...And Then There Were Seven

Another chemotherapy treatment knocked off the list and seven remaining. This is the first infusion he's done here. Pretty much the same routine as before. They've dropped the Benadryl and antacid from the line up and made the Aloxi into an infusion rather than an injection and added Ativan to help with nausea and "anxiety." We're not sure where that came from--I don't know that Kev's reluctant resignation to treatment really qualifies as pre-treatment anxiety.

The Oxaliplatin has already kicked in with that quirky cold induced nerve reaction. He says it's not really bad yet but he's disappointed that it's here already. It doesn't sound like such a traumatic side effect when you think about some of the others, but it's one that really wears on him with time. It just intrudes every day in so many parts of his day.

The clinic here feels less oppressive than the one in Indiana. Larger, lighter, better nursing staff to patient ratio. Kevin was pleased to have a wireless internet connection for his computer and less overall chaos and congestion in his day. Sometimes it's the little things that really count. The place doesn't stink of chemotherapy. The smell at the other place had come to be such a bad trigger for Kevin that just walking in was enough to make him feel awful.

Another difference is that we store his infusion pump and all of the assorted related supplies between treatments. What are the chances of us remembering to take it with us to the clinic for his next treatment?

He'll wear the portable pump--it came loaded with 5-FU which is like toxic Kool-Aid to cancer cells--until Thursday when a home nurse will meet him at our home (this is a big plus--within the driving radius of the home care program, he can designate a meeting place that best suits his schedule...his office, at home or even at the cancer center) to remove the pump and flush his port with heparin. We walked out of the cancer center with 2 big plastic bags full of the stuff needed for this home care aspect of his portable pump and implanted access port....Kevin, being the naive soul that he is, likens them to the goody bags which he carries home from conferences.

Right.

A quick inventory of the bags includes sterile wrapped huber needles (These are noxious looking beasts if you happen to be needle phobic. Thankfully Kevin is not. When someone you love has cancer, you find yourself appreciating even the smallest of upbeat things in their treatment. That Kevin isn't done in by needles has occasionally been the brightest part of a treatment day.), safety gloves, gown and mask, dressing kits, scissors, tape, sealed empty syringes and loaded syringes of saline and heparin. And a big waste disposal container to collect the toxic medical waste produced via infused chemotherapy.

What really hit me, though, is the "Chemotherapy Drug Spill Kit."

"KEEP EVERYONE AWAY FROM SPILL SITE"

1. Take out all contents of this kit. Display sign near spill area.
2. Put on ChemoPlus Gown, shoe coverings, respirator mask, safety glasses and both pairs of gloves (large gloves first). Important: Read enclosed instruciton for the respirator mask to ensure proper fit.
3. Lay ChemoSorb Pads over the spill. The pads will absorb the liquid and transform it into a gel to assist in disposal. Caution: ChemoSorb gel is extremely slippery when wet. Avoid skin and eye contact and do not inhale. (I like this part. Do not inhale. They left off the warning to not land in the stuff when you pass out from not breathing.)

***I'll skip the numerical details but from here you are to bag anything remotely connected with the clean up, then bag the entire mess into a second bag.***

My mind keeps playing out what the scenario would really look like in our house.

I would be reading the instructions for a second and third time and preparing for a step by step attack while the spill was soaking into the carpet. If the spill was on the new sofa (fondly referred to as the "Man Couch") I would alternate reading with an occasional curse. Cut me some slack here, for gosh sakes; the check I wrote to pay for it hasn't even made it to the bank yet.

Kevin, being a man, would damn the instructions, rip open the entire contents of the kit and use it all to sop up the mess. One big handful of gown, shoe coverings, mask, safety glasses, gloves and ChemoSorb pads. Any gelified liquid remaining would be triumphantly sucked up with the ShopVac, a tool Kevin considers worthy of use on any mess--organic, animate or toxic. As an afterthought, he would flap the warning sign (see instruction #1 above) frantically to fan the spot dry. Once he had stomped everything down into one of the Waste Disposal Bags, he would notice my bug-eyed stare and respond with a shrill "WHAT?!"

It's good to laugh at the imagery. Otherwise I'll get fixated on those stern instructions warning about the hazards of a chemotherapy drug spill. We're not talking "Don't let the dog lap this gunk up" or "Be careful not to splash it in your eyes." We're talking don't come in external contact with this crap in any way, shape or form.

And here we are tonight, watching it drip into Kevin with each little whirrr of the pump, one minutely fractionated dose at a time.