Wednesday, October 7, 2009


My nurse tonight is a nice guy who was sure we had met before, but for the life of me I couldn't remember meeting him. He told me it was a while ago, and that I had pulled the I.V. out of my arm in the middle of the night and walked out into the hallway looking for help. While it sounded like something I would do, I honestly didn't remember doing that. Eventually it dawned on me that it was the night I was awakened by a crisp popping sound, whereafter my vein started gushing blood because the badly-inserted I.V. needle had fallen out of my arm after three days of hanging on for dear life. I can see where he had gotten confused, though.

I'm not speaking for everyone, but in my experience the nurses here have been hit or miss with putting in my I.V. They all comment on how pronounced my veins are, which should make it easy to put the needle in, but while my veins are easy to find they are also "slippery." The first nurse to give it a try just stabbed me with the needle about seven or eight times before I said something like, "Dude, what the-- do you know what you're doing?"

Of course, he said, "Yeah man, I've done this, like, thousands of times. Just let me get it."

After maybe 5 more painful yet unsuccessful needle stabs I was pretty irritated and demanded that he stop. I made it a point to not let him be my nurse again, but other nurses struggled, too. It was the sloppy work of an "I.V. team" member that had resulted in my midnight river of blood. She was a specialist on the special team dedicated to putting in good I.V.'s, yet hers woke me up either from the needle falling out of my arm or by feeling blood streaming down my arm. I called my nurse and she patched me up, but nobody should ever have to wake up like that. If that woman had done her job right, I wouldn't have.

There was another occasion when I was undergoing a procedure as part of this vaccine trial in which I participated. Hopefully the vaccine, when administered at the very end of chemo, will give me a greater chance of fending off the tumor's return once we've got it into remission.

Anyway, this one part of the vaccine required that I have two I.V.'s going at once; one in each arm. The left arm was a normal I.V., but the right arm I.V. was done with a thicker metal needle and wire, which was much less forgiving of mistakes. Obviously, the left arm nurse couldn't successfully start her I.V. for a while. The right arm nurse had more immediate success, so we focused our attention at getting the left arm working correctly. That remained our priority until a mysterious sound from my right arm made me swing my eyes over, only to see that my vein had popped. That really is the diagnosis they gave me: a "popped vein." Not very comforting. They told me it would bruise and probably swell, but would eventually go back to normal.

To make a long story short, a 5-hour procedure turned into a 9-hour procedure, two I.V.'s turned into seven bandaged holes in my arms, and even then we barely got the blood we needed for the vaccine. Either I have weak veins, or the nurses are not as adept at putting in I.V.'s as they should be. Considering the number of quick and easy, successfull I.V.'s I have had over the course of my life, hell, over the past few months, my determination is that they leave something to be desired. I will say that the clinic nurses here have been very good at starting an arm I.V., so I know it's possible.

Just before participating in the vaccine, I had a port put into my chest, which has made it easier because now I don't have to deal with I.V.'s in my arm veins. The port is this small, plastic, circular device that sits in a small pocket in my right pectoral muscle. That's the chest for those who don't know. Anyway, the plastic ring has a jelly center into which the I.V. needle is inserted and through which chemo is given, blood taken, etc. The port also has a hollow plastic tube that extends up from the plastic circle and follows an artery up to my neck. Apparently, they need access to an artery close to the heart to efficiently administer chemo and other drugs.

There are doctors and nurses who come in to ask me questions on a regular basis and I usually have no clue who they are, though they always tell me when we've met and probably assume that I remember them too. I would never stop them to say I don't know who they are, so I just let them continue. Usually, they're just here to ask questions about how the treatment is going or they want to give me a checkup despite the fact that a nurse has usually done it twenty minutes earlier. Generally, I'm anxious to see them go away.

The point I'm trying to get at is that at the very beginning, when I was still on those really intense I.V. pain meds, I wasn't all there mentally and there's a lot I don't remember. My sister started writing down my funniest statements, so I'll have to ask her for the highlights. I distinctly remember announcing, "Two points for the drunk kid," after one of the funny things I said, though I was obviously not drunk. I also remember various phone conversations when I would doze off in the middle of talking, so when whoever I was talking to asked me if I was still there, I would be confused and ask what we were talking about.

"I don't know, you were the one talking," was the most common response.

I don't remember exactly when or what it was, but the doctors were giving me some medication that can make you hallucinate. It was right around the beginning of the first chemo, and I was anxious to get off the I.V. meds, so I was willing to go with whatever they wanted to try. Obviously, when they asked me, I told them I had no signs of hallucination, though I was tripping like a fool. Unfortunately, one thing happened that made my hallucinations difficult to deny.

I was having this dream where I was an actor in one of Adam Sandler's upcoming movies. The scene we were about to shoot required that I be a patient in a bed and that a dentist come to examine me. In my dream, I had walked over to the hospital with a few members of the cast, so naturally I was surprised to wake up all alone in the hospital room. I got out of bed to start searching for the cast and crew, but since I couldn't find them I thought it wise to pee in the garbage can next to the door before anyone else arrived. The bathroom standing ten feet away never even registered as an option in my mind. But as time went on and nobody showed up, I started to get worried and thought it best to go look for people.

The first person I found was the nurse sitting behind the desk in the hall, who looked up at me with immediate concern. "Is everything alright?" she asked.

"Yes, thank you," I responded. "But where is the crew?"

"Excuse me?" she asked. "What crew?"

"You know, for the movie," I said confidently. I was proud of myself and convinced she just hadn't heard of what was going on.

"Do you know where you are?" she asked very nicely, trying not to make the inevitable transition back to reality too harsh for me, I'm sure.

"What do you mean?" I responded.

"Where are you?" she asked, and I took a moment to really think about it.

I was not there to be in an Adam Sandler movie. I was there for cancer treatment because I have cancer and it needs treatment if I'm going to have a chance at getting better. It was hard to swallow.

The nurse accompanied me back into my room and I apologized for urinating in the garbage can. I also apologized for missing the garbage can a little bit. She was more concerned with making sure I was alright, and when I settled back into bed we said goodnight and she left.

I remember sitting up in bed that night, being particularly scared of what my future held. Really, I was scared that I wouldn't have a future. I've always wanted to know what was going to happen someday, and I admit that I didn't spend enough time in the here and now. Now, I don't really have a choice. I don't know what tomorrow brings, just like everyone else, but I have to take this one day at a time because it's the best way of doing it. Tomorrow I might feel crappy, so I get through that day, maybe by looking to the next day. That day I might feel good, so I'll enjoy feeling good that day and try not to think about the day after that when I might feel shitty again.

The point of that last story was to show an example of how there are so many people here who say they know me but I simply don't remember meeting them because of those first few weeks. But I want to remember the people I meet here. While some are difficult to deal with or leave something to be desired in the way they interact with their patients, there are also a lot of great people here. There are brilliant, funny, interesting, caring people working here and I'm not going to miss that by focusing on the idiots. People really can surprise you.

Eventually, I will regain the opportunities I had to enjoy more things. Maybe, eventually, I'll get to be in an Adam Sandler movie and it won't be a hallucination.