Well, Juan has survived his first day of chemo...but I'll start with yesterday.
Yesterday (Wednesday) we had the PICC [peripherally inserted central catheter] line placed. This is essentially a semi-permanent IV that goes into the upper arm and then follows the veins down to right above the heart. Chemo used to be inserted directly into a normal arm IV, but patients often found that the medicines would burn all the way up the arm. The advantage of the PICC line is that it drops the chemicals where the blood flow is turbulent and fast, thus diluting the chemicals very quickly.
The procedure is rather interesting and we had a nurse (Klaus) who claimed that he still found the whole thing fascinating despite having performed it thousands of times before. The insertion is treated like surgery, using only brand new tools for the sake of sterility. I (Amanda) got to stay in the room and watch/read. They started in the right arm, and got the initial insertion tube in, but found that the guide wire was catching on something. Watching them put the line in and out twice, trying to make it work, was when I had to leave the room and sit on the floor outside for a few minutes. So, they had to throw everything away: the gown, the tools, the tubes, the paper sheets, even the pair of scissors they had used (just once mind you). Then everything was resterilized, all new equipment delivered, and a second attempt begun on the left arm. Fortunately, this time the procedure went off without a hitch and we were home before noon.
Today, again, we had to be at the hospital early for the start of chemo. We all noticed right away that Kaiser takes special care with its oncology waiting rooms. They had a rocking chair, tables, puzzles for people to work on, and more comfortable seating than usual. The chemotherapy waiting rooms are even nicer: couches, large floor pillows, a library of oncology/treatment/self-help/survivor/spiritual/well-being books, CDs, DVDs, and a teddy bear. The doctor informed us that we would only be doing two chemo drugs for now instead of three. The explanation is a little long, and not very important to this blog, but the decision was satisfactorily justified to all three of us.
This time (I think because it was his first time), Juan was given a little private room where both mom and I could hang out whenever we liked. Strangely, although Juan could eat to his heart's content in his room, we could not....we have yet to figure out the reason for this, though a few theories have come to mind. Juan had to go through three 2-hour IV drips. The first was a saline solution combined with anti-nausea drugs. The second contained the chemo drugs. And finally a simple saline solution.
The second drug is to be delivered slowly and continuously over the next three weeks via a little pump that Juan wears on his belt. It's very quiet and surprisingly unobtrusive...so far. This means that we have to go in only once a week to get the pump refilled - a much simpler and more pleasant schedule and experience than we had expected. After three weeks the whole process starts again.
Juan has said that so far he feels no side-effects. However, the doctors warned that (like working out at the gym) it's not likely to hit you for about 2 days. I suppose we will see then what kind of experience he's in for for the next couple of months.
As we must all get up very early tomorrow: TTFN.
