Saturday, April 29, 2006

4:18PM, 4/28/06

This might be a rambling, long ass one, but bear with me. I kind of feel like ass. More than usual. i will try to be entertaining as always. take your time. There are some necessary tangents in here. But I believe it will be damn entertaining!

4/28/06 9:35AM
We arrive at the hospital early. I've had only a few hours sleep and might be just a tad hung over. We have some Thank yous to hand off. 99% Of The Cancer Staff have been phenomenal. Incredible people with a gift of kindness like none I've ever seen. First we drop off a Card and cookies to the front desk people of the Lombardi Cancer Center. plus a personal card to my first Nurse Case Coordinator, Betsy.

Now we head off to the basement floor of Bles. My Dr. and her team have been relocated there. Dani is worried that it will tense, especially with Kim. i tell her not to worry and remind her: NO COOKIES FOR THEM!!!!!!!!

Last Monday Dani called Angela who is the Radiology Coordinator at Georgetown because we were told we could schedule my PET Scan. Angela, who is also amazing, says she never got the consent letter from my Dr. as needed. the Incompetent fuck heads started the process a month ago, supposedly. Two letters need to be sent; one to my insurer and one to Radiology. This is done by my Dr.'s Nurse Caseworker and the Admin Asst., Kim.

My last PET Scan "approval process" begin in December and I finally got approval in late February with a Scan in March. This was also a Cluster Fuck in which Kim was involved with my first Nurse Caseworker, Betsy. we learned the first time who was at fault because Angela keeps records of all conversations. A CMA procedure I assume she felt is very necessary, for obvious reasons.

So Dani calls Kim and very nicely asks what the problem is? kim seems confused on the whole procedure and then informs Dani She doesn't have time today to draft the letter because she has to go to clinic. Dani Relays this information to me. I reply:

"I'm done."

Anyone who knows me really knows what that means. I say it politely and calm but I'm on the edge of pure evil hatred. I'm pissed beyond description and barely containing my sicilian temper. i tell her to get ready, we are paying them a visit. i jump in the shower and think. All I can think is what Kim said: "I don't have time today". it repeats in my head and I start saying "No. No She did not".

i get out of the shower and dani is worried. she's never seen this in me and she's not sure if we should go. she doesn't think it will do any good if we piss people off. i tell her "I'm not waiting 3 months for my PET Scan. Nothing gets accomplished by Phone, i'm going to do this in person."

We head to the Hospital. Dani voices her concerns again; "I don't think a confrontation will accomplish anything." I respond: "Don't worry. I'm done with Kim. I'm going to her Supervisor"

In hindsight, Dani's concern was amusing. it's usually She you don't want to mess with. I think it threw her Since it was I who was really pissed off and she's never seen me like that. I think Dani thought I might hunt down Kim and tear her a knew one. LOL :D

We get to the Lombardi front desk and I tell them "I can't seem to get my PET Scan scheduled, may I speak with Kim's Supervisor?" Five minutes later the Clinical Administrator, Phyllis, comes out and invites us to her office. We calmly explain everything to her and her eyes bug out when we mention the 3 month approval process for my last Scan. And I ask in the most subtle sarcastic way I can: "It is important to get these Scans on time, no?" She assures us that someone is screwing up, apologizes, and promises to have this resolved in 24hrs after She talks with all parties involved. And no, not having time is never acceptable.

We walk out feeling very relaxed. Kim's gonna get reamed and I'm so happy about it. We've been so nice to everyone I have no qualms about this at all. it needed to be done and we didn't need to be worried about when my PET was gonna be approved. I need the Scan right after chemo is done. very dangerous to discontinue chemo if I still have Cancer.

It takes two days, but Phyllis calls us with the news that all is taken care of and we Can schedule my Scan when needed. Taint gonna complain about that. God Bless her.

We check in with Kim and have a seat. Med Tech Antoinette comes and gets us. We Love her. She draws my blood, takes my vitals, and then we wait. As usual, the Dr. is running late. finally a fellow steps in and does a preliminary. I discuss some newish symptoms.

My left hand is numb and tingles on occassion
My right hand is swollen.
I've had one decent crap in the last two weeks, the day before today, in fact. I've been crapping bricks, with some blood, and I went up to 6-700mg of the stool softener Docusate Sodium. i continued the Docusate for a full day after I stopped the Zofran. This caused me to have @8-10 unpleasent Movements each day for the next two days.

before last treatment I had a bloody incident which might have implied a hemmorhoid. My Dr. and I both seemed a little uncomfortable with the idea of a butt exam so we both agreed to see how things "progressed".

The fellow was only concerned with the possible neurological damage. since it wasn't severe he recommended that I finish my treatment. Thanks Einstein.

My Oncologist finally gets in to see me around 11AM. she was in a good mood and happy to see that I was about to "Graduate". she asked me if there was any other problems. When i said "No" she said, with a smirk; "No wrestling?" I blurted back "Oh plenty of Wrestling, just no problems."

This is an interesting communication "issue" The Last treatment I had complained of shortness of breath. The Dr. aske if it was resting shortness or during exertion. Dani and I play wrestle a lot and I exhaust quickly from that so i said "during exertion, when we are wrestling." The Dr. said "Wrestling?" I looked at Dani. The Doc is foreign. Dani decided that I might be using a euphemism. I wasn't. I just didn't want to embarrass dani so why mention the worse incident? it was a bad incident so i guess maybe I should have been straight forward.

Dani looked at the Doctor and said "Actually, it was while we were fooling around." DOH! It did look like I was gonna pass out after it happened. the Dr had a small smile on her face and I had my little shit eating grin. But for one of the few times in my life, I blushed a little. Dani's frankness blindsided me. the doctor approved me for a Pulmonary test after the PET Scan. Something else to schedule with the bag-o-incompetent shithead Kim.

The Doctors humor regarding wrestling made me smile like never before. But my lung capacity did seem better the last two weeks. we go back to Shitheads desk and schedule the Pulminary Test. It was rough. rough in that Shithead had to call the Pulminary tech and read the 'script verbatim. we then had a run in with the Nurse Caseworker who showed us a copy of the letter she sent to my insurer but admitted She didn't no Radiology needed one also. Oy vey!

It's @12PM now. we are late for my treatment in Infusion. we need to go to The BMTx floor and drop of cookies and a card for that Staff. We are kind of dissapointed my last treatment wasn't there but it probably, in hindsight, saved us some emotional blubbering. Almost all my infusion treatments were there and we became close. No one we recognize is at the front desk but the card has the 4 Nurses names on it that we dealt with the most. So we hand of the Thank You and run out.

Infusion Central: We hand off my chart to the desk and turn around to see Betsy. She Tracked us down to thank us for the card!!!!! Damn. Dani does most of the talking, tears welling up in her eyes. I say a few words and almost lose it. Damn it again.

I forgot to mention that my Absolute Neutrophil Count is low and to call the Doc for treatment approval. Apparently it's below the threshold where treatment is advise. Because treatment will knock it down more and I become highly susceptible to infection. And also my cell count may then be even lower for next treatment. However, I have no more treatments so I don't "need" to recover my cell counts in 2 weeks. i just need to be extra careful with hygiene. and if I get sick most likely it won't be worse than Cancer (knock on Wood). :)

So the wait is a little longer while they discuss my counts with the Pharmacy and then they decide to call my doc.

Vinblastine Label : "Do not remove covering until moment of injection. Fatal if given intrathecally. For intravenous use only." This warning is always attached to vinblastine syringes. A chemo drug with a similar name is delivered intrathecally, or in laymens terms: injected into the spinal canal. A healthcare provider, somewhere, inadvertently delivered vinblastine intrathecally. This proved instantly fatal to the patient on the recieving end of this mistake. OOPS. And thus they now know it's fatal through the spinal canal and now they have a warning label on all vinblastine syringes. This would be called an Iatrogenic Death. A nice way to say Death by Doctor/Nurse/Technician.

I remember "iatrogenic" from a report regarding an undetermined bunny death during my days at a Pharma Testing Company. They never proved I killed the Wabbit but the evidence pointed to an Iatrogenic "incident"! :D


At 2:30 I start treatment. the Nurse gets me with One Stick!!!! That is the advantage of the Infusion Nurses. They Hit me a lot better. First my anti-nausea meds. Then the Nurse does the two slo bolus pushes, 15 minute bleomycin, and then I get hooked up to the much anticipated 60 minute infusion of Adriamycin. Dani and I have been laughing all day. I'm working on little sleep and no food. And one point I go into my new laugh-no-air-intake routine and almost pass out. The end is getting near and we discuss the anti-climatic nature of this. i'll be done with chemo but not 1005 well. it's also anti-climatic because I've spent so little time in the Infusion Ward. we don't recognize the Nurse who delivered my drugs and she didn't recognize us.

4:18 PM: The Infusion pump stops. I note the time because it seems to be a milestone. From my beginning in the George Washington ER on 11/04/06 to the end of chemo at Georgetown on 4/28/06, 4:18 PM. We've been through a Lifetime, Dani & I. At least it seems to be a lifetime.

We walk out in our own little World, my arm draped around Danis Shoulders. She's quietly sobbing. I have tears in my eyes and I'm barely holding it together. I also have a smile on my lips. Today is one of the most beautiful days in my Life. The longest struggle of my life, for my life, is over.

In about two hours the symptoms will start. It will be by far the quickest onset of chemo side effects ever for me.

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