There and Back Again

We did it!  We made it!  Fred and I, with the assistance of the very good-natured Ruby the Honda CR-V, arrived at the oncology infusion clinic almost on time!  I'll knock off the use of these annoying exclamation marks now!

The next visit will be much easier, as I filled out a novella of forms and produced redundancies of documentation that were then both scanned into the electronic medical record *and* photocopied.  Since they had so well established the theme of overabundance, the unit clerk supplemented the scanned and photocopied photo ID with an impromptu Polaroid of my cushingoid charms. So much for that pesky rumor about how an Electronic Medical Record garners savings of money and time.

It looked to me like three different records were being compiled:  a shorthand cheat sheet for use by the nurses right then and there; an electronic collection of my data; and an old fashioned paper chart. 

Once that was done, along with signing myriad permissions to bill, resuscitate, and transfuse, we were escorted into one of those huge, pseudo-cozy rooms littered with options to lay down, recline or rock.  I was still in the process of transferring from my wheelchair to the recliner when a clipboard began hovering before my eyes, along with the nub of a pencil.

"You'd best get started on this questionnaire.  It takes a while."

I was still filling it out when we left, which is not as much of an impossibility as it might sound.

The Head Ketamine Dood over at the Catastrophic Hospital had insisted I get this damned port implanted in my chest and connected with that major vessel called the subclavian. "I'll allow you to get the first treatment via a standard i.v. but if you show up for the second one without an implanted port, I will not treat you.  You need a port anyway.  You'll thank me for it."

You would have done what my doctors and I did -- move heaven and earth to arrange a surgical consult, pre-admission testing, and surgery itself -- all while dealing with the strange new world of subanesthetic ketamine infusions, and all within seven days.

That casual requirement of his cost roughly $13,000.00. 

I found the BardPort Titanium Implant for sale on eBay for $75.00 -- under the Buy It Now option.  Shipping added a hefty $11.95.

Fred and I are avid Do-It-YourSelfers, and we figure we could have handled the whole implantation thing with a minimum of fuss and a modicum of sterility for about $200 bucks.  That doesn't include antibiotics and Infectious Disease guidance.

Anyway (my preferred segue), after finally getting ourselves comfortably plopped in cushy seating, and accessorized with another ream of paperwork, I figured we had come to the easy part.  The staff had other plans, though, and insisted on taking vital signs.

On the off chance that my temperature, pulse, oxygen saturation, and blood pressure would turn out to be within shouting distance of normal, I abstained from my usual preface explaining why my numbers would probably be a bit off.  It was early in the morning, how bad could things be?

Right.

Phone calls, facsimiles, and expert opinions were made and sought, each costing me something, I'm sure, and wasting more of the earth's resources as old charts were pulled and ink was jotted and blotted on Big Pharma scratch pads, gifts from Pfohnzon and MerZenOtt. 

Resources.  Lots and lots of resources, human, natural, and electronic, all to flush and heparinize a port.

We finally determined that I was not likely to die this morning, I tidied up the assertions on my questionnaire (SEX? Yes), the nurse pulled the privacy drape around our little triad of chairs, and we got started...

Right after she finished scanning my plastic armband and each of the supplies, from 20 gauge non-coring needles (of the wrong length) to the 5 cc syringe of saline (we ended up needing four of them). 

Fred and I had developed a skit designed to so impress and delight the nurses that they'd agree to train us in the sterile procedure so that we could do it at home in the future.  We didn't make it out of the witty prologue before our nurse -- still desperately scanning -- panned the performance. 

"You can't do this at home.  You just can't," she explained.

Fred waited a beat and said, "But the lobotomy went off without a hitch!"

You could hear the gurgling lungs of the jaundiced woman across the room from us, it was that quiet.  Fred promptly buried his nose in an Illustrated Giant Print New Testament ("Easy on the Eyes!").

Gloved and masked, the nurse made quick work of prepping the skin, and inserted the needle with confidence.  She attached the syringe with 5 cc of saline, pulling back to check for a blood return... and there wasn't one.  I knew there would not be one but had decided against wowing her with my prognostications.  Besides, it could happen.  It could.  One day, I will have a PICC or even this same port, and there will be a blood return.

I believe.

I did let her know that I was a "saline taster," and that I had not tasted the distinctive metallic remnants after the injection.  She countered with "but I know it's in there, I could feel the needle hit the back of the port."

I said, "I'm just sayin'.  You know?"

That's how we ended up needing extra syringes.  Which is why she had to do more scanning.  Eventually, we found common ground.  I tasted the saline afterglow and she was confident of her placement, even without a blood return.  "Ha!" she crowed.

Fred, who was paying attention despite the red-lettered Testament, took that as a cue to try again, so he sat up and yelled in her ear:  "But the lobotomy went off without a hitch!"

It's tough to read a face covered with a mask.

She slapped a band aid on me, disposed of her sharps, and threatened to introduce some sort of medical Drano into the port when I returned in 4-6 weeks.  "Next time?  There will be a blood return.  Know what I mean?"

She cut off my plastic ID bracelet, made a few notations on the back of some gauze packaging.

As we wove our way out of what was now a crowded room, I tried to smile and nod at the pretty sad looking slew of cancer patients being infused with poison, and Fred wondered, in a loud and unfocused sort of way, if they gave out tokens to cover parking expenses.

Like I said at the beginning:  We did it, we made it, and next time will be much easier.

Courtesy of BARD Nordic