Sunday, November 18, 2007

Cluster Fuck

Tuesday, 11/6

We wake at the crack-o-dawn and head over to Georgetown, getting there around 0830 AM. They don't seem to have a room for me so they send us to the Bone Marrow Transplant Unit, 2 Bles. We "sign in" and go to the waiting room. G'town is packed and only certain units can do heart telemetry. I need a room b/c the drug to break up my clot (tPA) is quite potent and they'll need to monitor me overnight and make sure I don't have any internal bleeding issues. They often use it for stroke victims. So we wait. And wait. After an hour or so a Hematology/Oncology Fellow shows up and apologizes. They can't get secure a room. He sends us to ER.

Isn't that nice? Going to ER for a major, not-yet-medical-emergency procedure. Nothing more comfortable and disease free than an ER. Well, except perhaps a Gulag. Thank You. This is the first place on my list for where I want a procedure done. Off to ER we go......................

.............and ER seems confused. No one told them we were coming. They're also worried that since its not an emergency and I will be needing a room, then my insurance might pay for one or the other but not both. They send us to where I got my port, Intervention Radiology (IR). We "sign in" and hang out in the waiting room. It will be an IR Doc who will perform the procedure. Seems logical, no?

No. At least not "hospital logic"

Two Nurses come out and explain that they can't do it there and try and send us back to ER. We refuse. On Insurance grounds and Nasty grounds. It's nearing Noon. I'm near the point of telling them "obviously my condition isn't important to you. I think I'll go home and wait for your call when you have a room for me." I mean, for anyone who knows me, I'm on the edge of being so "done". We were told to get to the hospital early in the morning so they could secure a bed. With telemetry. A fancy machine that monitors hearts. Seems like a hospital might have an extra hanging around for these unscheduled events. Even though, God knows, unscheduled events, like additional patients, never do the "pop in" at hospitals. Yes?

They go back inside. They come out and put me in a room. A consultation room. My IR doc and one of his underling docs comes in and apologizes. He's very nice, actually. States the hospital is no longer big enough for the demand. I appreciate his honesty. A nurse comes in and tries to call the person in charge of securing beds. A few ER people pop in saying they're ready to do the procedure. My Oncologist and her fellow show up. basicall, my Onco is their to say "What The Fuck?" and "Don't mess with me or my patients". She's super protective of her patients and I love that. And currently acting Director of Lombardi Cancer Center. She's a force to be reckoned with.

Can you picture this? There's not enough room for all these professionals in the room, half are in the hallway.

So, in the end, IR agrees to do my procedure in there patient prep area. It's much like the in-patient infusion unit. A bed and a curtain to go around it. And, oh yeah, apparently a fucking telemetry machine!!! Where'd that come from????? I knew there must be one lying around the Hospital somewhere. IR is an interesting sub-field(?). If anyone's interested:


Now, I must get prepped before infusion. They roll me into an OR. and onto the table. Above me is an x-ray machine. The doc will pump a fluorescent through the mediport and see how the clot interferes with it. As they expose my chest an excitement builds. Most have never seen a dual port before. And never a port set up one on top of the other. Usually it's side by side. I soon have 6 people surrounding me and touching my chest. Thanks freaks. I ask for extra alcohol as they swab me down. An Infusion Nurse will access my ports since they are experienced. First she hits the top one, then the bottom port. She can't get blood back but maybe its b/c of the clot. She leaves stating a 99% confidence that the ports are accessed. A technician turns on the x-ray and it is clear the infusion nurse accessed the top port twice. Nice going. They have to go find another "expert". She removes the "lower" needle and hits the bottom port. Three sticks. I also have two sticks from them trying to access a vein for a drip. You'd think I'd stop feeling it. You'd be wrong. And know they can get blood back.

I can see the x-ray perfectly. And it's pretty cool. I see the needles in my two ports. I see the ports. The catheter runs up to my neck then makes a U turn and ends at the entrance of the Superior Vena Cava, right above the heart. I can't see my heart and I think I'm thankful for that. The doc starts flushing the fluorescent compound through. And sees........not much. he keeps flushing. I see it go through the vena cava. He can't seem to find the clot. He expresses this. stating nothing is interfering with the flow. "Oh Goody" I think. Maybe it detached and is in my Lung where it "shouldn't" cause Pulmonary embolism. Or he's an idiot. My confidence level is low. I give 50:50 odds on either.

Why not pull up the CT scan from yesterday?

He leaves the room and consults my Doctor. I think he paged him. My doctor, BTW, took me as a patient on his day off. Guess that was the only option. Guess this is a serious condition. Anyway, Doctor 50:50 comes back and says they won't need to give as much tPA as they had anticipated and it should take about two hours, instead of four, to infuse. I'm only confident now b/c my Doc showed up for the consultation. Back to the waiting area I go for infusion.

Infusion starts at 2:30. Woo Hoo. The Nurse who starts it won't be finishing it so she labels both lines, starts the two pumps, and leaves. Soon after another Nurse comes over. Apparently I need close monitoring. I make her aware of the fact that the Heart Telemetry Machine is not on. Yes, the machine they needed to make sure I could have this procedure, the machine needed in case the compound really does a number on me. She turns it on. And long, dull story short, I'm done. It's about 5-5:30. They're gonna release me. They say its b/c I didn't need a lot of tPA. I think it's b/c they don't have a bed for me. The Nurse stresses the importance of me not falling or bumping anything too hard for the next 24hrs. And to call 911 if anything doesn't feel right.

I don't think I could sleep without my 1mg Lorazepam. I wish Dani would take some.

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