It has been a long day. I think that's how things are when it comes to these Stanford visits. Let's see... what did I expect? I wrote:
(9:30) To the ITA for labs, cxr, ekg. (11am) To Clinic E to
meet with Doctor. (2:00pm) To the ITA for catheter and self-injection class.
Arrival at Stanford: The Infusion Room
In case you are wondering, ITA stands for "Infusion Treatment Area." I believe that's where I'll get my outpatient infusions, but, for today, that is where I will have my labs drawn. In addition to that, I'll have an EKG and a chest x-ray performed.
After my name was called, I left the waiting room and had my identity verified by the nurse.
"Would you like a bed or a chair?", she asked.
I was kind-of taken aback. A bed... for labs?!? Sit me on a milk crate, or whatever -- labs only take 10 minutes or so! But I wasn't about to be taken by surprise... I didn't get much sleep last night and if I had to wait long, I would rather take a bed a catch some z's. "Well, how long will this all take?"
"Oh, you're just getting labs. It wont be long."
So I ask for a chair and get taken into the infusion area.
It's not like at the cancer center in Berkeley. Instead of individual rooms, there are about 8 comfy recliners facing the center of the rooms. There are a lot of people wearing HEPA masks in here. We take a seat, and wait.
I play my DS, and wait, and wait, and wait. Almost two hours have passed and I still haven't seen my nurse! Barbara and I leave the infusion area, but I decide to inform as nurse anyways. Basically, I said, "I was supposed to get labs drawn at 9:30am (time was 11:20am), but I'm already late for the oncology appointment and I haven't even been seen yet. We've got to go." The nurse told us to wait a few more minutes, and made a few calls. Meanwhile, Barbara scrambled to the downstairs clinic to ensure that all appointments would not be lost due to a labwork delay.
The guy sitting next to me was a doctor. He was calling his patients, informing them that he would make appointments as-planned. I thought it was kinda trippy for a doctor to be sitting here with me, as a patient. Maybe that is silly, but still... kinda trippy.
The Oncology Appointment
The meeting with my doctor was pretty straightforward. First, she reviewed my latest Pet/CT scan. "Your scan was fine," she said. In addition, she noted that certain parts of the scan seemed to indicate that there was still some chemo activity. Meaning that certain parts of the scan were "brighter" because the chemo was still working while the scan was being performed. This means that my results are likely better than indicated.
Barbara asked if it was possible that my third ICE treatment got rid of all the cancer. "Sure," she said.
thinking about ICE, I inquired about the possible 4th ICE treatment. Apparently, my local oncologist misheard -- after my second scan, she never planned a 4th.
Next, she inquired about my health. So I told her all about the coughing and the throat (better, now) and whatnot. The throat soreness didn't phase her a bit, but the coughing, apparently, was cause for concern. If there was a viral infection, this could mean a delay in the treatment. A delay is no good. Still, she has to know... so she ordered a "nasal swab."
Later, when the scheduling nurse arrived, she systematically laid out the tools to perform the swab. She said, in her bone-marrow-biopsy-tone, "*sigh* As you know, I have to perform a nasal swap. It's a bit uncomfortable." At this point, I'm imagining her sticking a corkscrew up my nose... my mind is trying to imaging biopsy-level pain in the nasal region... not good.
Still, maybe I'm over-reacting. Hey! I've never had one of these done before! If a procedure is bad, then the nurses under-report the amount of pain. Otherwise, it's just-the-facts. Realizing this, I start to feel better. I even tell the nurse, "Hey, I haven't had one of these before. That means I have no idea what it's like... For all I know, the swab is fun!"
She looks at me for a moment. "I'm just so excited to give you this nasal swab", she says. "I can't wait!"
The "nasal swab" was a piece of cake -- just made me sneeze a bit. Probably something like snorting pepper. Anyhow, after the procedure, I say, "I wish I had three nostrils!"
"It's ok, I could just do it all again if you like."
Sensing the attack on my established delusion, I offer up one final attack: "Oh, I wouldn't want you to have to go through all the trouble of getting new tools. I'm happy as-is."
She nods... Victory!!! :P
She then talked a bit about Cytoxan, and how I needed to drink 3 liters of water when I was not in the hospital. She asked me whether I was good at drinking that amount of fluid, I said "Yes, when I need to."
Then Barbara said, "But not beer, of course."
*sigh*
I then get a quick lecture on alcohol. Bah. What was cool was that she said, "I've couldn't possibly imagine anyone even remotely wanting alcohol after Cytoxan!" O RLY? Is that a challenge? :P Just kidding.. I promised to drink no beer once BMT was underway.
Then, she hands us a whole heap of prescription orders and we run to the cafeteria for a quick bite to eat.
Catheter Maintenance and Self-Injection Class
Drives me nuts how they call this a class. They should call it a tutorial. Classes have students, plural. Bah. I even asked the nurse; they only give about 5 of these "classes" a week. I'll bet ya that they all had only one cancer patient attending.
ok.... let's try that again...
Catheter Maintenance and Self-Injection Tutorial
That's better.
So it starts with a video. I secretly wish to myself to see Troy Maclure (Simpsons) introducing "So, you've got a new catheter." It looks like a lot of work. And I can't go swimming, or have showers (without taping a bag over the catheter) -- I love showers! Bah. Oh well.
Then the nurse brings out a bunch of materials. It looks like we're going to re-enact the tutorial. Great, I learn the best this way anyways. She brings out a rubber torso of a female with a catheter installed and says, "This is how it will look."
I paused for a moment... "I certainly hope not!", I said. The nurse probably heard that a hundred times, but I couldn't resist. :P
Then we're presented with a video and demonstration on self-injection. Kinda funny how the lady narrating the video looks totally stoned -- like she's "self-injected" quite a bit herself.
The Pharmacy
We got tons of pills! Stanford wants Barbara to bring all my prescriptions to the hospital when I get discharged after Cytoxan. That's such a good idea!!! I remember getting out of my first ICE treatment, and having to scramble to get some Ativan. No chance of blowing chunks at the local pharmacy this time!
Still waiting on the authorization for the Neupogen. Apparently, my prescription for Neupogen (for two weeks) costs about 15 grand. Ouch!
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