Practicing Medicine

As I stepped into the infusion center, a wave of apprehension washed over me. The cleaning team was recently in the suite. I could smell the sterile smell of disinfectant in the air. The lobby decor consisted of the same blue hue that I had seen in the other offices. Patients and accompanying family members were scattered throughout the waiting area. Some of their faces looked exhausted and worn out. I could only imagine the depth of their thoughts and battles they faced. I wondered if this were going to be me in a few months. I guess I would soon find out.

Checking in for my first chemotherapy appointment felt like crossing a threshold into the unknown. This moment marked the beginning of a grueling yet necessary journey. The friendly faces of the nurses and staff greeted me but I couldn’t shake the feeling of unease that settled in the pit of my stomach. My assigned nurse called my name and escorted me to a scale to obtain my weight. We then walked past the blanket warmer and ice machine to a treatment room. As we approached the room, I could feel the weight of anticipation bearing down on me.

Once inside, I settled into a comfortable chair. I had a room with a view. From this twenty first floor suite, I could see the city skyline. It offered a calming view as the sun pierced through the clouds,rising for the day. My blood pressure was checked and my port was accessed to obtain ordered labs. Before accessing the port a catheter, the area is cleaned thoroughly with antiseptics and sterile gloves are worn to prevent infections. This procedure involved inserting a special needle into the device implanted under my skin, on my right chest. Doing this allows healthcare providers to easily administer medications and treatments directly into my bloodstream without sticking me multiple times. A numbing spray was used on the site and then the nurse accessed the port. The numbing spray was freezing cold. It felt like my skin was burning. The nurse used pressure to push the needle through my skin into the hub for the device. The blood specimens needed were drawn from the site and collected in several specimen tubes. The site was dressed with a plastic covering to protect the site. After labeling the blood, the nurse flushed the line with saline. I could instantly taste the chloride. I was informed that I needed to wait 1-2 hours for the results to post. The lab work would confirm that I was stable and ready to receive the medication.

The process began with blood being drawn to compare my current levels to the baseline labs that were drawn previously to ensure that I was ready to proceed with chemotherapy. As the results came back and the medications were ordered, a sense of anticipation filled the room. I was informed that each medication would be infused for a duration of 60-90 minutes, with 30 minutes of rest or observation time between each infusion. I would need to take an oral and intravenous (IV) medication prior to starting the first drug infusion. The nurse gave me 650mg of Tylenol and 25mg of Benadryl IV approximately 30 minutes before starting the first drug infusion. This regimen was given to reduce the chances of having a reaction to the new medications being introduced to my body.

As the first medication began to flow through my veins, I felt a sense of anxiety wash over me. This was it. The moment I had been mentally preparing for. I didn’t know what to expect. It was almost as if I was waiting to transform into something. It’s crazy how our imagination runs wild filling in the gaps within the stories of the unknown. After the first 45 minutes of the infusion, I started to feel chilly. It started at my fingertips and then climbed to my wrists and then forearms. By the time the temperature changed in my forearms, my hands felt ice cold. I was in the room with my family, so I tried to hide my hands by burying them in my pockets. I called the nurse on the call light and told him I thought I was experiencing a reaction. He gave me steroids through the infusion line and slowed the infusion. About 45 mins later, there was another wave of cold that took over my body. Again, I was able to keep my discomfort hidden from those in the room. I looked at the time. I only need to get through a few more minutes. The infusion ended and now my body was given the opportunity to rest.

During the 30-minute wait, normal saline was infusing to flush the line of the residue of the first medication. I still had chills but was able to control the urge to shiver. As we ate lunch, the next medication was started. For the 45 minutes of this infusion, everything seemed to be going well. But just as quickly as the sense of calm settled in, it was shattered by the onset of rigors—a sudden, uncontrollable shaking that swept over my body. I pressed the call light for the nurse to come to the room. I could only speak through chattering teeth. My family told me that my lips suddenly turned gray and my entire body was cold. The nurses sprang into action, administering additional steroids to help alleviate the symptoms. The medication was stopped, new vital signs were obtained the oncologist was called. The nurse was instructed many the oncologist to discounted the treatment for today. My blood pressure and heart rate were high. Shear panic started to set in and I seemed to have gone into a panic mode. It became apparent that my body was not tolerating this treatment as expected.

The oncologist was called again. This time the order was to stop further infusions to ensure that my body was able to adjust. The uncertainty of what this meant for my treatment plan weighed heavily on my mind. Would I still be eligible for the clinical trial? Would I have to switch to harsher drugs before giving the investigational drug a chance to work its magic? As my anxiety continued to rise, so did my blood pressure. It was a physical manifestation of the mixture of fear and uncertainty swirling inside me. The nurses reassured me as best they could, but the reality of the situation was sinking in.

I just sat there in shear disbelief that my body wasn’t accepting of the medication that would help me. I instantly became disconnected from the room. My pulse was racing on the heart monitor. I knew I needed to calm myself down. The calm facade I displayed to everyone was quickly being broken into pieces by this noninvasive vital sign machine. I have never been the one to show my true feelings to others, so showing my vulnerable side was not the norm for me. Not being in control was truly driving me crazy. I was told that I would need to return to the infusion center on the next day to complete the treatment. The infusion center couldn’t guarantee a spot for me the next day, and I was faced with the possibility of having to remove my port access and delay treatment.

I started thinking quickly, trying to figure out a way to ensure that an opening would be made for me. So, I asked the nurse if I could deaccess my port. Of course, she told me no. I then told the nurse that I didn’t want to have my access removed and I would wait to have it removed at the end of my treatment session. Because they couldn’t just leave the port accessed, they had to schedule time for me to return. Through sheer determination and perseverance, I managed to secure an appointment for the following day. This would allow my treatment to continue without interruption. As I left the infusion center that evening, exhausted yet determined. I knew that the road ahead would be filled with additional challenges, but I was ready to face whatever obstacles came my way.