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20Feb 0800: admitted to Cancer Care unit, room 453 (the VIP suite—this room was HUGE). Plan for the day: do chemo without the PICC line, which is to be installed Tuesday morning. Plans do sometimes change, however, and this was one of those times. The nurses gave up on finding a useful vein, and the decision was made to just delay all of the chemo by one day.
21Feb, early AM: A special team of nurses shows up (after I've taken a 2 mg Ativan to help me relax—my normal dosage is 1 mg, but this time around, the hospital gave me a double dose) to put in the PICC line. For those who may not know, a PICC line is a catheter inserted into a DEEP vein in your upper arm, and then pushed through that vein to a point about one inch above the heart, where it opens up via a special valve. There is then a tube sticking out of your arm with two quick-disconnect connectors for IVs (or, depending on who you ask, for drawing blood, too). The whole area around the PICC line's entry point must be properly cared for, or infection is a serious possibility.
Each day of chemo leaves me feeling more and more weak, sick, and tired. Nausea is getting to be the norm after chemo sessions, as is taking Ativan for said nausea (remember, Ativan doubles as both anti-stress and anti-nausea).
So sick/tired from the chemo that I end up sleeping almost all day...and have no trouble sleeping that night, either.
Starting work on moving me out of my apartment. Still feeling very sick (weak, tired, plus the usual nausea). While working on that, we make what is intended to be a quick stop by the oncologists' office to check on my appointment times for the next two days, and to ask about the PICC line's insertion site, which, while not showing any visible signs of redness or swelling, is extremely sore. One CBC and doctor check later, we're on our way out. White blood cell (WBC) count was high (the acceptable range is 4–12, it was 18.5). Dr. gives me five individual samples of Anzimet, which he said cost $100 each. He also gave me a prescription, which Medicaid didn't cover, and we therefore did not get filled.
Day 09 chemo and another CBC. WBC now down to 9.3. Arm still sore, but with no visible symptoms.
Late evening: area all around PICC line entry point now visibly red and swollen. After changing the dressing, though, it seems OK.
Early AM: PICC line entry point is infected with pronounced redness and swelling (not to mention pain), and a slight bit of puss right at the entry point. Call Emerald Coast Cancer Center, nurse says come in right away. So, one hour-plus drive later, we're there. Dr. Chang looks at the site, doesn't see the puss (it's under paper tape), and asks one of the nurses to change the dressing. The nurse, upon removing the tape and seeing the puss, calls over a few other nurses, who, in turn, get the doctor back and basically insist that the PICC line MUST be removed. Upon seeing what they're looking at, he agrees, and the fun begins....
Unlike their counterparts at the hospital, the ECCC doesn't have any ability to administer a local, so I'm basically left with my PO (oral) Ativan and Darvocet to get through what's about to happen. We wait a bit (but not long enough...) to let those get into my system, and the nurse looks at me and basically says, look the other way and hold your breath..... Then she proceeds to pull this catheter out of an infected and extremely sore entry point. As the fire is shooting through my arm, I hear her announce that it's out, she's done, and I can breathe again. Nope...not ready for that...still on fire! She says it again, and I go ahead and take a breath.
Receive a new prescription for more antibiotics. White blood cell count now down to 7.1.
PM temperature: 99.5°F—just 0.9°F below the 100.4°F limit.
PM temperature: again, 99.5°F.
Early-AM temperature: 99.0°F.
Late-AM temperature: 102.8°F with chills. It's time for a trip to the emergency room. By the time we get there, my temperature has dropped (steadily along the way) to 100.4°F. WBC count now down to 3.0 (below the minimum). Admitted to Cancer Care unit upstairs—room 464 again. I really hate this particular room. For some reason, when I'm in that room, I'm always getting calls from people trying to reach rehab., and it gets highly annoying.
New CBC: WBC 2.7, fever + neutropenia (but not QUITE bad enough that everyone entering my room has to wear a surgical gown/mask).
Chemo (Bleomycin only). Unfortunately, as all of the veins in my left arm were pretty much shot, the nurses had to use my right arm (the one that had previously had the PICC line...the one with the big, extremely sore vein, etc.). So, we're talking FIRE going through my arm. For the next 36 hours or so, each dosage of Ativan and Darvocet HAD to be on time, or I was not a happy camper.
Released from the hospital with yet another prescription (two, actually—the second in case Medicaid didn't cover the first...and they didn't, so it was a good thing I had the second one) for antibiotics.