Friday Clinic Visit - Maintenance Round 26

Today's clinic visit consisted of the following:
1) Port access
2) a blood draw
3) Vincristine (Chemo)

Today's clinic visit was a REALLY long one. It started out with the typical height & weight and then waiting for someone to access Katie's port. Two of the main nurses (Bea & Helen) were out today, so that meant Katie's port was being accessed by one of the newer, less experienced nurses. I get a knot in my stomach every time someone "new" has to access her port because it's usually a disaster and today was no different. The nurse accessed Katie's port and tried to get a blood draw, but had no luck. She tried rotating the needle around in Katie's skin, but that didn't work either. All the while, Katie was SCREAMING bloody murder. After much rotating and screaming, the nurse decided it was best to take the needle out and try again with a fresh stick. So, one needle out and another needle in, there was still no blood return. Finally, after much ear piercing screaming, one of the more experienced nurses came in to help and her suggestion was to take the needle out and try again. So, second needle out and third needle in, STILL no blood return. This is when they decided there was a problem with the port. They left the third needle in, taped it up and let Katie go back into the infusion room to "play". They wanted to try and have her change position, do some jumping jacks and see if they could get the port working before calling in "the man". Peter, is "the man" that get the ports working again when they are clogged.

Well, after 1/2 an hour of playing leap frog with "Fun Kris" around the infusion room, they tried for another blood draw and they got nothing. So, after 2 hours, Peter was called.

12:00pm - Peter came and checked out her port and decided to use a medicine called "TPA" to get her port working. It's been referred to as "Drano for the port". It is a stronger blood thinner than Heparin and it has to sit in the port for an hour in hopes of breaking down any kind of blood clots that may be clogging the port.

I thought that he administered the TPA at about 12:30pm. We later found out that this wasn't the case. But, I will get to that later. Katie had additional testing scheduled today for her heart and I had the bright idea that we could get that out of the way while we were waiting for the TPA to do it's magic. So, the Nurse Practitioner called the cardio lab and told them to come and do the testing on Katie. First, she had to go and have an EKG.

An electrocardiogram (EKG) is a test that measures the electrical signals that control heart rhythm. The test measures how electrical impulses move through the heart muscle as it contracts and relaxes. This consisted of about 10 small stickers being placed all over Katie's body in order to connect the wires from the EKG machine to her body. Now, this doesn't sound too bad. But, Katie freaks out whenever she has anything ripped off of her skin, such as these high stick stickers for the EKG. This was another scream-fest.

After the EKG, it was back to the infusion room for a few brief minutes. Then, we were told that the technician was there to run her ECHO tests. An echocardiogram (ECHO) is a test that uses ultrasound to evaluate your heart muscle, heart valves, and risk for heart disease.

No one really thought about the fact that Katie's port was accessed and it sits directly over her heart, thus making it quite difficult for the tech to get good pictures of her heart without pressing on her port and trying to maneuver the transducer around the needle in her port. This fairly simple test ended up being 45 minutes of torture for Katie because her port was accessed during the test. Why didn't anyone think of this???

After Katie's tests, the tech told us to wait for the cardiologist to look over the pictures and make sure they got enough information for the baseline tests. I assumed we were going to be waiting in the room for quite a while, so I went down to the infusion room to gather our stuff. This is when I found out that Peter, the magic man, never administered the TPA. My jaw hit the floor because I thought he had given it an hour & 1/2 ago and that they would be ready to take a blood draw as soon as all this other testing was done. I was TOTALLY WRONG. All I could do was shake my head and try not to scream at someone. UNBELIEVABLE!

As I was walking back to the other room with all of our stuff, I met Mike & Katie in the hallway walking back to the infusion room with the cardiologist. After we were settled back into our space in the infusion room, the cardiologist spoke with us about her testing and he informed us that everything looks normal now, but she that she will have these tests repeated every two years in case there are any late effects of the chemotherapy treatments she has received. Luckily, she did not receive "toxic" doses of the particular drug that causes the most heart problems.

After speaking with the cardiologist, Peter came back to administer the TPA...2 hours after the time I THOUGHT she had received it...UGH! Now, all we could do was sit and wait for the TPA to do it's job.

Tick, tock... tick, tock... tick, tock....

An hour later, the nurse withdrew the TPA and by golly, the blood came with it! I felt like we had struck oil! SO, now 3:30pm, blood draw was complete and sent to the lab. Nothing to do, but wait some more...

Tick, tock... tick, tock... tick, tock....

4:15pm - blood counts back, all counts look good, chemo administered and port de-accessed.

4:30pm - Finally on our way home from clinic - 6 & 1/2 hours later.

Second to last clinic visit couldn't just go smoothly, could it? This is just a reminder that it isn't over until it's over. Hopefully our next (AND LAST!) clinic visit will be much smoother than this and we can get out of there and CELEBRATE!!!!

This cycle will consist of the following:
Vincristine - Day 1 (same dose as previous cycles)
Methotrexate (oral at home chemo) - Days 1, 8 & 15 (same dose as the last cycle)
6-mercapturine (oral at home chemo) - Days 1-14 (same dose as the last cycle)
Dexamethasone (oral at home steroid)- Days 1-5 (same dose as the last cycle)

Next planned clinic visit will be in three weeks, Friday, October 1st.

I CAN'T EVEN BELIEVE I AM SAYING THIS.....ONLY 1 MORE CHEMO VISIT LEFT!!!!!!!!!!!!!!