I'm Not Sure What to Do with This

So $30,000 Thursday is over and, as usual, it was a mixed bag.

First, in the positive category: my tumor markers have dropped significantly since I started on the irinotecan. Prior to starting on the current regimen, they were hovering in the mid to high thirties, but the most recent value was thirteen. So yay for that. But the weird thing is that I've gotten so used to bad news, I'm actually not sure how to process this first bit of good news I've had in a few months. Ah well, I'll figure it out. 

Next, in the you must be kidding me category: today I learned that it is in fact possible to have both diarrhea and constipation at the same time, and I got a whole education on how to medicate for that. In fact, there was a whole host of drugs pushed in my direction today, but more on that below.

And third, in the negative category: there was a whole host of drugs pushed in my direction today. We'll ignore the suggested drugs for various bowel movement issues, and focus on the more alarming suggested prescriptions. The first was for a drug whose name I don't remember, but it's an injection designed to boost your blood marrow into making more white blood cells. Apparently, my white blood cell count is starting to drop. 

The next suggested drug was, I kid you not, Ritalin. It seems 33% of chemo patients suffering from fatigue find that a daily dose of Ritalin helps them feel more energized. 
Ritalin? Really? I'm sure I'm an ill-informed yutz, but I just have no interest in starting up with that particular drug. 

And finally, after nearly a year of seeing a variety of health care providers at the SCCA, someone finally brought up the subject of medical marijuana. 

I have to say, it felt a little drug pushery today. Particularly, because in every case the drug in question was offered up as my choice. "Your white blood cell count is a little low. Want a drug for that?" I don't know. You're the health care professional. You tell me if I should want a drug for that. I mean, on the one hand it's nice that my opinion is valued, but on the other, even I can tell that my opinion isn't actually worth very much. 

It was sort of weird. 

And for the record, we wound up with a yes on the white blood cell treatment, a no on the Ritalin, and I've already got a ton of (medical) marijuana, but still can't figure out how to make it work as intended. So it sits in my cupboard and mocks me.

Last bit of commentary, this time from the infusion. I had two nurses handling today's infusion because one was still in her training mode. The trainer nurse was one I've had before, and who cracks me up. She's a lot of fun, and very communicative about what's going on which is really nice. In any case, things started off bad in that my blood pressure was too high. They can't give chemo if the first number is above 150 and mine was at 156. Then 164. Then something even worse. So we all start yakking about how many times they can measure, how many times they can measure without entering the numbers into my medical record, how I should position my body to try to bring my blood pressure down, etc., etc., etc. After about the fourth or fifth try they got 146, so we were good to proceed.

At which point my chest port failed. They can't give chemo without first getting a blood return on the central line, and my line was not producing blood. So now we have three nurses in the room all monkeying with the bed to try to get it positioned so that my head is below my feet, as that sometimes helps. They finally got the bed correctly positioned, but it didn't help. 

So now they decide they'll pull the line and try to access it again, in case it's a problem with the way the needle was positioned. So I'm in the bed, still reclined, and the nurse pulls the line. And blood starts pouring everywhere. Normally, when you pull the line you might get a drop or two of blood. They'll usually stick a band aid on it, and when I pull the band aid a few hours later it'll be completely white. This time, the needle comes out and blood starts leaking down my chest, then down my neck. The nurse is pulling gauze as fast as she can to stop it, but the blood is soaking into the back of my shirt and the bed. It was a mess. 

But it stopped. And they inserted the new line. And it still didn't work. 

So now we have two options: drop the chest port for an IV in my arm, or run a TPA (not sure what that stands for) where they fill the line with a drug that's supposed to dissolve any blockages so it'll work. The problem is you have to wait a half an hour to give the drug time to work. 

Any guesses? Yup, we did both. And this, too, was an adventure.

Normally, there are two things I can reliably expect to hear from any suitable health care provide: first, that I've got excellent blood pressure -- and we've already addressed the fact that that's gone to hell; and second, that I've got really great veins that make it easy to insert an IV. 

Yeah, not so much anymore. The pour trainee nurse was patting my arm, turning it this way and that, rubbing this spot for a bit and then that, wrapping the whole thing in a heating pad, and then starting back at square one. I'm not exaggerating when I say that it took her about fifteen minutes to get the IV inserted.

But she did, and the drugs started flowing. and I started getting tired, and the rest of the afternoon became something of a fog. 

And it is on this that I blame the fact that I lost all three hands of Spite & Malice.