I left off in my last post with me getting my first chemo bag. When I returned home, the first few nights weren't too bad. I was a little tired and queasy, but I could handle it with a few tv shows and movies. Each day over the weekend, I returned to the hospital to have my chemo bag changed. Other than wearing a fanny pack and being pretty dang tired, I could go about my daily business.
Tuesday was the final day of my first cycle chemo treatment. The nurses removed my chemo bag and administered a drug called Cytoxin (the nausea drug) through my IV. Before the infusion, they gave me a triple dose of an anti-nausea medicine known as Zofran. The cytoxin infusion took a few hours, during which I was praying that Zofran would do it's job.
I'd have to say that not knowing what to expect is one of the scariest parts of chemo. You always feel a little on edge--what's going to happen next? How am I going to feel? Everyone reacts differently to chemo, so all you can do is wait and see. Thankfully, I only had a mild upset stomach the night of the cytoxin, not the terrible vomiting that some of the other patients experienced.
The following day, Wednesday, March 6, I returned to the hospital to learn how to give myself a neupogen injection. Basically, neupogen is a drug that forces the bone marrow to make more white blood cells since they become a victim of chemo. More on this later...
On Thursday, March 7, I again returned to the hospital for a procedure to eliminate the blood clot that had formed in my neck a few weeks earlier. When the clot was first found, the doctors at my original hospital believed the best way to treat it was to keep me on blood thinners over the next six to nine months in hopes that the clot would break up into microscopic pieces over time. However, when I was sent to the NIH, I met Dr. Chang, who has a different opinion.
When I first met Dr. Chang, he looked at me, looked at my scans, and then expressed his surprise that I hadn't been sent to him sooner. When I told him that my doctors were going to wait for the clot to break up naturally, he said , "Show me one paper that actually shows that happens." When he said that, I knew I was in good hands.
Dr. Chang developed a clot busting procedure, that if used within one month of clot formation, can completely dissolve the clot. His work is well known throughout the NIH oncology clinics, and everyone loves Dr. Chang. So, on Thursday morning, I found myself sitting in the interventional radiology clinic, waiting for him to work his magic on me.
The nurses took me into a room about the size of an average bedroom. A large X-ray device hung from the ceiling, and a very narrow bed was placed in the center of the room under the machine. I think the Beach Boys were playing softly on the radio.
Nurses were hustling about, setting out the tools that would soon be snaked through my veins. A male nurse helped position me on the skinny bed and slathered an anti-bacterial, blue liquid all over my left arm. Is it just me, or does anyone else get a sense of alien abduction when going through a procedure like this?
After about 45 minutes of set-up, Dr. Chang entered the room. Something I've learned about myself throughout this experience is that my perception of someone's competence affects my feelings of anxiety. When Dr. Chang entered the room, I felt at ease. I trusted him.
First, he used an ultrasound (the use of sound waves to make an image) to assess the extent of my blood clot. As he moved the ultrasound wand down my neck and arm, I learned that I had blood flowing the wrong direction in my left internal jugular vein (the big vein that travels down your neck and normally carries blood away from the head). That's not a fun thing to learn.
When the procedure to eliminate the blood clot started, I was given some nice doses of a very strong pain killer that makes you feel a bit loopy and out of it. They couldn't completely knock me out due to my blood pressure dropping to 90/37 at some point during the process. In the midsts of the haze, I could hear them talking about threading a catheter up through my arm into the vein with the clot. To visualize where they were going, they injected a contrast agent and used the big X-ray machine hanging from the ceiling. Once Dr. Chang reached the clot, he sprayed an enzyme directly onto the clot. He also used a small balloon to stretch and open up my jugular vein. Even with the pain killers, I could feel it!
At the end of the procedure, Dr. Chang appeared happy with his work and sent me on my way to be checked into the hospital as an in-patient.
To be continued...
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