Downhill

I think everything went well today, but I don't really know right now.

I was supposed to be to the hospital early so they could do a H&P, but it was decided (later yesterday...no I was not called again) that my weekly visits with my radiation oncologist count for a H&P in the past 30 days. Unfortunately this meant I still arrived early which was shift change for the nurses. Partly because of shift change and partly because of all the last minute changes, no one knew what was happening. They paged the PA (physician assistant) and she told them to send me down to the dungeon right away. This was a over an hour early so the nurses weren't ready to pass me off that quick.

Before any of this was communicated to me I asked the nursing assistant to check into ordering a needle to access my port. The HUC (health unit coordinator) came into my room to tell me that last week she ordered a couple port kits specifically for me so they could make sure it was done before I went down. She then passed off one of these kits to my nurse.

My nurse decided to access my port asap. She did a good job, but for some reason it hurt like hell. Then she tried to flush it and I curled my toes and squeezed the blankets on the bed. I let her know it hurt and she did it again. Then she took some time to physically push on my port site A LOT. Hey, nurse friends I am going to give you a tip...If someone tells you it hurts like hell stop flushing!!! and sure as hell don't push on it like crazy!!! Since it is a port and I am able to tell her that it has been really positional (makes sense why later...ooooh foreshadowing) it would have been nice if she would have given me a chance to reposition.

Fortunately, I was saved from further torture by transport.

Once I got down to the dungeon I had a quick chat with my resident and then my anesthesiologist. It was a different anesthesiologist again, but she had already to talked to the others and knew all the drama about my port and that I am fairly specific with my requests. Honestly, she probably heard that I am a high maintenance pain in the ass, but she was awesome and possibly my favorite yet.

I told her about the pain with my port and that despite what she may have previously heard that I definitely want a peripheral (an iv) if it continues to hurt. When we got back into our procedure room and she tried it, and surprise! it hurt! Then she gave me meds and it continued to hurt. Possibly more important, I wasn't sleepy. I am typically a light weight and as she put it she gave me enough Midaz (versed) "to knock out a horse." She was surprised because she had also heard (and probably seen in my chart) that I am a lightweight.

Then she tried to give me propofol (another med used to help me sleep which can cause a burning sensation as it is administered through an iv) and I was started begging for an iv. At this point they were also using gas and I took the gas mask off my face to make sure they knew I meant it. If I had to rate my pain I would say it was a 9 out of 10 and I never rate pain above a 7 (with the exception of the whole retained placenta thing from Ella's birth, but we aren't going to talk about that...the birth itself though...a 7, maaaaybe an 8, and Ella was 12 lbs).

When I woke up my port was deaccessed, I had a lovely IV in my hand, and I was GROGGY! I don't remember anything about the ride to the recovery room today. I don't remember the equipment being switched over and I'm pretty sure I did not help with anything. I did remove my catheter as usual, but that was much later. I also had a chest xray in recovery room to see what the hell is going on with my port.

I was by all standards awake, but still secretively pretty groggy, by the time we got to my room. I convinced my nurse to take my iv out and then ordered food. About the same time I had a quick chat with my pa. According to her, the chewing gum spot on my cervix showed up on my MRI so it is probably scar tissue or tumor. I'll talk more with my radiation oncologist on Friday (she offered to page her but I didn't feel like dealing with it today-it won't change anything today). More significant to today, she told me she had talked with one of the NP's (nurse practitioner) from interventional radiology (the department that deals with my port) that I had talked with earlier while in recovery.

My chest xray showed that my port has "flipped" and it is no longer in my vena cava (a large vein from the heart that makes sure that the any medication injected into me is carried to the rest of my body quickly). This is NOT good, very not good. There was discussion about trying to manually flip it Friday, but we also discussed having the port taken out. We'll see. In addition, I was also told that my labs today weren't so great. I'm anemic enough that they debated giving me a blood transfusion (this may have still been being debated as I had my iv taken out thereby ended the discussion for today). Since I am below the cutoff for their department, I am sure this will be readdressed on Friday.

Also, my white blood cell count is 1. This is also not good and means I'm at high risk for infection. My neutrophils, a specific type of white blood cell, are also pretty low. This is also bad. Currently my neutrophils are above the cutoff for "neutropenic precautions," but any more dives and I'll officially have to wear a mask. My PA already told me that I should that I should start following the precautions so I guess no fresh fruit or veggies for me, no feta cheese, and strict hand-washing for all members of my household (that's going to go over well with the kids *eye roll*). My platelets were also really low, but right above the cutoff too.

I guess I know why I've been feeling so exhausted and crummy.

On the way home I decided to call my parents and see if they were available to help me with the kids tomorrow, in addition to their usually scheduled Friday. Then Geoff called his mom to see if she could stay through part of Monday to help too (she flew in yesterday from Abu Dhabi and was planning to come this weekend). This means all the days for the next week that I am usually a "stay-at-home" mom I have help. This takes an enormous weight off my shoulders because even though I may look "fine" or "good," I feel like crap! I don't want to miss out on the fun things with my kids, but I know I can't do it all right now. In addition my last didactic term (the next term starts clinicals...yay!) for school started yesterday and I keep seeing my classmates comment about our classes on Facebook, but I haven't even read the syllabuses (or is it syllabi?) yet. I guess I'll get some sleep and then see if I can get that much done tonight.