A Punch in the Neck

Constant Reader, today I begin a new label on my blog. "Chemotherapy". It's finally here!

Please note that I am writing about yesterday. I post this late on Tuesday, yet the events of this post are from Monday. I have been blessed with a very social day. My mother visited, as did two of my closest friends (who happen also to be colleagues). Those visits, in addition to the poking, prodding, measuring, prepping, counseling, and other actual hospital-related occurrences made this a busy day!

Cycle 1. Day 1.
Word of the day: Patience


Sunday night I couldn't sleep. go figure

After hacking at the hospital wi-fi for a while, I finally fell asleep at 0300. At 0500 nurse Maryyyy awoke me for bloodwork and vitals.

I have two nurses named "Mary." One spells her name "Maire". She's Irish, 'natch. My overnight nurse also was Mary. Spelled "Mary." Clearly that was unacceptible, so I challenged er to come up with a different spelling.

Dutifully wrote her name on my whiteboard. She wrote "Maryyyy".

Now, those of you who know me know what happens next.

I pronounced her name.

Loudly.

"Mar-ee ee ee ee" with a nice, high-pitched, banshee roll at the end.

And thus she became Maryyyy.

So, after Maryyyy took my precious fluids and my other numerical particulars, I dozed for another hour before the ward's morning rhythm made it difficult to sleep.

There's a shift change at 0700 and 1900. The hours before and after the shift changed are noisy and chaotic-filled with bustle and shuffle and this and that and needles and arm cuffs and hoses and plugs and beeps and rings and clunks and grunts.

You don't come to the hospital to rest.

Maryyyy became Maire at the shift change, and the wait began.

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My first post from my first morning in the clink. I'm on three hours' sleep, nothing by mouth since 11:00 last night, awaiting a procedure. Kickin' it.

To Port or Not to Port

This nurse and that doctor and this resident and that administrator and a few dancing bears stopped by to update me on this and that and the other. It was a busy early morning. Though, I may have hallucinated the dancing bears.

Finally a decision:

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It will be a port. It will not be until 2-3 this afternoon. That will be a 15 to 17 hour fast on less than three hours' sleep.

And I realize that sounds like whining. It's not. I'm in a good place and a good mood. Hungry? Yes. Tired? Yes. But I'm not out digging ditches, and I have wonderful people around me. Rock on!

Yes, I was hungry, but that was tolerable. It was the dry mouth that was getting to me. Hospital air is dry. It's not crazy dry, like a small house with blown-hot-air heating. But it's sufficiently dry, such that after 12 hours with nothing by mouth, its irritating. I hadn't had cotton mouth in years. Ick.

So, the afternoon passed. They started another slow-drip bottle of saline (to keep me bloated!), and I waited.

I received two visits from the chaplain corps. The first was Father William (call me "William"), a Craig Ferguson doppelganger. He looked and sounded so much like the comedian/talk-show host that I kept expecting him to break out into some briliant "How to Train Your Dragon" Scottish-ism.

My other visitor was a charming, nattily-dressed gentleman (whose name escapes me at the moment). I had the sense that he was a Baptist minister—t'was something about his dress and presentation. In both cases I told them that I appreciated their visits, that I was doing very well (as nothing had happened yet), and I hoped that they would stop by in later in the week when I expected that things would get...different.

You see, Email, Facebook, and a visit from my parents kept the day moving along. I was not lacking entertainment. Social media, reading, the phone...all were working for me. I was in a really good place.

But then, it is Day 1.

And I'm still feeling fine; but that may change on a dime.

The Transporter

I was called down to get my port imported. I was told my Transporer was on his way.

I love the job title, and considering that the Jason Statham Transporter movies are among my guilty pleasures, as soon as he arrived I asked him if we would have our won theme music. (Seriously, flying Audis, over-the-top fight sequences, and Eurotrash club beat soundtracks are not my daily fare, but sometimes you need to sit back with the popcorn and just gorge yourself!)

We didn't have theme music, but we had a pleasant conversation. He was 35, but he didn't look a day over 17. He had been at the hospital for more than ten years, and he knew everybody as he wheeled me from building to building, I felt like I was being escorted by the Mayor of GUH.

We chatted, and it turns out her was getting ready to leave the hospital permanently. He finished his degree in crime scene investigation and was soon to be on the market to do crime scene analysis. Yep, he admitted to watching too much TV. But he took a course in the subject, loved it, and he's attracted to the dynamic adventure of it. Not so much the paperwork, but he said that for the money (which sounded pretty good), he would put up with it.

Good luck to him!

Waiting, More Waiting

I was wheeled and left in the hallway of the radiology center in which I would have my procedure. (As a reminder, installing a port involves entering my jugular vein to gain access to my vascular system. They then treading my veins with a long tube that connects on one end to my subcutaneous port, enabling the infusions to flow directly into my heart.)

I waited and listened, snuggled under three pre-warmed blankets. They keep that area cold—I believe to
help maintain a sterile environment, and because many of the radiology machines generate heat.

Eventually I was collected and briefed. I signed the permissions and got prepped. I gave them two warnings.

First, I warned them that I am chatty when under sedation. It was possible that I would talk through the entire procedure (and not remember a thing about it for years). I told the nurse the story of my wisdom tooth extraction (I think I was 18 at the time). When I emerged from the sedation, I couldn't figure out why everyone in the room had stupid smiles on their faces—like someone had pulled off a successful practical joke. I learned months later (of the nurses was friendly with my parents) that I had sung along to the muzak—throughout the entire extraction—and that they were amazed at my note-perfect performance of all the Barry Manilow tunes.

Second, I warned them that my resting heart rate is 43 beats per minute. Dear reader, if you are athletic, and you go in for a procedure, FOR GOD'S SAKE WARN THEM! most of their alarms go off if you drop below 50 bpm. And those alarms make them very nervous. I needed to let them know that I would drop into the high thirties—and it was OK!

I was brought into the room, and slid into bliss. The placed me on a wonderfully warmed table. It was lovely. The room might have been 50 degrees, and I got to lie on a heated mattress draped in oven-warmed blankets. The next thing I knew, I was being lubed (for the electric sensors) and shaved (for the incisions).

Pampered, I was. Lubed, shaved, warmed...how would this end? People pay good money for this!

Getting It Done

They started giving me sedation. I overheard Theresa, the nurse anesthesiologist, say "He nailed it...43." All was good, and I drifted into my twilight.

I won't tell you precisely where I went in my dreamland, but I can tell you that it involved two things.

First were visions of a specific woman and the positive resolution of my crush on her. No, not sex (shocking, I know!) It was lovely. That segued (in the way of Dream) into adventuring on various waterways on a stand up paddleboard. Visioning, I was. Alone and with company, in fine weather and not-so-fine, I early-spring paddling on my local reservoir and summer paddled in Maine. Lovely escapes.

As I paddled with my Lady of the Lake, dappled light and bliss, I was overcome by the oddest sense that someone had punched me in the throat. I emerged a little and heard some operating room chatter. I head a few grunts that may have been mine, and, indeed, I someone was punching me in the throat.

"Meh", I thought, and I dove back down into Dream.

You know how you're having a great dream, wake a little, and then try to get back into the dream at precisely the same point you left it? And you know how that happens...like...never? Not then. Not me. I opened my Dream eyes and found myself right back with her, riding the wave, splendoring the breeze, happy.

Sedation is joy.

And it was done. I emerged fully. They told me all went well. We as they cleaned up I lay there and we chatted about heart rates, triathlons, endurance events, and injuries. My people!

I spent one hour prone in the recovery room. With the major vacular incisions, I needed to keep my blood pressure steady and low (my normal BP is 117/68) to allow everything to clot and heal. Springing a leak is a bad thing!

Transporter II

When it was time to go, my next transporter appeared. He was a well-built, handsome lad from South Florida. Women and men swooned in his wake as he wheeled me through.

The best part wasn't his gorgeousness.

The best part?

We had a soundtrack.

When I asked him my standard question, he said: "what do you want to hear?"

What d'ya got?

"Christmas songs."

Cool! Let's roll!

And he whistled Christmas carols as we rolled.

It made my day!

Back at Home

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Just got out of procedure. Feel like ive been punched in the neck.
Oh, yeah, right t. Thats because i was juet punched in the neck.
Note, this is precisely how I typed it when I posted it.
Sedation is joy!

It was 1900 Monday night. The original plan was for me to start my infusions at noon on Sunday. We were more than a little late.

So, as soon as I hit the room, Maire was on it. She brought me some food (a fabulous sandwich procured by my parents earlier in the day and stored in the fridge for just this moment). and as I ate she started my pre-meds. For those in the know...

• Benadryl - 50mg
• Pepcid - 20mg
• Zofran - 16mg
• Dexamethazone - 20mg

These went directly into my new toy. It felt...weird. I noticed the temperature difference of the injections. One was warming, a gentle cascade of happiness passing along my soul. Another...not so much. Imagine a cool wave passing though your heart—like one of those ice-deep fears that sometimes befall you. That's exactly how it felt.

The Benadryl came last.

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Getting closer...just had my pre-chemo medications fed in through my port. Benadryl, Pepcid, Zofran, Dexamthozone. I felt the warmth of one of the meds—giving new definition to "heartburn" and e Bemadryl has hit me like a jackhammer.

I've got this...

Imagine someone walking up to you and smacking you across the face with a large fish.

That's exactly what it did not feel like, but the affect was the same.

It was shocking and disorienting and unexpected and mind-bending.

It was drunkenness without the taste.

It was stoopidity.

It involved drooling.

I. Was. Out. Of. It.

The rational part of me knew that I had an hour before they would administer my first actual chemotherapy. It wanted me to soldier through Delirium, so I would be lucid enough to respond to the infusion. Anaplylaxis is the initial side effect of Taxol, and I needed to be aware enough to read my body's reaction to the drug.

Meanwhile, little bits of me kept falling off. Rationality be damned! The residual sedation and the fresh Benadryl synergized somewhere in my metabolism, and I was a hot mess. I felt like a Popsicle on a warm day. At my core was the thin stick of my rational resolve. Everything else was melting.

With my hands free and my food eaten and Maire leaving, I quickly made two phone calls—one to the Little Angels, the other to my parents.

I have no idea what I said.

All I know is that I made contact, and it felt good.

I held on. It was exactly like the long chase I did during Pelotonia in 2011. Only now, my rabbit was the minute hand on the clock at the foot of my bed. I stared at it, willing it to change, to move, to advance, to tick...

And So It Begins

The clock stuck. In walked Bronwyn, my nurse for the night. Welsh. clearly, I am destined to be nursed and counselled by Great Britian—Scottish chaplain, Irish and Welsh nurses...for me, it's perfect.

She hooked the bags onto the IV tree, connected the tubes, and it started to drip. Chemotherapy began.

I would receive 520mg of Taxol (paclitaxel http://en.wikipedia.org/wiki/Paclitaxel) over 24 hours.

We chatted a little about nothing I can remember, both knowing that our talking was merely a pretense as we awaited any reaction to the meds. Chances were, if I reacted, it would be in the first ten minutes.

No reaction.

Nothing.

Thank the gods!

I relaxed, embracing the warm bosom of my medications. Twilight became dusk, and I slept.

Sleeping with the Angels

My normal-life sleep routine includes me waking 2-3 times every night. In the hospital, your sleep routine includes being awakened 2-3 times every night as they tap you for blood and measure you for temperature, blood pressure, heart rate, and blood oxygen level.

In other words, it was a normal night.

When I slept, I slept.

When I emerged, lovely female voices purred as they did things to me. When they left, I went to the bathroom, returned to my cocoon, and slept some more.

I passed a restful night.

And it was good.

What will be will be what will be.
I've got this.