waiting snicker that I got to cut.  My thoughts?  When you get sliced open, you'll get to cut in line, too!  I roll up my sleeves and tell the phlebotomist that it's her choice, wherever she can find a vein.  I tell her that it's extremely hard to find them as chemo has killed them.  She picks a vein on my left arm and on the first try, she gets blood.  I didn't feel the needle and was so happy with her skills!

Blood draw before surgery.
Next we head on over to Admitting where they will set me up in the system for my surgery.  I meet Virginia who will be processing my paperwork.  She is such a nice lady and we talk.  She takes my $20 copay and gives me a lovely wristband to wear.  She gives me a stack of paperwork and tells me to go to radiology and hand it to the receptionist.  We walk to radiology, another busy department, and I hand in my paperwork where the receptionist tells me to take a seat and she'll call them in the back to let them know I'm here.  I sit down for a few minutes and then I get called back.  I take my sister with me.  The nurse who called me back, Igor, tells me that they are filled up in the back and my sister can't come with me.  I'm bummed out so I give her a hug and I follow Igor.  He leads me into a room filled with curtains and I take the bed in the middle.  There is a guy to my right who looks like he is prepped and ready to go in for his surgery.  To my left, I hear a woman and some male visitors.  That's it. Igor said they were backed up?  I don't get it.  And I didn't think it was fair that my sister wasn't allowed to come with me.  Igor gives me a gown and tells me to take everything off from the waist up.  I ask him if I get some snazzy looking sock since I'm wearing flip flops.  Ok, he says.  I'm getting the feeling that Igor is not a warm and fuzzy guy.  It's too bad because I strongly feel that people who work in healthcare have to have a certain degree of compassion and warmth.  I change into my gown and socks and wait on my bed.  Igor comes back and we go through my list of medications.  I tell him about how I didn't get any pre op instructions and all he could say is that that was strange.  There is another nurse sitting across from me asking me if I had done my blood work.  I told her that all I did was the INR test that I was instructed to do when I had called Monday.  The nurse, Yolanda, says that I should have done a CBC also.  She looks further in her computer and comments out loud that someone had cancelled it.  All they had to work with were the numbers from last week before I had chemo.  In my head all I could think about was how things were not going as planned with radiology.  Someone was obviously not doing their job.

So excited to be finally getting my port!
The next step was to place an IV in my arm so that I would be able to get my meds for surgery.  Igor is off in the background doing something and Sergio comes over to start my IV.  I show him my arms and tell him that it's his choice, wherever he can find a good place. I tell him I'll buy him lunch if he can start the IV on the first stick.  He chooses my right arm and uses a rubber band to torture my arm and cut off my circulation.  That part always hurts!  Sergio sticks me and fails.  Igor comes over and takes my left arm, inspecting it, choosing my hand as his choice.  He taps my hand over and over and this hurts.  The man is not gentle.  Sergio is looking at my right hand, contemplating on sticking me again.  Igor feels confident enough on his vein choice and I allow him to stick me.  Fail.  He said he burst my vein.  I look and it's at least not bleeding.  He bandages me up.  Sergio calls over Mayra for assistance.  Sergio tries explaining to me why my veins are so hard to stick, something about them being noodle like.  Mayra feels all over my right arm.  She sticks me in my right arm, the same area where Sergio had first attempted.  I never look when they stick me.  And it's not the needle poke that hurts me, its the wiggling around that makes me cringe.  I hear snickering going on to my right and I look.  Mayra is not wearing any gloves and my arm is drenched in my deep red blood.  I know I don't have cooties but I don't know what kind of cooties Mayra has been touching!  My stomach starts to churn at the site.  They stare at the floor and I peer over, only to see a pool of my blood there.  Sergio and Mayra call out to Jackie, who comes over and see blood everywhere.  It's like a slaughterhouse around here, I say out loud.  Jackie runs back to her office.  The techs tell me that she hates blood and will faint at it's sight.  In the moment, I played along and even asked Jackie to hold my hand but now that I think about it, I kind of feel offended at the mockery they created over the mess they made!  Sergio finally gets up and brings over towels to clean up the mess.  Another tech, John, comes over to see what's going on.  Mayra is giving it one more try to see if she can start an IV.  John is trying to distract me by asking me about the tattoo that I have on my left arm.  He shows me his and we have a conversation about tattoos.  Mayra finally gets the IV going on the fourth stick on my upper right wrist.  I am just glad she finally got it.  

My bloody wristband. 
Dr. Nelson appears and introduces herself as the radiologist that will be performing my surgery.  She is a young, pretty doctor.  She tells me about the procedure and asks me if I have any questions, and I don't.  The next thing I know, I'm being wheeled into the procedure room where there are several LCD screens.  John and Sergio get me ready and I roll over to the table where I will have my surgery.  Mayra puts a hair net on me and oxygen tubes for my nose.  She asks me to lay with my head facing to the left.  She adjusts my gown and sterilizes the right side of my neck and chest.  The sponge is cold against my skin and I'm shivering.  Yolanda comes over and she tells me she is going to give me medication through my IV that will relax me but I will be awake.  I lay there, stop shivering, and feel very relax.  I hear Dr. Nelson take charge.  Everyone announces their name.  They ask me to recite my name, date of birth, medical record number, and what type of procedure I'm having. I also tell them that I want a smoothie.  I hear Sergio call out the tools they will be using.  Dr. Nelson says she will inject my neck with Lidocaine and make a small incision in my neck.  She'll use an ultrasound to guide her as she inserts the port.  I feel the shot but it doesn't bother me.  I hear her say she's making the incision.   I'm somewhat drugged up but still awake.  All of a sudden I hear Dr. Nelson say that she see's a blood clot and she can't continue.  The procedure must stop as continuing can be very dangerous.  Dr. Nelson comes to my side and tells me we have to stop.  I start to cry.  I want this port badly.  Yolanda tries to comfort me.  They bandage up my neck and Sergio applies pressure for a few minutes, since I'm on blood thinners and more likely to bleed.  I couldn't help but to just cry.  They move me over to my old bed and wheel me out to the sectioned off curtains.  John hands me a box of tissues.  Dr. Nelson comes to talk to me and I ask her if she can try again later on my left side and she tells me possibly, but for now we can't proceed and we need the blood clots to dissolve.  Since I'm on Lovenox already, we're on the right track.  Yolanda tells me that I have to wait about half an hour before they can discharge me because they have given me meds to relax me.  Igor calls my sister to let her know that I'm out.  Since it's Wednesday and my oncologist is not working, they let me know that they spoke with the oncology department to let them know what's going on.  I'm devastated and heart broken.  The thought of needle sticks makes me cringe.

Crying my eyes out and bandaged up.


My sister comes back to see me and I cry, explaining to her what happened.  We leave and pick up something to eat on the way home.  I run to my room and close the blinds.  I nibble on my tacos and take some Ativan.  I continue to cry and cry.  I just want to be left alone and sleep. All I want is my Molly.  I started to doubt why I was doing this.  I was starting to lose hope.  I thought about the rest of my life and receiving chemo through my veins.  I hated the thought.  I didn't know if I could do it.  I thought about whether Dr. Nelson had lied to me about being able to possibly go in later on to give me a port.  I had a good cry session.  I needed to let it out.  I thought about my life a year ago and how I was a normal girl.  My life was not supposed to be this way.  I hated cancer.  I didn't know why it picked me.  It really does not care who you are.  I cringed at the thought of the months ahead of treatment.  Not being able to work.  Enduring the side effects of chemo.  Feel nauseous.  Feeling pain.  I just didn't know if I wanted to do it anymore.  Why was I doing this?  Was I living for me or was I living because everyone expects me to fight?  It's almost like I feel all this pressure to be strong and here I was breaking.  It was just a bad day.  I was reading status updates from fellow cancer warriors and they too were having bad days.  I hated cancer.  I was now apart of this community that no one should ever be part of.  The cancer community.  I hated that I had to be a member but I was grateful at the same time.  Cancer has connected me to so many great people.  Other people who know what I'm going through.  We cheer each other on, cry on each others shoulders, and talk just like normal people.  Cancer has also given me so many supporters who have my back and will lift me up when I'm feeling down.  The tremendous outpour of support was so overwhelming yesterday.  I just needed to kick, scream, and yell.  To get it all out.  I know that I'll have my tough days, days where I'll feel like giving up, but I have to remember that this is not over and that I will never give up.  Not that easily.  I have to allow myself to feel these emotions and know that they are temporary.  

I woke up today, with tears in my eyes, and I allowed myself to cry some more.  I stayed in my room and my sister tried to get me to eat.  I wasn't having any of it.  She carried on with her day and brought me home some food.  First thing in the morning, I had emailed my oncologist, telling her how heartbroken I was over not being able to get my port but I was wondering if there was still a chance for me to get one.  Normally my oncologist is very good about calling or emailing me back but by 4pm, I hadn't heard from her so I called.  The nurse who answered told me that she was running behind a little and since she had been on vacation last week, she did has a full in basket.  I understood and told her that if she could get back to me by tomorrow that would be great.  To my surprise, my oncologist wrote back to me shortly after 5pm.  She told me she spoke with Dr. Nelson and that she was willing to try again this time using a "midline which goes into your veins around your armpit area." She said interventional radiology would call me with an appointment.  I was so ecstatic!  I have an appointment tomorrow morning for my Areadia treatment and although I'll have to get stuck with a needle, I was joyed to know that quite possibly I would have a port by my next chemo which is July 11. I finally came out of my room and joined my sister in the living room.  My spirit started to come back and my heart slowly started to smile.  We watched tv together and ate dinner.  I painted my nails a mint green color (nail painting is one of my favorite things to do).  I was finally back to my old self.  I told my sister that this time around I wanted her to be there with me.  I understand that she can't be there to witness the procedure but she could at least be there for the prepping.  This is something I'll have to insist upon, especially with the carelessness I had experienced with the techs trying to start my IV.  So Marta is back and she is ever so hopeful!  I know that I'll have more rough days ahead, but if I sit here and reflect, I have had more good days than bad.  I have to remember that I am blessed and thank the big man upstairs for listening to me.  Sometimes I do get mad at him and lose faith, but I know he hears me.  After Aredia tomorrow, I plan on doing some retail therapy and indulging a little.  I've had another punch to the gut but things are looking up.

The incision that was made in my neck.