Ported

We seem to be settling into our routine. It is surprising how such adverse circumstances become normalized and you just sort of meld them into your life. We already are scheduling both our personal and professional lives using the term “chemo week” and “non chemo week”.

So here we are, it is chemo week and we left with our full outfit about noon yesterday for Seattle. First a blood draw at the lab on floor (1) and then up to the 3rd for our bi weekly consult. The nurse practitioner had a spill while jogging that AM, but our regular RN Heidi filled in.

I always enjoy our visits with Heidi, she has a warm, chatty personality that seems to make you comfortable while still making sure the appointment is productive and not over length. Estrogen was a major topic, both for Jamie’s health as well as my sanity. We will be making some adjustments, switching from the patch (which I call the “crazy patch”) to daily pill form. All of our other concerns were swiftly addressed as well, and we left with a cadre of instructions and a list of other medications to pick up the following day.

The Silver Cloud has become our hotel of choice, as they have properties close to both UWMC and the SCCA on Eastlake. We arrived a little after 3 pm, to find the lobby in a bit of chaos as the reception staff was trying to check in a herd of touristy looking types while coping with a cleaning staff that was behind schedule.

I waited in line patiently, and when I finally made my way to the front, I began to carefully relay my concerns about my reservation.

Three nights ago I had called the reservation hotline armed with my Silver Rewards Card to cash in my bonus points for a free room. Despite her cordial manners, the woman on the other end was unable to confirm that I had enough points. Disappointed, but tamed by my caner spouse experience, I figured I could reconcile this later and asked for a room at the SCCA or UWMC rate. She said this offer was “closed” and that I could not get a discounted booking. Undaunted, I accepted the standard rate and jotted down my confirmation number.

Well about half way through relaying this to the very patient counter staff at the Hotel in person, one of the previously mentioned tourist herd walked up and said “can I interrupt, I just have a quick question?”. Before I could even think, little alone say “f%$& you, how about I just kick you in the balls instead”. He began rambling on about since they were waiting would it be faster if unloaded his luggage onto a cart and brought his luggage into the lobby and then went up the elevator from the lobby, or should he just wait until the room was ready, gather a cart and use the elevator tower in the parking garage. Sensing my disgust (probably the death stare I was giving this guy) the counterwoman tried to be brief and said he could bring his stuff into the lobby if he wished, that two of his rooms just came available, to which he replied something like “that seems like a lot of bother I think I will just wait in the lobby for the rooms all to be ready”.

Now that I rightfully had this woman’s attention again, she confirmed that I only had 400 points showing in the computer and that neither of the discounted rates I requested were available. She did however offer me the corporate rate, which seemed satisfactory and began to assign me a standard king room. As she did so she said that it would not be, ready for an hour (due to the delays described above), which I responded to her with “when is check in?”. She confirmed what I already knew which was that check in was after 3 pm and it was nearly 3:45 now. Unwilling to wait the estimated hour, citing my wife’s need to lie down and rest, she offered me a double queen room (apparently an upgrade) at the same rate.

I accepted room 511 which had an excellent view of Lake Union. Our neighbors Joan and Leo had recently recounted their past stay at the same hotel for a previous 4th of July. Certainly with the view and the spaciousness of room, it would be an ideal spot to view Seattle’s firework display.

With dinner on our minds, I got our luggage in order and left Jamie to seek some take out. I drove around the end of the lake, spotting nothing of interest, so I turned around in the Kenmore air parking lot and headed back towards the SCCA. After wandering a couple of blocks I recalled an Irish pub I had seen on a past trip to the neighborhood, scrolled through the addresses stored on the truck’s navigation and found the entry that had originally guided me to that same block some weeks before.

I parked at the curb and walked into the pub, taking the first available stool at the bar. Thinking I was trying something new, I scanned the happy hour menu, only to find that it was in fact the original Paddy Coynes, the clone of which I had visited in Tacoma with my sister and Dave just a few months prior.

I placed my order, along with a pint to kill the time and started the typically chatter with the bartender. “Where are you from?” I asked. “Ireland” he replied. “No shit?” I said. I suppose he probably gets this a lot, but I expected a more specific answer, which I eventually got. “County Atrium, where they shoot and blow each other up”. That over with we discussed his most recent trip to Hawaii and his experience diving in the shark cage. Although extremely susceptible to sunburn (he described his head feeling like it was on fire most of the time despite spf 50 sunblock), this particular Irishman has a fascination with sharks and now plans to visit South Africa and / or Australia where he can repeat the experience with great whites.

We left the sharks to discuss his choice of Seattle which eventually lead to his complaints about house prices. I said he should come to Olympia and open a pub down there, where I promised to be his best customer. He said that it would take $300k to start such a venture, to which I responded with some brief math on mean house price in Seattle vs. Olympia, and how with the same $ he could probably afford both for the same net sum in Olympia. Either lost by or uninterested in my scheme, conversation turned to a recent “encounter” with a young woman from Olympia to which I inquired if she shaved her legs. Thinking that this would really narrow the field to just a handful of candidates, he replied with “yes, but not her moustache”.

I returned to the room with a loaf of soda bread, salad and a Shepard’s pie. Although the pub’s conversation was superb, the pie was not and was soon rejected by Jamie. So back on the road again to fulfill her request for much simpler fair, cheeseburger, onion rings and chocolate shake. I had spotted a typical drive-in along Eastlake during our hospital stay, but it was closed, probably for Memorial weekend. Well this time they were open, and I was not disappointed. Dinging interior with quirky cartoons on the wall, accommodating but stoned looking staff, and good greasy food.

Stomachs full, we lounged around watching HGTV and other reality TV shows. I went down to the workout room about 9 to try to burn off some of the grease. I returned to the room to find Jamie still watching shows about stupid people, so I took a shower and prepared for bed. Jamie was restless through the night despite trying a sleeping pill for the first time. Although assured that Friday’s port install would be a breeze, she was still anxious. I slept well slept for a few hours and arose early without an alarm to ensure timely arrival for our 7 am appointment at SCCA radiology.

Our guide for this leg of the journey was Pat, an excellent nurse who gave us a complete (and very accurate) run down of the morning’s procedures. When we mentioned being from Olympia and in the construction industry, she said that her brother was a contractor and of course I recognized him as a Tectonix customer. Although I did my best to like Pat, she was not as accommodating as the infusion staff. In her post Op instructions, she was quite clear that Jamie should not make any important decisions or sign any documents for the rest of the day, explicitly including new diesel pick ups.

After Pat’s review and a couple of attempts at installing IV’s we met the famous Dr. Hickman. He is the primary installer of ports her at the SCCA, so such devices are commonly known around here as a “Hickman”. He began repeating the basics of the port devices and their use with both of us, and then as they completed the IV, he went into greater depth of detail with me on its use and maintenance, ensuring that if the need came outside of the SCCA, I would be able to supervise its access and use. If we travel at all, we will also be issued a couple of spare needles as outlying hospitals may not have them in stock.

For those unfamiliar with this device, it is about the diameter of a quarter and 3/8” tall, with a long tail which is the catheter. It is installed on the chest below the collar bone, but above the breast tissue just beneath the surface. The catheter is routed up towards the next where it travels down the jugular and into the first heart chamber. They select this route because it exits into a high volume of blood ensuring almost instant dilution, thus minimizing the toxic effects of the chemo drugs. The device has a life span of several years and in Jamie’s case her model is compatible for use with any IV fluid including that used for CT scans.

The port access itself is compressed, self healing siliconized rubber. The access needle is a non coring type, with a slight hook to it. As Dr. Hickman demonstrated for me, you simply locate the port center beneath the skin with your fingers and push the needle through the skin into the port until you feel the needle hit the back side of the port. If needed, the area can be numbed a few minutes beforehand with topical anesthetic.

The installation procedure is fairly straightforward with Dr. Hickman selecting his route beforehand using an ultrasound (which he again demonstrated for me). It is all done under local anesthetic along with sedation, much like wisdom tooth removal. Jamie was in and out in under an hour.

After the procedure, Dr. Hickman guided me through the haul into one of the labs where he showed me her chest x-ray. You could clearly see the port outline in the picture as well as the catheter. He also pointed out an obvious gas bubble in intestine and suggested I burp her as soon as possible.

When I met up with her in recovery, Jamie was happily sipping on cans of juice and eating Lorna Dune cookies while chatting with Pat. A bit dizzy still, Pat supplied a wheel chair so we could return to the dressing room.

With an access needle still attached, the whole outfit quadruples in size, as the needle and short tube are covered by a large dressing with a clear window through it. It was obvious that the geometry was not favorable for wearing a bra, so Jamie decided to go Olympia Co-op style for the infusion appointment. This now obvious issue fully explains why I see so many women around here wearing low cut shirts. Who knew that cancer would be so sexy. I will be sure to get Jamie properly outfitted with an assortment of tube tops.

With my laptop and Jamie’s comfort basket already in hand, Pat graciously helped us up to the 5th floor for infusion. After a brief wait we were called to berth 12, not quite as private as room 23, but definitely larger and thus more comfortable.

As promised, Dan is our chemo nurse again, and even though we are on just our second visit, he and I got Jamie settled and things rolling like a well orchestrated ballet. While he handles the medical stuff, I went to the nutrition station and got lunch rolling, pillows out and slippers on her feet.

It’s about 1 o’clock and we are through with the primer drugs and into the Taxol. We have both lunched and Jamie is resting comfortably and looking a bit sleepy. Once all the set up is done, the actual infusion time is quite peaceful and relaxing, giving me time catch up on email, type this and let Jamie catch up on her fashion and decorating tips via the TLC and HGTV networks.

Once we wrap things up here, our routine is east on 520 to Kirkland, apparently one of the only uncongested routes out of the city on Friday afternoon, for relaxation and dinner with the Woods. Once our bellies are full and Jamie is rested we will hit the interstate late evening, hopefully with little or no traffic to slow us down.

I think I have failed to mention that my cookies did arrive from NJ more than a week ago. They scored as follows;

Presentation = 10

Form = 10

Taste = 10

Another fine job Ali, your skills have only improved with age. However there was no bill of lading in the box, how am I going to verify my shipment AJ?