Wednesday October 9, 2013
Well it was an interesting night. After not getting to sleep until after 12:30 a.m. and then finding out that the nurses come in and check on you every hour during the night. It wasn't a good nights sleep. Now is the day that I get to start learning the routine of being in the hospital. The night shift nurse comes in at around 6:30 to check and make sure you don't need anything. Shift turn over is at 7:00 a.m. So, I find out that they do a shift exchange in the room with the patient some time between 7 and 7:30. So, much for sleeping in.
There is not much to tell this morning. New admit with a diagnoses of AML, had a Muga scan last night and is scheduled for a PIC line at 10:00 a.m.
I also find out that there are daily blood draws to measure my CBC levels. So, at around 8:00 a.m. here comes a technician from the lab to poke me with a needle and get some blood. I am sure not liking needles at this point because it takes her twice to stick me. But, she does finally get the blood drawn.
I was impressed with how proficient they were in doing my PIC line. It was like an assembly line they did it so effortlessly. I had waited 20 minutes in recovery to get into the room where they do basically on operation to install the PIC line. What amazed me is it seemed like it only took 10 minutes to install the PIC line. They put you on this big live x-ray machine and the PIC line has to go into the vein that is running through your right bicep. This is because` the catheter of the PIC line runs down that vein to just above your heart. The one they are installing in me is a two line PIC. Two lines so one can be used to give continuous chemo and the other for antibiotics, saline and to do blood draws.
They drape and dress and get the location sterile. The doctor comes in and uses the ultra sound machine to find the vein and after they deaden the incision site they cut into the arm and start inserting this catheter. I could feel it a little while they were fishing it up my vein towards my heart. This was a little freaky. But there was not pain. After that they actually attach the Y port that connect to the catheter to you arm with a couple of stitches. They do not want this thing coming out and me bleeding to death and that is a good thing. There is a sterile dressing specifically made for the PIC that is clear in the middle so that the nurses and doctors can check it to make sure that there is no infections going on over the next 4 to 8 weeks that this is supposed to be installed in my arm. And that is it. They are done and I am back into recovery.
I wait another 20 minutes for a nurse from Oncology to escort me back to my room and that was it. Easy peasy. I would come to like the PIC line. It is so much nicer than getting poked with a needle every time you turn around. It was so difficult for the nurses to start an IV because of the anemia and it was taking them multiple times to get one started. Now most everything is through the PIC. It makes it easier for them and for me. The major deals with a PIC is the worry of infection. If there were to be any infection then they will have to pull the PIC line and go to IV's in my arms that can only be in for 4 days at a time and then they have to be removed and another put in a different spot.
Let's see, the next things to happen today are a blood transfusion and chemo. Well since I am back from the PIC line installation around 11:00 lunch is really the next thing on the agenda.
They want to get my hemoglobin levels up before they start giving me my chemo. This will take 3 hours a pint. This is my second blood transfusion and it goes much smoother than the first. They give me pre-meds of Tylenol and Bendadryl to help prevent a negative reaction to the blood. They also have to stay in the room for the first 15 minutes to monitor me and take vitals. They are looking for any major changes. But, in particular a spike in temperature. If that happens they have to stop the transfusion and re access.
It ends up being close to 6:00 p.m. by the time they are done giving me my blood transfusion. As soon as they are done with that they are ready to start my chemo. They start the cytarabine but they wait a bit to do the "pushes" of daunorubicin. You see they have something like on the job training that each Oncology nurse has to do to become chemo certified. This includes each nurse having to do three pushes of daunorubicin. I would find out that this doesn't happen often and that there is a list of nurses that need this opportunity. They call Elizabeth and she agrees to come in at 6:30 so she can get her chance. This drug is a nasty drug and there is a certain way that it needs to be administered. They hook up a syringe of 20 ml of the stuff and it can only be "pushed" at 2 ml per minute and after each 2 ml they have to check for blood return down the catheter. It takes about 15 to 20 minutes to administer.
The reason for all this is because the drug can actually damage tissue if it is not injected directly into the blood stream. And they can only give a person so much before they know that it will damage the heart.
Everything goes well and this is the start of my 7 +3 chemo regiment.
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