Brianna, the Infusion Coordinator, did a great job of not only showing me around but also explaining the routine and what would occur on infusion days. From checking in, to getting my parking validated, to weigh-ins, to paperwork, she covered everything and showed me where the important things were located: fridge, microwave, and bathroom. I really appreciated the time she took to provide some orientation to this Infusion Newbie, and the fact that she did it gladly and graciously.
The infusion room was a huge space furnished with maybe 15 recliners in two rows facing huge picture windows. Next to each recliner was a small magazine-stocked cabinet with TV and headphones, DVD player, and electrical outlets, and a guest chair. Flip-up trays on each side of the recliner allowed for keeping phones, water, snacks, etc. within easy reach. Behind each recliner were the mobile infusion pumps/IV poles on their little rollie wheels. I'm SO glad I got to see all this beforehand; a pre-visit is definitely recommended for anyone who's gonna attend a series of soirees at an infusion center.
There were no special instructions for infusion day, so I showered, took my regular meds and vitamins, had a light breakfast of Special K Protein cereal with raisins and soy milk and a kick-ass cuppa coffee, grabbed my bag (already packed with over-abundance of books, magazines, water, pretzels, yogurt, cheese, and granola bars), and hit the road.
My appointment was for 11:00 AM, but was dependent upon chair availability. I checked in, turned in my paperwork, weighed in, and got fitted with a stylish personalized bracelet. The waiting area was full, so I sort of guessed they were running behind. But Brianna and her assistant were constantly checking chair availability and getting patients seated as soon as possible, so it was no big deal.
I was escorted to my chair and made comfy (having my own pillow and blankie from home helped), introduced to my nurse Peggy, and blood pressure and temperature taken. Arlene, the Oncology Case Manager, popped in to introduce herself and let me know about Sharp's cancer support groups, healing programs, complementary therapies, etc. While she had me thoroughly engaged, my left arm was prepped and the IV started and I hardly noticed. Think they figured out that the distraction method is the best way to do it?
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| Fashionable arm hardware..... |
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| .....tethering me to my new favorite cocktail. |
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| Let the games begin. |
The IV was flushed, and the Benadryl was started. Common side effects of Rituxan infusion are similar to an allergic reaction - itchiness, throat swelling, chest tightening, breathing difficulties - so protocol is to pre-med with Benadryl to get that on board before the Rituxan is started. I was given two Tylenol to relieve the fever that's also common with infusions. After that, I just kicked back and put my feet up.
The woman in the chair to my right and I began chatting; she had been getting chemo every week for two and a half years for leukemia, and is on oral chemo every day. I started to say something but the words sounded disconnected and like they were coming out of my mouth really s-l-o-w: yep, the Benadryl kicked in quick! At about 12:30 PM, Peggy started the Rituxan.
To lessen infusion side effects and reactions, Rituxan is started slowly and gradually increased until they reach a target drip rate. For me, it was to be increased by 50-somethings every 30 minutes until they reached the target drip rate of 400-somethings (milligrams, inches, cubits, chickenlips, I dunno - some medical unit of measure).
I was super-drowsy and in a Benadryl stupor and just wanted to sleep, but needed to call my LaLa, my Lymphoma Angel, Carol (see the blog post of April 17, 2012). I promised to let her know when I was settled in so she could come by. And from the Benadryl-feel of things, it would need to be quick, because I was gonna be in nite-nite land pretty soon!
Because my LaLa is my LaLa, she came bearing gifts!
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| Yeah, baby! Wine and Warrior Cookies! An adult Happy Meal!!! |
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| I was surely the most fashionable patient that day, adorned in the beautiful handmade, sunny yellow apron that Carol brought back from our trip to Alaska and gifted to me for my birthday!! And yes, I DID wear it during the infusion! |
LaLa and I visited while I scratched my itchy Rituxan head. That, and a little itchiness in my throat were all the side effects I was experiencing to that point. Piece 'o cake, right? LaLa sat in the guest chair at the end of my recliner and we were yakking away when all of a sudden her voice started to retreat and the room began to narrow.
Hmmmmmm. I ain't feeling so good.
She looked me in the eye and said, "Are you alright?"
"Nah, I think I better get to the bathroom."
So we got me untangled and I pushed my pump/pole into the restroom on wobbly legs. In hindsight, that was a stupid idea! I was close to passing out and definitely shouldn't have been on my feet, but of course I wasn't ready to admit that yet. I felt like I should try and throw up, but nothing came out. When I went to the sink to wash my hands, I got a glimpse of this ghostly white face in the mirror - geez, woman, you look like hell! Better get back to the chair, stat.
When I got back and sat down, I got really flushed, then all the blood drained away and I broke out in a drenching sweat. LaLa called the nurse over and said I wasn't doing well. Apparently that was my cue to grab the trash can from beside my chair and involuntarily perform the vomiting maneuver that I unsuccessfully attempted a few minutes prior in the bathroom. There was no nausea and nothing really came up - it was just intense heaving (sorry if this is grapic and gross). For some reason, I was trying to talk and apologize to LaLa and the nurses for the drama - with my head in the trash can - while heaving. WTF?! Just shut up and puke already!
For the next several minutes, I was only vaguely aware of little snippets of stuff: a nurse rapidly reclining my chair; staring at a can light on the ceiling; feeling the blood pressure cuff go on my arm and then the nurse saying it was 80/over-something (the last time they took it, it was 124/over-something, so it had really plummeted); Peggy saying that she was stopping the Rituxan and giving me a steroid, Zofran, and more Benadryl; someone putting a cold washcloth on my forehead.
But the one thing that I was acutely aware of - I mean, super focused on - was LaLa gently rubbing and patting my lower leg. That was the only real thing in that momentarily surreal world, the thing that grounded me and kept me from completely blacking out.
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| Nearly passed out but still stylish in her apron! |
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| Stabilized, now time for a NAP. |
After my BP returned to normal and everything was again stable, Peggy re-started the Rituxan back up again, at a slower rate.
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| Drip. Drip. Drip. |
I finally got up and LaLa and I walked around the infusion room, just to MOVE my irritating, vexsome limbs! Peggy said it was a side effect of the steroid used to stabilize the bad reaction. Walking really helped.
By this time, it was about 4:30 PM; Peggy looked at the Rituxan bag and said I should be done in about a half hour - WOO HOO! LaLa called my daughter Amanda to tell her if she wanted to see me in the infusion center, she needed to come quick because I was almost done! And it was a great excuse for her to leave work early!
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| My sweet baby Amanda. |
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| The most beautiful view in the infusion room! |
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| Geez, haven't we been through enough cancer together?!?! |
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| Yes, as a matter of fact, blood cancers DO blow! |
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| What's missing? The IV! Time to go home! |
Still, I needed some REAL EATS! So I went directly to Hooley's Irish Pub for my comfort food: Mac and Cheese with Bacon! What a perfect way to end the day!
With a full tummy and Benadryl still fogging my brain, I was more than ready for bed - and slept 12 hours that night. I woke up frequently, because I was sweating and peeing a LOT, but slept super well.
YAY! One of four DONE!
To the dying and dead cancer cells now being flushed out of my body: SO LONG, SUCKAS!
