freeio
Senior User
Joined: 20 Dec 2004
Posts: 116
Location: Guntersville, Alabama
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 Posted: Tue Jul 25, 2006 9:46 am Post subject: "Medical Standard Time" |
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How can a 90 minute chemotherapy infusion take all day?
Yesterday I was scheduled to back to Kirklin Clinic, in Birmingham, Alabama, for my bi-weekly dose of gemcitabine. The infusion consists of putting in an IV, and pumping in 1.5 Grams of gemcitabine, diluted in about half a liter of saline solution, over 90 minutes time. That shouldn't take but a couple of hours maximum, right?
A good fiend and fellow Sunday School class member picked me up at our business/home location at 9 a.m. sharp, for the trip to Birmingham. The trip was very uneventful, with little traffic until we went through Tarrant, near where Highway 79 intersects Interstate 20. Even the State Trooper was kind, by merely flashing his blue lights briefly to get us to slow down a bit. So we made it to the Kirklin Clinic parking garage at about 10:35 a.m. My driver dropped me off there, and went to visit with a friend, while I went on in to the Oncology/Hematology Department for my treatment.
The first stop was the lab, to get them to draw some blood. There is a blood test each time, to make sure that my blood count is high enough to allow them to give the the treatment. When I got there, the nice ladies at the desk could not find my lab order, so I proceeded to the Infusion check-in desk, where I checked in. They provided a copy of the lab paperwork, and I headed back there. The phlebotomist did a fine job, and drew the blood painlessly, letting me leave in less than two minutes. So far, so good. It was now 10:50 a.m., and my infusion appointment was at 11:30. So I sat down with four magazines to read, in the big waiting room. There were a number of interesting conversations going on (usually having to do with cancer and its treatment) so I participated in those as it seemed appropriate.
I made it all the way through the first magazine, the most recent issue of Fine Homebuilding, and time passed. By 12:30 I was well into my second magazine, and the crowd in the waiting room had changed, but I had not yet been called. At about 1:15 p.m., my name was called, and so I went to the infusion room door, but the nice lady informed me that there had been a problem. My blood sample had been lost. It had fallen out of the tray, got lost under the centrifuge machine, and they had just now found it. So it would be a while longer while they ran the blood tests. At about 1:45, they called again, and sat me down in one of the big gray recliners in the infusion room.
First there were the questions about any symptoms I might have. I always wonder how to answer these questions, because the cancer itself has so many symptoms, and the medications add their own additional set of side effects. So I answered my best, and then waited some more. A while later, the technician introduced herself, and began the ritual sticking of the hands. After this many treatments and hospital stays, my veins are pretty well used, up, and are hard as rock. So to complicate matters, it always seems to take multiple attempts to get an IV to stay in and flow. The first technician tried three places, once on the back of my left hand,and then twice on the back of my right hand, before passing the job onto another technician. The second lady succeeded quickly in getting an IV going in my right hand, and then all progress stopped. I sat there for about 25 minutes, waiting. This always happens, and yet it always surprises me. It would appear that until they get an IV working, they do not order the drugs from the on-site pharmacy. So after a considerable delay, the first technician returns with a big syringe full of an anti-nausea drug, and slowly injects that into my system. After another while, she returns with the diluted gemcitabine, and another large bag with more saline solution, and sets the pump to pump the gemcitabine in over about 100 minutes. OK, now there is nothing to do but wait, and wait I do.
It is rather cold in this lab. I understand why they keep it cold – it helps make it less likely that patients will feel sick to their stomachs, but it is nevertheless cold enough to be really bothersome. Twice I ask for a blanket, twice I am told one is coming, and none arrives. They are busy, I can see that, that does not warm me up any. I continue to read, until I doze off a bit. I have brought along a wool watch cap, and have spread my sweater over my top as best I can to conserve heat. Time crawls. In this room there are about eighteen of us, all waiting for the pumps to pump, and the fine poison to be injected. Time crawls even more.
By the time my pump ran out of gemcitabine mix to pump, half of the crew had gone off on break, and so the pump beeps and beeps for nearly ten minutes. The supervisor finally came over and shut off the alarm, but left me hooked up. After another ten minutes, the first technician reappeared, pulled off the tape, pulls out the IV, put a piece of gauze and some tape on the injection site, and I was free to leave. The clock showed the time to be 4:20 p.m. Then I had to find my ride, and she drove me through rush-hour traffic back from Birmingham, to Guntersville. So by the time I got home, it was 6:30 p.m.
So, for a nominal 90 minute infusion, it required nine and a half hours of clock time. In the process I missed my mid-day meal and meds (I had thought I would certainly be out of the infusion by 1:45 p.m., and that would be a good time to stop, eat, and take the meds, but that obviously was not the case).
About every other time I go down to Kirkln Clinic, the day goes weird like this. I call it “Medical Standard Time.” Things happen when they happen, and cannot by any means be predicted or rushed.
Sigh...
_________________
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whipple procedure, Oct. 21, 2004
28 days of radiation
56 days of Chemo using Xeloda
diagnosed as progressive recurrent pancreatic adenocarcinoma (Stage IV) Jun. 20, 2006
was treated with gemcitabine, oxaliplatin, and tarceva, which all failed.
Cancer blog: http://diehlmartin.com/cancer.html |
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