chemo 101...
We are enjoying our time back at home but I wanted to back-track a little and give you a peek into the whole hospital/chemo experience. It's a little different each time, but these pictures from Meghan's last round will give you the general idea. (Remember you can click on the pictures to see them larger.)
On this day (last week Thursday) we were expected at the hospital at 11:00 am. Our morning began much earlier than that with saying goodbye to Dad as he headed off to work, last minute laundry, house stuff, packing our bags, and bringing Rileigh and Aidan to Grandpa and Grandma Tasker's house in Grandville. 
1) At Grandpa & Grandma's house 2) Goodbye Meghan & Mama 3) Woody says goodbye too!
On this particular day we stopped for a special treat - Starbucks (Meghan's beverage of choice - white mocha with whipped cream - something she is not allowed to have very often!). While we are in the parking lot Meghan puts her Emla cream over her port and covers it over with a tegaderm bandage. This will ensure that the skin covering her port is numb by the time we get to the hospital and they need to access it.
Highway driving, off at College St. exit, approaching "Medical Mile" (Michigan street), Turning onto Barclay (Meijer Heart Center on corner), past the emergency entrance, and into the patient parking ramp
Meghan is convinced that the smell of the hospital makes her nauseated so as we pull into our parking spot she is doing her new routine - anti-nausea pill, cinnamon chewing gum, scented lipgloss, and a face mask - now we are ready to go in :)
The doors into the hospital from the parking ramp, through the halls, to the elevator, up to 7 south, down the hall, and through the double doors into the Hematology/Oncology Unit. (When we are only coming in for clinic and not an admit we've been going to the lab on the first floor for her lab draw - they do a peripheral draw from her arm instead of using her port. If she doesn't need any blood products her port doesn't get accessed which means she can still shower and swim. When the port is accessed she has to wait 24 hours after de-access to get wet.)
We check in at the front desk and then take a seat in the waiting room. Soon (hopefully) John will come and get Meghan to take her vitals (the "official" check-in).
Every single visit to the clinic begins with these things - weight, height, blood pressure, pulse, and temperature. After these are completed, it's back to the waiting room.
We do A LOT of waiting in the waiting room! Meghan's waiting room "essentials" - her starbucks, some good books (a recent gift of "The Girls' Book - How to be the best at everything" from one of her chemo angels has been favorite), and her ipod. There is also a playroom where she can go and do arts & crafts, video games, etc.. but it is often crowded with the littler kids.
Next her nurse Mary will come to the waiting room and review all Meghan's meds with mom and ask general questions about how Meghan has been doing. Then she will take Meghan to the port room to get her port accessed and do the blood draws for her lab work. 
1) Sterile supplies 2) After removing Meghan's tegaderm and wiping the emla cream off, Mary cleans the area over the port 3) Access #1 (Meghan has a double-lumen port and for chemo both ports will be accessed) 4) Blood draw for lab work
1) Blood draw 2) Access #2 - Ouch! That one hurt! 3) Both are accessed and taped down; next the whole area will be covered with a tegaderm 4) Close-up of a huber needle (these are the special needles inserted into the port - notice the 90 degree curve)
Here is a little more information on ports:
Implantable
Vascular Access Devices (Port-A-Cath; PAS Port)
Implantable
Ports are catheters which are inserted completely under the skin. The distal
end of the catheter is formed by a small metal "drum" or reservoir, which
has on one side a membrane for needle access. This drum is surgically placed
under the skin, just below the clavicle, with the membrane immediately
below the skin. The catheter runs from the drum into the subclavian vein.
Access is always with a special needle that is pushed through the skin
and the membrane into the reservoir inside the drum. Such ports come in
different sizes, and can have either one or two lumens. Since the entire
catheter is under the skin, the risk of infection is smaller than with
external catheter
*From
left to right: Single Lumen Port; PAS Port;
Duel Lumen Port; Quarter; Duel
Lumen Port
Two of Meghan's favorite people - her clinic nurse Mary and direct care technician John (a.k.a. the check-in guy)
After her port is accessed it is back to the waiting room. We have to wait for the lab to run her CBC (complete blood count) to verify that her counts are acceptable for starting chemo.
After her counts come back, one of the Physician Assistants, Krista, will come and get Meghan and bring her to an exam room for a quick check-up.
We review meds again and answer an array of questions (some of which are embarrassing for Meghan but she is getting used to these). Krista checks her ears, mouth, throat, lungs, heart, belly, etc..
And then... you guessed it... back to the waiting room.
We wait
and wait
and wait
Meghan's counts are a little low, but after consulting the doctors they decide she can go ahead and start chemo. After awhile Mary comes and hooks Meghan up to an IV pole with fluids - she will start hydrating her heavily to prepare her body for chemo. (We also get another exam from a PA student - pretty much all repeat information.)
Late in the afternoon we are finally brought over to the inpatient unit and given a room - our "home away from home" for the next few days.
First order of business... 
Another "trick" we've learned -
using Febreze plug-ins in our room
are wonderful for helping Meghan
with the nauseous feeling she gets
from the "hospital smell."
1) Mom's sleeping accomodations 2) Mom's hospital essentials - Bible, Macbook, books (currently reading "100 Years of Solitude" by Gabriel Garcia Marquez and "I Feel Bad About My Neck" by Nora Ephron), camera, phone, sketchbook
While we are in our room we try to stay occupied with reading, playing card and board games, watching tv and movies (this round we watched the movie, "August Rush," and a bunch of old "I Love Lucy" episodes), and using the laptop. (For her last round, the inpatient child life specialist, Rhys, brought her a Playstation 2 to use in her room.) Visitors are always a welcome distraction and Meghan especially appreciates food from "the outside" :) And of course there is the purpose for our being here....
1) Meghan's nurse, Jessie, hangs her chemo 2) Chemo bags hanging on the IV pole
Depending on what combination of drugs she is getting, they are all given a little differently. With this particular round she got 2 - four hour infusions of Cisplatin and 2 infusions of Doxorubicin/Adriamycin, along with some supportive meds and antiemetics (anti-nausea drugs). She is heavily hydrated for the entire stay which means many, many trips to the bathroom (even during the night she is up at least once an hour). The nurses are also in a lot checking her vitals. One extra thing we've had the last two rounds is inpatient physical therapy which Meghan really enjoys.
As I've mentioned before, she also does A LOT of this...
When I compare these more recent rounds to the ones at the beginning of her treatment it literally brings tears to my eyes. It doesn't seem all that long ago when she was getting so very sick from the chemo and spending much of her time throwing up and feeling miserable. Now I tell her, "Tired and bored is good - it could be much worse!"
Early each morning we get vitals and weight taken, later one of the inpatient P.A.s (Nicole or Aaron) comes in and does a quick exam and then mid-morning we get a room full of people doing rounds with whatever oncologist is on rotation. This time it was Meghan's primary oncologist, Dr. Deanna Mitchell, who we absolutely love.
We also love the wonderful nurses on the floor. Here are just a few of them...
1) Amy & Jessica 2) Annie & Holly (a childhood cancer survivor herself) 3) Jessie
We also have a couple of visits from the discharge nurse, Joyce, to make sure everything is in order to leave when it's time. She makes sure we have all our prescriptions filled up and she orders our home IV supplies and arranges their delivery (Meghan always goes home on 3 days of IV fluids).
Michael and I have been trying to alternate staying overnight with Meghan (he does nights when he doesn't have work the next day). This gives me a chance to have some good sleep at home and a little more time with Rileigh and Aidan. We try to have Rileigh and Aidan come up in the evenings to have dinner together and hang out for awhile. But no moment is ever better than this...
1) Leaving! (Nice that Meghan is walking this time instead of needing the wheelchair!) 2) Waiting for the elevator (Aidan cracks me up!) 3) Yea!
1) Tucked into Dad & Mom's bed with IV fluids 2) I may be biased, but this kid looks AMAZING for someone who has just finished her 10th round of chemo! 3) Just because I haven't posted a pic of her arm recently - it really has healed beautifully.
And for those of you who actually made it to the end of this monster post, thank you for taking the time to check in with us and read the blog and most especially for your continued prayers. They are being answered in abundance!
PRAISE GOD FROM WHOM ALL BLESSINGS FLOW!
