Tag Archives: canula

Checking out the opposition

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We know life likes to slip in little surprises now and then but this week has been exceptional for them. Firstly, we plan to make our first trip to Charing Cross to see the oncologist, have blood taken and then have chemo picking up Mr Mason jnr and Ms Atherton on the way back. All the timings are realistic – leave at 7am, oncologist at 11am, chemo at 2pm meaning we can leave shortly after 3pm. What happens is we get to see the oncologist around midday but have had bloods done in the meantime so that’s OK. She is reassuring about the pains I have been experiencing in my chest and upper back and shows me from my last bone scan where I have damage to my upper spine (apart from elsewhere) and prescribes a muscle relaxant to help with those. My chest is a bit crackly but that’s nothing new. We have time to go to Maggie’s to see lovely friends Ms Baranska and Ms De Roeck who are meeting there and manage to have a good catch up with them. We also see two of the staff who give us a ‘Good luck in your new home’ card with a lovely keyring and we are so touched that they have thought of us when they have so many people to look out for. So far, so good.

We make our way up to the chemo suite and are told my chemo isn’t up from pharmacy yet but that my bloods are OK so all is good. My friend Ms Greer arrives and the three of us sit in the waiting room discussing sanding worktops, Danish oil and the like. Time ticks on. We have arranged to meet Mr Mason jnr and Ms Atherton at 4pm so shortly before then I suggest Mr Mason goes down to explain the situation to them. Ms Greer and I go into the chemo suite just before 4pm and the pantomime continues. It is not the chemo suite’s fault the drugs are so late being delivered but then I have to endure what I can only describe as clumsy attempts to insert the needle into my portacath. And yes, in case you don’t know, it hurts. Quite a lot. Two nurses take a couple of goes each and I suggest other nurses in the suite who I know are proficient. One is summoned over – Rosie, who gave me my first and last lot of chemo the first time round. She manages to get the needle in first time and the two nurses who are sharing me are still laughing and joking about “It will take 3 hours now, OK?” My friend Ms Greer observes she cannot tell if they are serious or not. They know we have a long journey ahead of us and that our day started earlier than theirs but they don’t seem to grasp I am actually quite upset with the process. A little soothing would do wonders at this point but it doesn’t seem to click with them.

With the needle in, I am given chemo over 30 minutes when every time before it has been given over 90 or 60 minutes because it makes my blood pressure increase. I just want to get home so say nothing. Of course,by the time we leave it is around 5pm and the traffic is appalling. I am worried about how tired Mr Mason is but he wants to drive straight through and we get home just before 10pm, worn out and cold but luckily with pizza in the freezer so we can eat pretty quickly.

For the next couple of days I don’t feel really well. I make an appointment online with my GP so I can discuss the merits of changing to the local hospital but I feel really sleepy and exhausted all the time. I keep going to bed early so I’m not really making the most of seeing our guests who I have been really looking forward to. On Saturday morning, I wake in the early hours shivering. I know my skin feels hot but convince myself in that “I don’t want go to hospital” way that I’ll be fine. I wake a couple of hours later just feeling hot. I take some Domperidone as I feel a little sick, a little oramorph as I ache and ask Mr Mason to go and get some paracetamol from downstairs as I have run out in my drug arsenal. While he is gone, I take my temperature. It is 39.4. Ooops. Advice from oncology is always to go to hospital if your temperature reaches 38 and I know my normal temperature is in the 36 range so it really is high for me. Should we go by car to A&E or would an ambulance be faster? In the end, I dial 999 (first time for myself) and speak to the ambulance people who, given that I am not registered at the local hospital, say they will send an ambulance “in case they need to pull over to provide assistance to you”. The operator suggests I take a pull on an inhaler while I wait and get all my meds together. The ambulance is here in very few minutes and the paramedics come upstairs and assess me. They phone the hospital to see if they can take me straight to the ward and by-pass A&E. Luckily the sister agrees so we set off with Mr Mason in pursuit and Mr Mason jnr and Ms Atherton in charge of Dog and the cats.

We have a nice welcome on the ward and they apologise that they cannot put me in a bed straight away but that as soon as they have taken bloods and put up some antibiotics, I will have one. The nurse who comes to take bloods is obviously tired and at the end of her shift as it is nearly 7am. She says she will have a go but if it doesn’t work, she will pass it on to someone else “as I’ve been up all night”. I point out my One Good Vein helpfully and she manages to drag some blood out of it although it’s now buggered for anyone else to try using it. Then she has to put a canula in. This proves more tricky and I’m quite glad when she leaves after she just stabs a needle apparently randomly in the back of my hand. A very nice young doctor comes to try and I point out areas where canula have been inserted before but after stabbing me at least 6 times – (and twice in the wrist where, trust me, it really, really hurts) he calls a nurse from Intensive Care to come and have a go. She has clearly just been for a fag break and repeatedly says how sorry she feels for me, punctuating every bit of conversation with “Oh, bless your heart”. She tries again and again, finally getting one in the outside of my right arm. The sister, Bee, comes to put the antibiotics in by syringe but it really stings so she puts it into a bag and puts that up. After a couple of minutes, we notice my arm is swelling a lot so clearly the antibiotics are going into my flesh rather than my vein. Sigh. The Intensive Care nurse, Tina, comes back and wrangles my arm again, finding a spot in my hand that hasn’t been stabbed before but she hits the vein and the rest of the antibiotics go in. They also find me a bed on a ward with Gillian, who has been there for over 4 months, and Lena, who has also been there a long time. There is another lady there but she appears to be in extreme pain and it’s nice to see the staff are aware of this, putting off a scan she needs as she is asleep and they know she’s been awake most of the night. The nurse asks me what I want for breakfast and I opt for some toast which they also bring for Mr Mason. Every time an auxilliary nurse comes round asking about tea or coffee, Mr Mason is included. At lunch time, Mr Mason is given the left overs, for which he is very grateful. Gillian knows everything about everyone, having been there so long, and is determined to give us a good grilling. At this point I realise I am very tired and close my eyes, leaving Mr Mason to explain himself to her. She tells us intimate details of all the other patients at the top of her voice. Either they are deaf or past caring as no-one complains or tells her to shut up.

An oncologist is summoned from Lincoln to come and have a look at me. They don’t go in for privacy much at this hospital so even though curtains are pulled, people bark at the top of their voices. The oncologist tells me my bloods are fine and my neuts are particularly good (they are the white blood cells which fight off infection). They can’t find an infection but they know I have one. It might even be a virus. Thankfully they give me the choice whether to stay or go home. I obviously opt for the latter although it turns out that involves a four and a half hour wait for antibiotics I already have at home to come up from pharmacy. Not good. I am released into the wild, navigating the hospital and car park in dressing gown and slippers and we make our getaway.

It transpires that while we have been gone, we have missed a parade of 50 or so tractors which have gone past the house. Now, the road in front of our house is small and requires one car to pull to the side if another is coming so the tractor parade is clearly A Big Deal. I am sad to have missed such a rural treat, even though it has left Mr Mason jnr and Ms Atherton a bit bewildered. Happily she has filmed a little bit of it for me so I don’t feel entirely left out.

The following morning, the ward sister, Bee, rings to see how I am which I think is pretty good service. My temperature continues to go up and down for the next couple of days, causing me anxious moments, but decides to behave and just leaves me feeling drained and worn out. I am determined that we will do some nice things over the weekend so book us a table for lunch at the oldest thatched inn in Lincolnshire. I ask if we can have a table for 12.30 but am told they only have one for 12.15. That will do. On our way, we go to the imaginatively named Chocolate Drop which is a chocolate shop/factory in a place that looks as though people just go there to dump old tyres. It really does not sing ‘chocolate of exceptional quality can be purchased here’. Today it’s the male owner who serves us and he is keen on making us eat as much chocolate as possible which is nice but there comes a time when we have to declare a truce and just buy what we like best. When we arrive at the inn, we realise we have been there before and are a bit puzzled by the strict timing of our table as there are lots of free tables. But the food is good and the fish we have promised Mr Mason jnr will be the biggest piece he has ever seen, certainly as big as his head, is honoured and enjoyed.

I am rapidly coming to the conclusion that I will not be able to make my carefully planned trip to Charing Cross every three weeks. The delay over chemo and the stupid virus all have conspired to show me that things are not so simple as I have hoped so today I am going to see my new GP (appointment booked online with GP of my choice within a week) to discuss our options.

The case of the incredible shrinking woman

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Last week I spent time with my girlfriends, happily painting woobs. This week is somewhat different. Still not learning from the idea that I cannot plan a single day without things potentially going awry, I whizz off to my oncology appointment, telling Mr Mason that it will just be a normal appointment with nothing to worry about. I get blood taken and am called in to see the registrar as my consultant is on holiday. She asks me how I am and I tell her my breathing isn’t too good. I have noticed over the last few days that going upstairs makes me feel really out of breath. She is immediately worried and questions me about my temperature and any other symptoms. She decides to have my blood oxygen measured immediately and also to get me an emergency ct scan but first to go and get an x-ray to see what fluid is in my chest. Luckily, my friend Ms Marsden is on hand to keep me entertained and hold bags and clothing. The x-ray technician recognises me as is happening increasingly often, even in a hospital of this size.

The x-ray technician shows me a copy of the x-ray compared to the last one done in July and we agree there is less fluid there than before. He also comments on the camisole I am wearing in that the straps have plastic attachments whereas the ring which holds the straps is metal and therefore shows up on the x-ray. He tells me this is to do with costs and maximising profits. I wonder if he is doing a business degree in his spare time. We trot back to the oncologist who sees me again and she arranges for a nurse to insert a canula for a ct scan. The nurse who inserts the canula is friendly and comments on the bruising already on my arm from the blood taken earlier in the morning. Ms Marsden and I grab some food from the cafe and go to the ct scan area. Once inside, I am laid on the table while the iodine contrast is pumped into my arm. Now, with a ct scan you can feel the iodine go around the body as a flush which ends up by making you feel as though you have wet yourself. This happens within seconds but doesn’t happen this time and I can feel the iodine going into my arm but not the vein. I call out to get them to stop and the technician comes and rather techily detaches the iodine pump and tells me to sit with my arm up and an ice pack on. Then come the words I don’t want to hear. “You are going to go up to 6 South”. Aaarrrggghhh! This is a precursor to being kept in overnight which I really don’t want. I ask them to bring Ms Marsden in and we sit and make small talk until the porter arrives. He is also familiar.

Up on the ward, a nice oncology doctor, James, comes to see if he can canulate me. He removes the canula and puts a dressing on it. I seize the moment and nip to the loo only to find blood coursing down my arm and dripping on the floor, soaking my gown and causing me to shout “Oh, shit!” which Ms Marsden says was clearly audible from the ward. I grab a wad of paper towels and holding my arm up, make my way back to James who is slightly alarmed to see all the blood. He tries to clean me up and stop the flow of blood. The next thing is to put another canula in. But where? Another oncology doctor arrives. I have no idea of her name but she points to areas on me as though I am a piece of meat, taking my shoes off an examining my feet. i want to tell her she has to actually communicate with the patient rather than look at me like something on a slab but I am tired and really can’t be bothered to tell her something she should know.

Mr Mason arrives and relieves Ms Marsden who has stayed with me all day. The canula is inserted in my foot, an arterial blood sample is taken from my wrist and after the results come back, I am wheeled down to the first floor for another ct scan. The technician is tetchy, it being midway throuh the evening and she is even tetchier when she seems the canula is in my foot. She thinks this might not work but will grudgingly have a go. At least the iodine gets round my system this time and the technician says she thinks it will have worked well enough. I am back to the ward and Mr Mason goes home, without me. As there is no room on the proper oncology ward, I am left on the assessment ward but they give me a nice side room of my own and only disturb me 3 times during the night to monitor my vital signs and to give me a blood-thinning injection which hurts.

The next morning I am desperate to get out and go home. I don’t feel ill, just breathless, and I’m sure I can have a much better rest at home. Also my phone and ereader are rapidly running out of charge so I find myself resorting to reading an old copy of Chat or something similar and going over all the wrong answers on the crossword page. The consultant comes in to see me to say there is no blood clot, which is a relief, but that they don’t know why my breathing is so bad. They think it is damage from chemotherapy but that could be from a previous time or the 2 sessions I have had recently. It certainly means there will be no chemo today which is a bit of a blow. They are going to put me on steroids to try and help my lungs and then I may be able to have chemo the following week. Mr Mason arrives with toiletries and chargers and I clean myself up and plug in all the essentials. The registrar comes back at 3pm to say I can be discharged and we then wait, wait and wait some more. Finally, at around 7.30 I am given the all clear and we are on our way home. Why it takes so long to discharge me is not quite clear but apparently involves the length of time it takes to get drugs from the pharmacy. I am also being given antibiotics for what they think is a fungal infection which might account for the pain in my osophaegus when I am having steroids. We shall see.

I arrive home to find a copy of a letter from my consultant written to my GP. She updates her on what had been happening (although the letter is now out of date) and tells her that my weight has dropped to 1.4kg. This is a shock even to me. I know my weight has been dropping but to be the size of a very small cat is beyond even my capabilites. Just another case of the incredible shrinking woman, I guess.

First treatments

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It has been a very trying week. After being in hospital to get some more fluid drained off, the next day we go to see the oncologist. She is frustrated. There is still no news on the plueral fluid but we all agree to go ahead with the chemotherapy. I will also get a referral to and ENT specialist as I have so much pain in my osophaegus which no-one can seem to understand. I am already sleeping propped up at night and still taking a mixture of pain killers to help dull it. The phlebotomist who takes blood is not the usual one and he seems obvlivous to the fact that inserting the needle in and pushing it around under the skin actually causes a lot of pain. After fifteen minutes of so of this, he hands me over to a colleague who gets into a vein on my forearm straight away. There are 2 research nurses waiting to take extra blood but the vein will only give enough for the basic tests so they fade away like sad vampires.

Thursday sees me in the chemo suite for the first time in a year. I am starting with Herceptin which has to be loaded. This means they deliver it over an hour and then I have to wait for 6 hours to see if I have a reaction to it. Firstly, getting a canula in is a major job and they use a vein in one of my fingers which is a little painful. I feel fine after the infusion although that feeling gradually fades away. By the time Mr Mason arrives at 5pm, my blood pressure is shooting up and my heart rate is high. A doctor is summoned. She has to take a full history which takes some time and I am constantly monitored. The unit has emptied out and apart from 2 patients who are waiting for transport, it is just me, Mr Mason, a doctor and nurse. The doctor asks for some bloods to be taken. I feel so ill and it takes quite a while for the nurse, who should already have left, to get anything out of me. The doctor rings the on-call oncologist who agrees I can go home if I take some blood-pressure medication as soon as I get in. We finally get home at 8.30pm

Friday I am back in the suite and they are very unhappy about trying to canulate me again as Docetaxel is not something they want to put in a vein that might burst. The nurse takes around 45 minutes to get a canula into my next finger and it is strapped down as firmly as possible. The first drug, Perjeta, goes in over an hour and I manage to sleep through it. After that, we have to wait for an hour to see if I have any reaction to it which, thankfully, I don’t. Then the anti-sickness meds go in and finally Docetaxel. Somewhere around 5pm I get a visit from Ms Cantini and Mr Tozer who have been to the radiotherapy unit. I also get a visit from Steve, the unit’s administrator, who tells me he is leaving during the middle of next week to go temping. He had seen my name and remembered me from last year and I feel so touched he has come to say goodbye. Steve was the person who was so witty during the ‘Dont’ call her Beryl’ incident nearly 2 years ago. You’ll probably have to delve into the archives for that one.

We eventually leave the chemo suite at 6pm, tired and just weary of the whole thing, My appetite is not great at the moment so we stop at Tesco Express to buy some eggs and, a current favourite, trifle. Scrambled eggs and trifle slip down easily so they are currently on the menu quite a bit. Mr Mason gets some fish and chips from our favourite shop as he is so hungry and I know he is tired. He is always up earlier than me and is also decorating my office in addition to doing all the housework and walking Dog. It’s such a lot for him so fish and chips is the least I can do. He breaks off a little piece of fish and puts a few chips on a plate and that’s enough for me. I take a raft full of drugs and then get into bed. I am so physically and mentally tired, I just need to get into bed and stare into space. It’s such a lot to take in but at least we’ve begun the treatment which I am glad about. The oncologist did say that if I tolerate Docetaxel well, I may be able to stay on it long-term. Hmmm. Not so sure how happy I feel about that but we’ll have to see how things go. We are hoping to treat this as a chronic condition but won’t know if that’s possible until after we have a couple of treatments under our belts.

So were basically doing OK and looking forward to visits by two separate groups of friends next week. It’s not going to be an easy road this time, not that it was last time but last time we had hope of cure and this time that’s not possible. Sorry, a bit gloomy this time but that’s probably all the drugs and I know I have loads of people routing for me and that feels good. Thank you.

Allergy redness

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It’s been a busy week. Working in Southampton, seeing Fran and Rouzbeh off to live in Bangkok, an NIHR training day and then, on Friday, a minor procedure to have my portacath removed. I’ve been here before. This is portacath number 2 which is leaving me, having done sterling service since October 2012. Portacath number 1 lasted from April to October and then gave up and now lives in a plastic pot, sometimes on the mantelpiece, sometimes in the box with all my cancer memorabilia.

The day is a glorious one and I arrive before 9am, empty and thirsty and go to 6 East, the Chemo Suite, where the oncology registrar has told me to go. It is the wrong place. Steve, the receptionist who has made my visits to the chemo suite entertaining, tells me to go to a different ward where they are expecting me and I am admitted and given a bed. My obs are done several times by different nurses who are polite but ask the same questions over and over, including asking if I am allergic to anything. I tell them I am allergic to all dressings except one called Mepilex. I am so tired from not sleeping well for the last couple of nights that my book doesn’t keep my attention so I stretch out and doze, hoping I am not drooling or snoring too much. Around 1.30 the ward sister comes to put a canula in my hand.This can be entertaining in that it is extremely difficult to canulate me but this woman means business and tuts over my veins, slapping my hands and arms repeatedly. She then fetches a bowl of very hot water and plunges my hand into it. It is way too hot for me so I pull my hand out but she pushes it back in, so we endure a little playful push and pull with me saying “Ouch” and the sister talking to another nurse and not listening to me. Eventually the water cools sufficiently for me to put my hand in and leave it there while she rushes off to deal with some emergency. When she comes back, my hand is bright red but even with a torniquet and repeated slapping, the veins in my hand won’t play. She searches my forearm intently, looking for any rogue veins which might not have hidden themselves too well. With choice of just one, she is limited. Looking in the crook of my elbow. she spies a site which was raided by the phlebotomist only the day before and swoops in. I’ve been stuck with a canula so many times now that I can pretty much tell when a needle has hit the right spot. It hurts a lot more if the vein isn’t punctured properly or if the needle passes right through. She plunges the canula into me, repeatedly withdrawing the needle almost to the skin and then wiggling it about again. She pulls the plunger and a little blood makes its way slowly into the line. She looks pleased and I can tell she thinks she has got it. She presses the plunger to push saline into me and I can feel it swelling beneath my skin. “I’m not sure it’s in properly” I say, trying not to teach her her own job. She purses her lips. “You saw blood drawn, didn’t you?” “Yeeeesss” I say, reluctantly. She says no more but proceeds to stick the canula down with almost an entire roll of sticky dressing. Not a single piece of Mepilex and I feel our relationship will deteriorate further if I mention I am allergic to it and it will make my arm red and sore.

Then the porter is there and I am whisked down to the Vascular department by chair. We chat all the way which is nice. Several nurses stop by my cubicle to say hello. Kingsley is a tall, African Caribbean nurse and he tells me he is there to take special care of me. I am looking at something on my tablet and he asks if I am a writer. I tell him I write a bit, thinking of this blog and the other things I write. He tells me he also writes but he specialises in poetry and spiritual writings. I am given a gown and eventually am taken into the operating theatre but not before one of the nurses has put a theatre hat on me. I tell her I did not wear one last time I had this procedure and she looks confused until I tell her I had no hair then.

The surgeon arrives and says a vague hello to me whilst bustling about and then counting out instruments with one of the theatre nurses. Suddenly he is all business and is giving me sharp injections in my chest. I wince. “Yes, it stings, doesn’t it?” he says cheerfully. I ask if I can have some sedation but he says it’s too late and that it won’t take long. “I’ve given you loads” he says in an admonishing tone. Shortly after this, he begins his work. I am unable to see what is happening as a theatre cloth is placed over my shoulder and covers half of my face. I’m not sure I want to twist my head to look while he is fiddling about with my jugular vein. Whilst I cannot feel pain, I do feel a lot of tugging and rough treatment. I feel him wipe blood away frequently and then, he is chatting with a colleague who appears to have just wandered in. They discuss colleagues and generally indulge in gossip while I lie there. I am hoping he is not too distracted as I don’t wish to spend my last moments listening to the surgical equivalent of boy racers. One of the nurses eventually shoos the other doctor away. “You’ll just feel a bit of pressure here” he says, pressing heavily on my neck. Afterwards I discover a large bruise there. He begins to sew me up and I ask him to make sure he does a good job to which he just grunts. The contact between us is minimal and I feel I am a bit of inconsequential meat to him. The nurses are different and want to interact. After he’s finished and the last of the sheeting has been taken away, and the huge adhesive mat he has stuck to me has been painfully peeled off, he asks for a container for my portacath which he presents me with. I am slid onto a bed, covered with a sheet and wheeled off into the recovery room.

The recovery room is a much better place to be. People (ie nurses) hang out with you, get you coffee, sandwiches and generally chat. They tell you what they are doing apart from nursing and know where the biscuits are kept. One helps me remove all the adhesive tape the nurse on the ward covered the canula with. The inside of my elbow is bright red where it has complained about the adhesive. ‘The canula wasn’t even in properly’ says the nurse as I remark they didn’t use it. They keep me for another 2 hours and then the magic hour of 5pm dawns and I am released into Mark’s care and we go home. The anaesthetic wears off and my wound hurts. A lot. It feels as though someone has taken a sharp implement and plunged it into my chest. Oh, wait… I take every painkiller I have in the house apart from morphine but it wakes me every time I move and hurts when I lie down. I wonder about the surgeon and whether he is having a good night’s sleep. The pain is so different from my previous experiences and I wonder how having something foreign removed could hurt as much as having something inserted. I also wonder why everyone asked me about allergies and then proceeded to use something I am sensitive to. As I write (Monday) the redness has gone down on my arm but the nurse taking blood from me today gasps as she sees the damage. My chest is a battlefield of scars, burns and allergy redness. Now there’s a name for the paint manufacturers to conjure with.