Azure Jane Lunatic (Azz) 🌺 (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
azurelunatic) wrote2023-11-01 10:43 pm
azurelunatic) wrote2023-11-01 10:43 pm
This is going to mention needles maybe a lot (chemo #2)
So, lost in the minutia that I didn't mention of Baby's First Chemo, was the Needle-go-'Round when they did my blood draw. I want to stress that I personally didn't take medical trauma from this one, because my phlebotomist was aware that it was my first time, she explained everything, and I am resistant to needle-related trauma in a medical context because of some elements of my personal history (former frequent plasma donor, O+, with trick veins and a variable supply of plasma phlebotomists).
So, I Exist In This World While Being Fat, which means that frequently the actual recommendation for a needle is longer than they're going to use. And I had a brand-new, possibly never accessed (I was technically conscious for most of the install but completely oblivious to most of the goings-on and singing my heart out with the R.E.M. playlist, so I don't recall if they accessed it at the time), implanted port.
The port has two main parts, which plug into each other. First, there's a tube that goes into a major blood vessel and will get anything that goes into it circulated tout de suite. If you've heard of a "central line", you may already be familiar with that general concept. Second, there's a chamber right under the skin that connects to the tube. Unlike a central line, which sticks out in a way that sounds terrifying from a potential infection standpoint, the way you get things connected is to stick a needle into a really specific target. The top of the port is some self-healing silicone/silicone-like situation.
First Phlebotomist gathered her equipment, explained that they had just swapped out medical tables that very day (everyone got new ones, and that explained the high-speed tables I'd seen being paraded one by one into the department, like a sight gag that played out over the course of the episode) so she was going to have to modify her process to fit the new table. She scrubbed my skin down and complimented my choice of shirt for the day (a very sleeveless trapeze-cut tunic with hella cleavage). She carefully opened the sterile-on-the-inside sheet with the two sterile gloves, and opened the sterile packages onto the sheet with practiced ease. She flubbed at least one thing, tossed the thing out, and redid it, explaining all the while. I'd mentioned The Day of Six Sticks, and she was determined to not repeat that.
She got the little needle, explained that it might look scary (like a butterfly needle but at a different angle so I immediately thought of it as a mosquito needle) but it really didn't hurt very much (I, pre-armed with lidocaine cream that I'd applied in accordance with the prophecy, was willing to believe) and stuck me.
Instant flashback, and I was pleased with the stick.
She started to flush the port (attach a syringe with The Solution, push it in to make sure the port could accept liquid and to clear out some of the old stuff, then draw out a blood mixture to discard before taking blood samples) but came up short. Push on the syringe as she might, it was goin' bloody nowhere.
She summoned Another Person, who examined the situation, tried his own hand at things.
"It, uh, that stings," I said, having been prompted by history and especially First Phlebotomist to sing out if it did, because that was an obvious error condition.
"Ew, there's a bubble," the Other Person said, horrifyingly. (I was fascinated.) The saline was going under my skin, not into the port and up the tube and into the bloodstream. Thus the sting, since it was going through a place with nerves.
A Grandboss was summoned, who looked at the situation, tried something, and then produced a 1" mosquito needle instead of a 3/4" one. It went in.
Another note was entered to my chart.
Over the course of the subsequent three weeks, when I occasionally touched the area, I noticed that about half the skin on the dome of the port, the right side, was thinner than the left side, as though the experience of First Chemo had brought it further towards the surface. Huh.
Fast-forward to today.
New phlebotomist, who dis? I dithered about 1" vs 3/4", but settled on 1" because that was the last success. She went through the elaborate ritual without explaining all the steps; I followed along pretty well. I held my less-suited shoulder strap out of the way. She stuck.
"Oh, ow!" I exclaimed. I felt a distinct poke, like I hadn't even used the lidocaine cream. (I'd used the lidocaine cream, and while going to get some cling film to put over the dot, I'd asked the household in general if they thought that I looked like I was in the queendom of my power.)
No flashback. No push. Nor the second time. "It feels like I'm hitting metal," my phlebotomist said to Additional Phlebotomist, who had the same problem. Between them, I collected at least five little punctures.
Grandmaster Phlebotomist (a different one) entered the ring, felt my skin with an expert and clean hand, and selected a regular 3/4" mosquitoneedle (hey, anybody else remember Master of Mosquiton? I saw, like, 15 minutes worth of several episodes back in like 1999 and it sounded agreeably off the wall) and punched it. (After doing the ritual.)
Yup, it fit admirably.
"I bet that took about the same amount of time as last time," I said when I came out to Belovedest, and collected an additional compliment on my hat.
After that we went and got some images for Dr. Skelebones. Blood test results started to ping in. We saw Dr. Bitsblobs, who said that yeah, my red blood cell entire situation was going to suck for a while, and iron supplements wouldn't necessarily solve the problem. Since marrow is a fast-dividing place, natch. And wow, I had a lot of hair left despite the visible thinning on top and the new short cut; typically it's "all gone" by this time. I mentioned that the control site is significantly gone. Good to know that the cold cap, despite being expensive, is helping.
We had some time to wait between that appointment and the infusion. I played gems a lot. Belovedest retrieved the three chemo bags. (Bag 1: the cold cap gear. Bag 2: miscellaneous gear. Bag 3: a cold bag with mitts, socks, and specially shaped ice packs to protect my poor peripheral nerves. 3 sets each.)
The blood-smell of one of the pre-medications they gave me was kind of like yuzu-oatmeal-cookie macaron, which was weird. I called it citrus-oatmeal at first, but that wasn't specific enough; I went to orange, but that was wrong too; I finally landed at yuzu, because it was bitter; and then I happen to recall an oatmeal cookie flavored macaron and that was even closer to the starchy component of the smell. My chemo nurse was fascinated.
I think the programming of the cold cap chiller machine was Somewhat Off, because I could swear that they are capable of attending to a 3 hour infusion, and I shouldn't have had to remain in post-infusion mode for another 2 hours. It cut out finally when I ran to the bathroom (again) on account of my bladder has Questions about the total amount of liquid getting into my system over the course of those few hours. But by that time I was on to the final drug of the chemo cocktail, and the hat was still substantially frozen when I took it off.
The neck/chin brace did help with the cold cap strap attempting to throttle me, but I could probably use some clever, 3-d printed part that hooks exactly correctly to further help. It worked for about an hour, and I learned some lessons about the timing. Eventually Belovedest registered the mask strap that goes around the back of my head, so I didn't have to rely on my ears or a special glasses arrangement to wear the mask.
My social worker did stop in to see me in costume. Dulcinea from the Locked Tomb. Pale seafoam green frilly nightgown as a shirt, floofy white skirt made from salvaged panels of curtain lining, exceptionally frivolous hat (made some years back, in my California days), white lace parasol that sometimes opens on its own, oatmeal colored sweater. The tacky novels are on my phone. My phone is on a sticky telescoping grabber-stick that I can easily hold in my ice-mitted hand. The other hand has a pencil-length stylus, and an EazyHold strap (small hole kind, not Universal Cuff big hole kind) to secure it around the other mitt. I'd sworn that I wasn't going to engage with the Seventh House, but after the diagnosis came back I figured oh what the goddamn fuck I might as well be Dulcie. (Short hair, and my hair does curl when it's that short, and all I have to do is encourage it slightly. I could also have long curls but they will attempt to stick together, so I usually kept it braided.) For actual Halloween, I had red lipstick and put some on my face to simulate her blood situation.
Dr. Skelebones came through on her way home, and said that while I could still walk and swim, my days of trollhugging large men are pretty much over. As are my vigorous dancing days.
Balls.
... Ed Balls.
We're home now, I'm tired, I have my meds to deal with the side effects and also the meds to deal with the knock-on side effects caused by the side effects meds, and I will be falling over into bed shortly.
So, I Exist In This World While Being Fat, which means that frequently the actual recommendation for a needle is longer than they're going to use. And I had a brand-new, possibly never accessed (I was technically conscious for most of the install but completely oblivious to most of the goings-on and singing my heart out with the R.E.M. playlist, so I don't recall if they accessed it at the time), implanted port.
The port has two main parts, which plug into each other. First, there's a tube that goes into a major blood vessel and will get anything that goes into it circulated tout de suite. If you've heard of a "central line", you may already be familiar with that general concept. Second, there's a chamber right under the skin that connects to the tube. Unlike a central line, which sticks out in a way that sounds terrifying from a potential infection standpoint, the way you get things connected is to stick a needle into a really specific target. The top of the port is some self-healing silicone/silicone-like situation.
First Phlebotomist gathered her equipment, explained that they had just swapped out medical tables that very day (everyone got new ones, and that explained the high-speed tables I'd seen being paraded one by one into the department, like a sight gag that played out over the course of the episode) so she was going to have to modify her process to fit the new table. She scrubbed my skin down and complimented my choice of shirt for the day (a very sleeveless trapeze-cut tunic with hella cleavage). She carefully opened the sterile-on-the-inside sheet with the two sterile gloves, and opened the sterile packages onto the sheet with practiced ease. She flubbed at least one thing, tossed the thing out, and redid it, explaining all the while. I'd mentioned The Day of Six Sticks, and she was determined to not repeat that.
She got the little needle, explained that it might look scary (like a butterfly needle but at a different angle so I immediately thought of it as a mosquito needle) but it really didn't hurt very much (I, pre-armed with lidocaine cream that I'd applied in accordance with the prophecy, was willing to believe) and stuck me.
Instant flashback, and I was pleased with the stick.
She started to flush the port (attach a syringe with The Solution, push it in to make sure the port could accept liquid and to clear out some of the old stuff, then draw out a blood mixture to discard before taking blood samples) but came up short. Push on the syringe as she might, it was goin' bloody nowhere.
She summoned Another Person, who examined the situation, tried his own hand at things.
"It, uh, that stings," I said, having been prompted by history and especially First Phlebotomist to sing out if it did, because that was an obvious error condition.
"Ew, there's a bubble," the Other Person said, horrifyingly. (I was fascinated.) The saline was going under my skin, not into the port and up the tube and into the bloodstream. Thus the sting, since it was going through a place with nerves.
A Grandboss was summoned, who looked at the situation, tried something, and then produced a 1" mosquito needle instead of a 3/4" one. It went in.
Another note was entered to my chart.
Over the course of the subsequent three weeks, when I occasionally touched the area, I noticed that about half the skin on the dome of the port, the right side, was thinner than the left side, as though the experience of First Chemo had brought it further towards the surface. Huh.
Fast-forward to today.
New phlebotomist, who dis? I dithered about 1" vs 3/4", but settled on 1" because that was the last success. She went through the elaborate ritual without explaining all the steps; I followed along pretty well. I held my less-suited shoulder strap out of the way. She stuck.
"Oh, ow!" I exclaimed. I felt a distinct poke, like I hadn't even used the lidocaine cream. (I'd used the lidocaine cream, and while going to get some cling film to put over the dot, I'd asked the household in general if they thought that I looked like I was in the queendom of my power.)
No flashback. No push. Nor the second time. "It feels like I'm hitting metal," my phlebotomist said to Additional Phlebotomist, who had the same problem. Between them, I collected at least five little punctures.
Grandmaster Phlebotomist (a different one) entered the ring, felt my skin with an expert and clean hand, and selected a regular 3/4" mosquitoneedle (hey, anybody else remember Master of Mosquiton? I saw, like, 15 minutes worth of several episodes back in like 1999 and it sounded agreeably off the wall) and punched it. (After doing the ritual.)
Yup, it fit admirably.
"I bet that took about the same amount of time as last time," I said when I came out to Belovedest, and collected an additional compliment on my hat.
After that we went and got some images for Dr. Skelebones. Blood test results started to ping in. We saw Dr. Bitsblobs, who said that yeah, my red blood cell entire situation was going to suck for a while, and iron supplements wouldn't necessarily solve the problem. Since marrow is a fast-dividing place, natch. And wow, I had a lot of hair left despite the visible thinning on top and the new short cut; typically it's "all gone" by this time. I mentioned that the control site is significantly gone. Good to know that the cold cap, despite being expensive, is helping.
We had some time to wait between that appointment and the infusion. I played gems a lot. Belovedest retrieved the three chemo bags. (Bag 1: the cold cap gear. Bag 2: miscellaneous gear. Bag 3: a cold bag with mitts, socks, and specially shaped ice packs to protect my poor peripheral nerves. 3 sets each.)
The blood-smell of one of the pre-medications they gave me was kind of like yuzu-oatmeal-cookie macaron, which was weird. I called it citrus-oatmeal at first, but that wasn't specific enough; I went to orange, but that was wrong too; I finally landed at yuzu, because it was bitter; and then I happen to recall an oatmeal cookie flavored macaron and that was even closer to the starchy component of the smell. My chemo nurse was fascinated.
I think the programming of the cold cap chiller machine was Somewhat Off, because I could swear that they are capable of attending to a 3 hour infusion, and I shouldn't have had to remain in post-infusion mode for another 2 hours. It cut out finally when I ran to the bathroom (again) on account of my bladder has Questions about the total amount of liquid getting into my system over the course of those few hours. But by that time I was on to the final drug of the chemo cocktail, and the hat was still substantially frozen when I took it off.
The neck/chin brace did help with the cold cap strap attempting to throttle me, but I could probably use some clever, 3-d printed part that hooks exactly correctly to further help. It worked for about an hour, and I learned some lessons about the timing. Eventually Belovedest registered the mask strap that goes around the back of my head, so I didn't have to rely on my ears or a special glasses arrangement to wear the mask.
My social worker did stop in to see me in costume. Dulcinea from the Locked Tomb. Pale seafoam green frilly nightgown as a shirt, floofy white skirt made from salvaged panels of curtain lining, exceptionally frivolous hat (made some years back, in my California days), white lace parasol that sometimes opens on its own, oatmeal colored sweater. The tacky novels are on my phone. My phone is on a sticky telescoping grabber-stick that I can easily hold in my ice-mitted hand. The other hand has a pencil-length stylus, and an EazyHold strap (small hole kind, not Universal Cuff big hole kind) to secure it around the other mitt. I'd sworn that I wasn't going to engage with the Seventh House, but after the diagnosis came back I figured oh what the goddamn fuck I might as well be Dulcie. (Short hair, and my hair does curl when it's that short, and all I have to do is encourage it slightly. I could also have long curls but they will attempt to stick together, so I usually kept it braided.) For actual Halloween, I had red lipstick and put some on my face to simulate her blood situation.
Dr. Skelebones came through on her way home, and said that while I could still walk and swim, my days of trollhugging large men are pretty much over. As are my vigorous dancing days.
Balls.
... Ed Balls.
We're home now, I'm tired, I have my meds to deal with the side effects and also the meds to deal with the knock-on side effects caused by the side effects meds, and I will be falling over into bed shortly.
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I would send you a cup of erythrocytes if I could and they would help. (I sometimes have to give the biohazard disposal bin a blood donation as treatment for transmasc irony poisoning. Yes, that's a real condition. No, it's not officially called that.)
Dr. Skelebones came through on her way home, and said that while I could still walk and swim, my days of trollhugging large men are pretty much over. As are my vigorous dancing days.
Balls.
... Ed Balls.
Only very slow, non-vigorous balls. I'm sorry, that's very shit.
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sooooo.... youre a 10,000 year old saint to serve the king undying?
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(I prefer Original Dulcie, but I could also have been the fake one!)
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