A day in the chemo ward

They are nice rooms, not a partitioned off dormitory like the old location, with a comfy recliner for Jim and a little couch for me. Blankets, snacks, tea, coffee, a TV with many channels and, of course, free WiFi. The nurses are profoundly helpful. They follow every protocol down to the letter; they wash their hands and lather up with disinfectant, they ask for Jim’s birth date and check every bag of medicine twice. Most importantly they can get that vein with precision the very first time they try. They do all of this with efficiency and good humor.

But I get ahead of myself. Way ahead. I thought I would describe a day of chemo from start to end. I will leave out the drive to Omaha as that is not the same for everybody. Your scheduled chemo time is 11:45 am. (This is a very long post. Do not feel obligated to read every word.)

 

It is still dark at 7:30 am or there-a-bout you check in for your lab work, very efficient and fast considering. Sometimes the waiting room is swollen with patients and family members. The day after Christmas it is not so crowded. Look around as some of these faces you will run into at each step of your journey. On this particular day there were two other couples approximately your age, one him, one her for the chemo. She has on makeup and a stylish green scarf. There is a mother with a girl child in a wheelchair managing the wheeled pole hung with her connecting medicines wandering around the waiting area. There is a 40ish rough looking fellow with a friend to drive him. You find out later he was checking in for a four-day. There is a 30ish African American woman with two 8ish children in tow. Six and eight? Eight and ten? There is one very feeble older man with his almost as feeble wife pushing him in a wheelchair. You don’t see them again for the rest of the day. You assume that he got checked in to the hospital. You wonder what happened to her. A lady with an older mother tells you where the nearest restroom is. The family of four is a puzzle. You can’t figure out which one is even sick. But you can tell it’s their first time. They are totally lost.

 

You get the picture.

After the blood draw you wander over to the little breakfast area… Although don’t, the food is not that good, but nobody notices the café on the other side of the stairs. They serve breakfast, but since nobody is in there you think they are closed. Next time you will try that. But there is a Starbucks so you get a big coffee and a bagel. The lady with the older mother scoots past breakfast. She already knows it’s bad.

 

The rest of the people file past with the doctors and nurses and security guards and maintenance people. Some go straight up to fourth floor. You follow. You check in to see the oncologist. In the waiting area some of your fellow travelers are already waiting. The man with the wife with the green scarf works patiently at the jigsaw puzzle. It’s a farm scene with an old red pickup truck in the foreground. The wife with the very thin husband (they can’t make that belt any smaller) shows him texts from their daughter who has made it home from her Christmas visit. She is already sending photos. The young mother and her two children arrive. They have breakfast in styrofoam containers from the place downstairs. The kids eat quietly waiting for their Mom’s name to be called. When it is they close their containers, pick up their backpacks and quietly follow her. She wears a multicolored knit scarf. It is really quite becoming.

 

The mother with the girl in the wheelchair pushes her up and down the hallway for something to do.

 

When it is your turn the nurse takes your vitals and asks you the same questions your doctor will ask. The labs are done already. The doctor looks you over, asks the same questions and makes sure you have enough of the medicines they have prescribed to get you through to the next visit. The check out lady signs you up for the next round in three weeks and a scan.

You go to the pharmacy. You wait.

 

You wander over to the chemo unit stopping at the restroom in the hall. The husband of the lady with the green scarf gazes thoughtfully at the rain pelting the garden as he waits for her. They saunter toward the next check-in station. No hurry. You are all a bit early.

 

They young mother takes her kids with her into the Wellness Center across the hall. She has some questions they are happy to answer. The mother with the girl in the wheel chair passes you again. The girl is extremely good at maneuvering that pole! The family of four scurries past. You get the feeling they think they are late to check in. You are sure they are not. The wife and her too skinny husband pass you on their way back down the hall. As you expected, it is too early to check in.

 

You look at the rain pelting the atrium windows. You hope it has let up by the time you are through. You are thankful it is not snow.

 

You check in. You are too early. The woman with the green scarf and her husband are at the jigsaw table. This one is a colorful garden scene. The waiting room smells of coffee. It is ringed with folks who are on their own journey: a man in overalls playing a game on his phone, a father and son watching Jeopardy. Who knew that Jeopardy was on in the morning? You take a seat on an open bench and the skinny man sits next to you. Now his wife is unhappy about something their daughter sent. They look at the text together. He stands up and walks a bit. His right leg is already falling asleep. The mom with the kids finds a place for them all on a couch behind you. The young girl still carries her Styrofoam container.

 

The rough looking man has a suitcase and a backpack they escort him out a different door.

 

One by one you are ushered into the inner sanctum of the Chemo Ward. You are weighed and charted and taken to your room. See the second paragraph…

More questions: Did you take your medications as directed? Yes you did. At eleven o’clock last night you took five, 4 mg of steroids. You took them again around five o’clock when you got up to pee after drinking the correct number of liters of water you are supposed to drink before chemo. Then you just stayed up because you had to get up soon anyway.

 

They put in the line, right side this time because you did the left side last time. Done before you know it!

Then they give you your oral meds: Zofran and Benedril, then your first drip, 15 minutes of Zantax.

 

Then your second drip, about an hour of saline just in case you didn’t really drink all those liters of water. Then 30 minutes of Emend (Aprepitant) anti-nausea medicine.

 

Now the chemo part of the chemotherapy can commence.

 

First is your 30 minute drip of Keytruda (Pembrolizumab) your immunotherapy drug. During your first visit the pharmacist (Tom) told you that this drug removes the cloaking device from the cancer cells that keeps your immune system from recognizing them as invaders. Once that cloaking device has been removed your own immune system can step right up and do what it is supposed to do! You are happy to have it circulating throughout your body helping the chemo drugs kill your cancer.

 

By now you are bored out of your skull. It is a good thing they have the Animal Planet Channel so you can watch that crazy tree house guy build cool things for rich people. You are already starting to be uncomfortable in your comfortable chair. You wheel your pole down the hall to the bathroom.

The woman with the two kids is in the room next to yours. You wonder what she did with those kids because they are being so quiet you think they are not there. Then you get a glimpse of them through the blinds, both engaged with a project or a book.

 

The nurse suits up for your next treatment. The stuff that she is about to push into your veins she doesn’t want to touch any part of her. She straps on a full length apron, gloves and a mask. You make a bad joke about it. Another nurse comes in to verify all facts: name, birth date, correct drug on the stand. You settle in for the three hour drip of Taxol. Maybe you will nap. Your partner heads out to get some soup and a sandwich to share. She knows where the good sandwiches are sold. She leads three of the four confused people to the cafeteria.

 

You read. You try to sleep, but fail. You switch channels finding the news channel you like. That gets old fast. You move your arm wrong and the machine starts beeping. Someone comes in and pokes a few buttons and it stops.

“Can I get you anything?”

“No, I’m fine. Thank you.”

 

You try closing your eyes again and you realize you need to use the restroom again. You are getting pretty good at this. You unplug the machine from the wall and the battery kicks in. You maneuver down the hall. You note that the woman with the green scarf and her husband are already on their way out. You are happy for them, but also a little jealous. You have three hours to go.

 

You settle back into your chair just as lunch is delivered. Your machine beeps again. You understand by this time that every time your machine beeps the dripping stops, every minute the drip is stopped is a minute added to the treatment. You are determined to keep your arm still. Someone comes in and pokes a few buttons and the machine stops beeping.

“Can I get you anything?”

“No, I’m fine. Thank you.”

 

The sandwich is pretty good. It requires many napkins. Yum. The soup is only fair, but you eat it all. The machine only beeps one more time while you are eating lunch.

 

You chat for awhile then both of you try to nap. No dice. She decides to walk to the east end of the hospital and back to get a stretch of her legs. You wish you could go too. You move over to the little couch for a change of position. The machine beeps.

 

At some point in time you realize that the mother with the little girl attached to the pole has been entertaining her daughter by walking around the Cancer center while the chemo is dripping into her daughter’s arm. They are not waiting. They are killing time. Walking around the hospital as a distraction! How very clever! You wish you had thought of it!

 

During one of your restroom breaks you note that the mother with the two well behaved children is gone. A twenty-something brunette is waiting by herself in the room where they had been.

 

Three hours and seventeen minutes after it started the IV infusion pump begins its “I’m almost-but-not-quite-empty” thing. Those nurses get every last drop out of it! This takes about fifteen more minutes of beeping and fiddling and starting again. By then you just don’t care anymore.

 

One more bag to go!

 

The last thirty minute drip is another chemo drug, Paraplatin. Again the nurse suits up, another nurse comes in to verify all facts: name, birth date, correct drug on the stand. You are almost there. It is dark outside, but you can still hear sound of the rain splatting on the window.

 

You are hungry again. Your legs ache from sitting. You wish you could just apparate home, or had in your possession, at the very least, a Portkey.

 

Finally, you are done. A bandage is covering the hole in your arm where the IV line had been. You are lacing up your shoes and planning one last trip to the restroom. Your partner is picking up after you. You thank your nurses and head for the exit. A woman is standing at the door where they weighed you earlier in the day. Her husband is getting weighed. It is nearly six o’clock. They are just beginning.”