Not that unexpected

Monday was the day I had several appointments scheduled in the hospital:

9 am blood draw

10 am meeting with oncologist

11 am Keytruda infusion

12:30 pm post operation checkup

2 pm preliminary meeting regarding radiology

But everything sort of went side-ways starting with the labs. My port had been removed during the operation (thank God), because I believed it was infected as it never really stopped hurting. It was implanted back on January 5th and after several weeks you are not supposed to feel it. Five months later, even wearing a t-shirt over it was sensitive. 

So now, the labs and the infusion would have to be done via regular IV. For almost two hours several nurses, including the specialist, were unable to find a vein for me, and we finally gave up. My veins are tricky, but this day probably some planet was in retrograde, and even with all the fancy equipment they were not able to draw blood.

And, consequently,  my schedule was in disarray, and at 10:50 am we met with my oncologist. She brought a study graph and explained that even though during chemo Keytruda is key, once the chemo is over, according to protocol there are 5 more infusions, but the efficacy of those is not that obvious. The difference of recurrence without these treatments is less that 2%, but the side-effects are still there.... so, considering that getting an IV for me seems to be in the realm of the impossible, we decided to forgo the left over treatments for now. So we crossed the Keytruda infusion from my schedule.

Operation day

Thursday June 1st, on the day of the surgery, Gwen dropped us off at 6 am at Faulkner Hospital. My surgery was scheduled at 7 am.

 After registration they whisked me away to prep for surgery: to hear about all the risks, to sign all the paperwork, to meet the surgery team, and --- most importantly--- to get the IV in. I always have trouble with the last one...

I am fair skinned with lovely blue veins, which are oh so deceptive, but no one was interested in listening to me. The nurse tried to get the IV into my wrist twice, but both times the veins popped leaving me black and blue. Now, I have been down that road so many times and I requested the professional IV people (turns out in MA you can always request one after two unsuccessful tries). The IV nurse was able to finally get the IV in, though painfully searching inside my vein for a while -- I was just grateful it was done at least in only one try.

I devote so much time to describing getting the IV, as it was the most dramatic event of that day. 

Once the IV was in, I was cruising down the corridor counting ceiling lamps... and then I woke up in the post-op station after the operation because George was squeezing my bruised hands. 

13 lymph nodes were removed, a breast lumpectomy, and, finally, the port was removed as well. The tissues were sent to the pathologist to figure out whether I actually still have cancer or not (diagnostically the only almost sure way to know).

We grabbed an Uber and by 12:30 pm we were already home. After wolfing down some leftovers, I crashed and slept for several hours.

So, of course I was super bruised and covered in bandages, but not much more pain beyond that, to the extent that I didn't even eat the painkiller tablets. I thought I would wait till the evening and eat one before going to sleep to hold me over through the night, but it never even got to that point.

3rd chemo

My 3rd chemo is done!✅ 

Most of the premeds are gone, so I felt a bit of a sting for the first time. My chemo was today, on Friday instead of my regular Thursday, because of the port procedure yesterday and we couldn't just skip it -- so Friday it was.

I actually asked to use a regular IV, because the port area is still very, very sore and painful and covered in 5 inch thick gauze that is impossible to take off.

Thankfully, the Dana Faber Center accommodated my request so the overall chemotherapy was a bit more uncomfortable, but easily bearable as I didn't have to deal with the raw wound of the port.

Port procedure

Three weeks into my chemotherapy regimen, after all the holidays, I was finally scheduled for a port procedure -- this time at Dana Farber in Boston. My overall experience at this location wasn't that great, though the actual procedure went well.

Who knew that within several weeks, I would play favorites! I so like my satellite office at Chestnut Hill (parking, easy registration, direct communications), that I am looking forward to going there tomorrow for chemo treatment instead of Boston.

After a flood of communication of where, when, and required preregistration, it turned out that I was supposed to be at a different building, different floor to draw blood, than rush across the street to yet another floor to check in, then brought along some convoluted labyrinth to the prep station. All this confusion at 7 AM in the morning

with nobody to ask is no fun. Then the nightmare of the nurse not being able to get an IV inserted started. She tried 5 times (!), which was excruciating and with each time she did it with more determination and less care, as if by sheer will her random stabbing would amount to anything. It turns out that large hospitals normally have an IV team that I could have requested... In comparison to that IV experience, the actual cut open procedure felt like a holiday! :)

So, back to the port. Until a month ago I didn't even know such thing existed or were highly desired. A port, per Doctor Google's definition: "A vascular access procedure involves placing a thin hollow plastic tube into a vein to permit drawing blood tests, and giving medications or transfusions directly into the bloodstream, over a period of weeks, months or even years."

In layman's terms, during an hour under local sedation in a bright white room (just like in all those hospital dramas), a small round blip was placed under the skin just below my right clavicle bone. I could hear everyone, see the gleaming machines that performed ultrasound and what else, but sorts of from very, very far away.

And now this will be used for all the blood draws and infusions, though I am hoping not tomorrow, as it takes several days to heal...

1st Chemo

Bright and early, after eating a few spoons of oatmeal and swallowing several steroid tablets, my daughter and I arrived at DF at 7:40 AM. After the mandatory Covid check-in on the 3rd floor, I headed straight to the labs to get the IV in and the basic pre-chemo blood draws.

The cubby-station felt like a luxury hotel -- light, aery, wall of windows. The lab technician wrapped a warm towel(!) over my hand, and then used some 007 spy looking stick to scan for veins, which glowed bright lime green. Surprisingly, the IV goes in the middle of the hand, and not in the regular vein.

After all the blood was sucked off, we met with my oncologist doctor and went over when/what/how. Long list of side effects and the schedule for the next several months.

We asked about medicinal weed candy to ease chemo aftereffects but were told to wait until a few days after chemo infusion...so no fun with weed for a while.

By 9:30 were already at the infusion center -- again, bright and cozy with a huge window; in the corner, a nice leather lazy-boy type chair that folds out as a bed with built-in heat, large TV screen and a first, lady with a snack cart stopped by, then acupuncturist.  

The nurse in a bright green garb was running around like a crazy chicken without a head because Dana Farber changed the infusion protocol and she had only seen how to do it via a printout. She was sweet and kind and talkative, and honestly, I got more tired from her talking, running around and asking different nurses how to do the infusion order, than the actual procedure. I guess this is a good thing :).

I got several pre-chemo infusions -- I remembered the one that stung for 15 minutes was Benadryl. Then the Taxol started... First chemo is usually done with lot of pre-drugs for allergies, nausea, etc. and at about two to three times the speed of infusion. 

Besides fatigue, I felt perfectly ok, so we didn't need to take breaks in between different drugs.

At 2:20 we were already in the parking lot, and home at 3 pm

First chemo ✅