What a Day

Well, it all started last Thursday when I got the news of a fungal infection and a relapse. It couldn’t get much worse and I was handling things pretty well. There were plans going on that were to take this shit out. The meeting of the minds had occurred and those plans were set in motion.

First thing out the gate was the fungal infection. It may seem like the cancer would be a priority but that would be wrong. Here’s how it goes. The chemotherapy that would be treat the cancer would kill off my immune system and the fungal infection would kill me. Not a good thing. So we were going after it with some hardcore anti-fungal amphotericin. Look at that thing. It is a huge macrocycle fused with a six member ring 18 chiral centers a boat load of conjugation and an active primary amine. I mean just wow. It is no wonder it requires some insurance approval before I can get this.  Either way it was on the way.

In order to save my veins for the upcoming anti-fungal and chemotherapy I needed a new line in. Doc Weiss was not going to approve a PICC line and I did not really want another. PICC lines are nice and they really helped with the infusions. I was really missing it when I was getting stuck at least 4 times a week. But there was a port. A port would allow me to take a shower and even swim. So a call was put in for a port to get put in. I received a call on Friday scheduling for a port on 19 Dec. I already had an follow up appointment with Wiess that day but it was okay for a slight double booking. I got triple booked when the infusion center called and put me on for amphotericin at 1:30. Big trouble was coming and I was willing to take it on. I had to wait till Wednesday to get the call for when to show up for the port insertion. I got lucky and they said 0630.

So space and I got up a “O-I should have just stayed up” time and headed out for the hospital. Because anesthesia does not work on me they could not do this under what is called twilight. I would just be awake as they cut into me. So they have to put me under with general anesthesia. I used to have a problem with that but the alternative is a lot of screaming and I am sure we want to avoid that. In any case, we got there and they prepped me for the first case of the day. Perhaps I should explain a port. Lets start with a PICC line. It is a peripheral line that is inserted into the vein at the arm and the tube goes to just above the heart. It works real nice because it can deliver medicine right to the distribution center of the circulatory system. It can save veins from some real harsh meds. It can save veins from getting stuck to death. The PICC line has drawbacks as mentioned above. The Port is another way to deliver meds right above the heart. Instead it is inserted just below the skin on the chest. It really kind of reminds me of a GC inlet port. There is a resealable silicone inlet that can be pierced repeatedly. Just look at it. That is it with a needle stuck in it. But that thing is inserted just below the shoulder and a line goes from it to the vein for distribution just like in a GC to a column. It also kind of reminds me of a Harkonen heart plug from David Lynch’s Dune so I am a little freaked out by that.  So I got prepped and the anesthesiologist stuck me with their elephant tranquilizer and explained some things to me. I had no idea what was going on. He then said he was going to inject me with something to help me relax like having a couple of drinks. I asked him why he couldn’t just give me a couple of drinks instead. He just laughed and honestly the next thing I remember was waking up. I don’t know what was in those drinks but they worked. They had installed the heaters because my temp dropped down to 95ish. In anycase, I got busy with the waking up. I knew I was on a schedule. There was not time to extend the nap. So as I recovered and woke up as much as I could. I got dressed and they called Space with time for lunch.

It was awesome. We went to Pauli’s and I got a Stromboli of meat. It was a delight of sausage, peperoni, ham and cheese all wrapped into carby goodness. They told me upon discharge from the short procedure unit to eat light so I didn’t eat the last couple of bites but I tore into that thing like it might grow feet and run away. Those sausage, peperoni and ham animals sure do grow delicious. I even had a regular cherry coke to wash it down. What a breakfast of champions. Then I was off.

I felt that it would be good form to kind of cancel the appointment with Weiss. He would understand and actually prefer that I get the infusion over seeing him anyway. So asked the ladies to pass on the message as to where I was going to be. I went and checked in at the infusion center two floors down with about 15 minutes to spare. How awesome was that. Well, no good goes unpunished. I should have known I was doomed from the start. The phlebotomist calls me back and draws out 6 vials of blood which seems excessive but okay. As usual after a blood draw I go back for some coffee but on my way back the phebotomist stops me. He forgot the other 3 vials. Wiskey Tango Foxtrot. I had to get stuck again. I am sitting there looking at the bloody hand that the anesthesiologist gave me. The most recently my good vein what hit by the guy I was looking at. That one was tapped. So I show him my right arm and say this all I got and no more. Three vials later he is done. So I go back to the waiting room and wait.

This is what I hate about afternoon appointments. Every other appointment before me that runs behind adds up and now at 2:30 I am still waiting. It happens and it is not anybodies fault. I get back there and everything is going well. I knew this was going to take some time. I was sat back with fluids and my old friend micafungen. I was prepared. I had books, stuff to write with and I had my laptop. Now was the time. I sat back with earplugs in and was catching up on some Star Trek Voyager. I love Netflix. I got some tylenol and benadryl then I got hooks up with what could be best described as chicken soup broth. I was told it would be a two hour infusion. So I sat back with another episode of Voyager ready to go. The pump started beeping because of some air in the line. Nothing to worry about someone would be around to start the pump up soon.

Then it happened. It all came crashing down. My stomach got all turned around. I was going to throw up. I unplugged the laptop and put it to the side and started toward the trash can but quickly realized I was not going to make it. I looked over and reached for the call button. I snatched it and pushed it like I was on Jeopardy. I knew that sometimes this does not work very well I decided to call for some help to the nurse across the way who was helping another patient and had her back to me. Nothing really came out. My voice was gone. My head was going spinny and it was going down quick as new symptoms were coming. Then it was Andrea and the Rescue Ninjas all on top of me. The blood pressure cuff was on. Benadryl was passed over and injected into the IV stream. The fluids were placed and running. I saw my blood pressure come out as it was spiking at 183 over 90. My kidneys were hurting real bad. The nausea was subsiding but I was still spinning on the inside. Some other stuff was injected in the line but it was happening so fast. And then my chest started hurting. I told them and they asked me to describe it. I thought about it for a second and said it was like something was grabbing my chest and squeezing. I heard the doc “call 911 now.”  I was going through anaphylaxis.

This shit just got real.

I started feeling better. At some point during all of this I said to call Space and actually gave out the right number to call. She hurried out of a meeting and was there on the double. My kidney pain subsided and the chest pain was going away. My blood pressure was going down and my pulse was no longer racing. I was on oxygen which is always good. Rose was down there checking on my and Doc Weiss was there as well. It seems like they were on their way when the got the call. Then the paramedics from the Philadelphia Fire Department were there with a stretcher and asking questions. They were sending me to the emergency room. I asked if it had to be the the Jefferson Emergency Room and they begrudgingly said yes. I was actually able to walk, with a wobble, to the stretcher. Down I went and took the 1 ½ block ride to the emergency room.

They got me in and it was all good. I was fighting the benadryl which wanted my consciousness. I got all checked in and then the docs started asking the questions. I had a phebotomist or tech I was not sure try to give me a stick. I gave them the back of my hand because there was no way I was going to give them my good vein for an IV. I don’t know what it is but those ER jerks are afraid of intravenous catheters like gays are to vaginas. Like there are gnomes down there. They failed at the IV stick and the doc determined that I did not need a new blood draw so they gave up. They wanted to observe me for about four hours to make sure none of the symptoms came back. So I took a nap and let the benadryl win and Space read some.

Just before 9:00 they let me out and were off for home. What a mess. As I was getting checked out I figured with such a disaster at least this meant that Arsenal was going to win this weekend. You here me Gunners. Beat Chelsea. Beat Chelsea for me.  Besides, I am running out of anti-fungal options.

Special thanks to Wikipedia for the amphotericin structure and port picture.

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