The first problem started when I checked in at the lab. I told them I was there for a pre-consult blood draw, the girl tapped at her computer for a moment, and then told me that I wasn't scheduled for a blood draw that day since they had drawn blood two days prior.
"Uh, no you haven't."
"Are you sure?"
"Yeah, pretty sure."
"Ok, tell me your name again."
I didn't mention that I hadn't told her my name yet at all, making "again" a challenge, but I did give her my name.
"Oh yes, you are scheduled for a draw. Sorry about that. Just have a seat and someone will call you."
I have a long history of falling victim to medical lab screw-ups, so it was a bit disappointing to have this sort of thing happen at the SCCA. In this day and age, most medical centers have figured out procedures to make sure they aren't getting patients confused. And I know SCCA has them, as I've seen them in action. Not sure what happened to cause this lapse at their lab.
In any case, looking back this was a small problem. The bigger problem came when the nurse drawing my blood figured out that my body has gotten fed up with my chest port. And who can blame it? In any case, I was told that your body starts to coat the port and its related central line with scar tissue almost as soon as it goes in. None of this is a problem until that tissue covers the end of the line that sits in your vein, drawing blood or dropping drug into your bloodstream. Once that line plugs up, the chest port is basically useless.
Lucky me, my line was plugged. The first response is to see if you can make it work by have the patient try various positions while the nurse tries to get the blood to flow. So I was taking deep breaths, coughing, turning my head this way and that, raising my arms, lowering my arms -- all to try to get the blood to flow. After forty minutes, the nurse had what she needed.
So I went to my consult with my PA. Of course, it took so long to get the blood that the PA didn't actually have the lab results when she saw me. So she checked me out, decided I was "doing a good job,"* and so gave contingent approval for the infusion, subject to the lab results being fine.
Sadly, my results were not fine. When I got to the infusion center, the nurse came in and asked me how things were going, to which she reponded, "Oh, that might explain it." Apparently, the lab results suggested that I should be bedridden in a semi-conscious state, rather than walking the halls getting ready for an infusion. And while I wasn't bedridden in a semi-conscious state, they'd have to re-run the tests before they could start the infusion.
So back to the chest port which, by this time, basically completely stopped working. This meant two things: first, I got to have an IV stuck in my forearm so they could draw the needed blood and potentially give he infusion; and second, the nurse went off to see if they had space to conduct the potentially two hour procedure (two minutes of action, 118 minutes of waiting) to try to get my line to work,
Can I just say, the last time I had an IV stuck in my forearm, I was under anesthesia and getting prepped for surgery. I liked it better that way. I don't mind IV's in my elbow, but I don't like them halfway down my forearm. Only thing worse is when they stick them in your hand. Ick.
Anyway, blood got drawn and went off to the lab, and the nurse went off on a quest to figure out if she could work on my central line.
And at this point the battery on my phone died. Freaking Nokia. How can anyone think a three hour lifespan on a phone battery is adequate?
So time passed very slowly, but eventually the lab results came back showing that I wasn't supposed to be bedridden in a semi-conscious state, and thus the Avastin could be ordered, and the nurse got approval to screw with my line. It's basically a two-step process. They fill the line with a drug that's supposed to dissolve over a thirty minute period any scar tissue that's formed. They check, and if it hasn't worked they fill the line with a different drug that's supposed to do the same thing over a ninety minute period.
Cutting to the chase, the thirty minute drug didn't work so the nurse started the ninety minute drug fifteen minutes into my thirty minute infusion, thus potentially extending my already tiresome stay at the SCCA by another hour or so. Ugh. Happily for me, about halfway through that process after the infusions were done and the IV was pulled, she actually looked at my face when she said, "OK, just 45 minutes more and we can check the port" 'cause then she said, "Actually, why don't I just check that now and see how it's doing?"
It was doing fine. Blood came out easily, so she flushed the line and I was on my way.
Back to work for two hours of mandatory meetings, and then home for fifteen hours of sleep. Some days, just the experience of being a patient is exhausting.
* This cracked me up. Aside from taking my pills, I'm not "doing" anything. My cancer may be doing a good job, but it seemed odd to assign me agency for the biochemical processes happening in my body.
Sounds like SCCA was doing a pretty good job and working through roadblocks that can arise during chemo. I would interpret the delay as reflecting they are quite able to do what it takes and solve problems.
ReplyDeleteFor the most part, I agree. That said, I do think there were two issues that reflected something else.
ReplyDeleteFirst, I'd argue that in this day and age, every receptionist at every medical center should be trained to ask for name and birth date (or whatever identifier the place uses) before doing anything else. And given how careful the SCCA generally is about patient identification -- starting an infusion requires two nurses, me to state my name and birth date, one nurse to read my name and ID number off my wrist band, one nurse to read them off the drug bag, and one to read it off the computer screen -- I'm surprised the receptionist at the lab just assumed she knew who I was.
Second, I'd also argue that when my chest port failed, the person trying to draw my blood should've tried plan B rather than submitting a sketchy tube to the lab. Given how busy the lab is, I get that she didn't want to try to restore the chest port, but she could've inserted an IV like the infusion nurse did and drawn the blood that way. Given how wonky the test results wound up being, it didn't matter a whole lot beyond extending my stay a bit. But had the results been erroneous, but not surprisingly so, it could've resulted in my not being allowed to proceed with the treatment. That would've been bad.
Interestingly, I've heard from others being treated at the SCCA that IVs are something of a problem. The vast majority of people being treated have chest ports and, as a result, the folks providing treatment don't get much practice inserting IVs, and, like a lot of things, without practice they forget how to do it. That becomes an issue when a situation comes along where an IV is needed.
But again, you're basically correct that none of the problems were that big a deal, and they did eventually get sorted out.