Friday, May 2, 2014

Minor Setbacks - Adjusting Expectations

"Things turn out best for the people who make the best of the way things turn out." John Wooden

Lesson learned today. What you expect to have happen may not always turn out that way. I arrived at the Cancer Centre, mentally and physically ready for my chemotherapy treatment. I had my bloodwork done, completed my patient assessment and settled in for a hour+ wait for bloodwork to be processed and have my new patient appointment with the pharmacist. Many of you who know my personality know that I am a planner and organizer. The process of mapping my life out to coincide and work around my upcoming chemo treatments had already long taken place. My expectations had been established.

Once I settled into my comfy chemo recliner, it became clear early on that the veins I have been gifted with were not conducive to IV insertion. Reinforcement nurse specialists were brought in, arms were wrapped in warm blankets, tapping and elastic bands utilized. Not happening. ABVD chemotherapy regime is a combination of four very highly toxic drugs. Only certain veins are able to withstand and handle these drugs travelling through to reach the tumours and cancer cells. Use a weak vein, the toxic drugs are at risk of leaking into your tissue and muscles risking permanent damage. I learned this first hand after my in-patient experience, the last drug that travels through the IV has ended up causing some damage in the vein they used, resulting in quite a bit of burning and discomfort in my right arm, rendering that vein no longer useable. I was aware that it is going to be difficult to establish an IV and had planned to discuss at an upcoming appointment with Dr. Stevens. I did not however, envision that this would be a cause of postponing my treatment. I didn't arrive with that as an option. Realistically I know that fluctuations in blood levels can result in your chemotherapy being postponed but I did not count on this being a factor as they had figured it out on the oncology floor when I was a patient.

In consulting with the oncologist on call, Dr McCarron, the recommendation is that I receive a PICC line. "A PICC line is a long, thin, flexible tube known as a catheter. It’s put into one of the large veins of the arm, near the bend of the elbow. It’s then threaded into the vein until the tip sits in a large vein just above the heart."A PICC line can remain in your arm for up to a year. I will require weekly CCAC nurse visits to change the dressing and there will be other inconveniences with showers etc but the benefits far outweigh those.
At one point, it was discussed that I may be a candidate for a Port-O-Cath. The downfall of this is that it requires surgery and general anesthetic. It is much more invasive and typically more used for long term treatment plans, with my chemotherapy being approximately 6 months, a PICC line is considered a more preferable option. And, more importantly, I am able to have the procedure to have the PICC line installed on Monday morning. I am grateful for the caring nature of the nurses who were attempting to find a solution to my disappointing setback as they were able to somehow re-schedule the chemo treatment for the same day on Monday afternoon. 

So back to my originial quote. "Things turn out best for the people who make the best of the way things turn out." What are the positives that I can take away from this? First, once again, I feel so incredibly blessed that Jason is not working and able to focus full time on my care. Setbacks such as this would be incredibly stressful if he were having to take time off work and then the treatment not happen. We have the flexibility that we can roll with whatever new scheduled times they give us and adjust our sails accordingly. Our children are old enough that we don't have to arrange care and we can exercise our flexibility in dealing with new timelines, with the help of our friends who are able to step up and assist with getting Jordan to gymnastics. Thanks Michelle, so appreciated. 

Second, I have a weekend unexpectedly that I can enjoy the time with the kids and our friends. I have a wonderful night of girl time, movie and buttery popcorn ahead of me tonight and dinner at friends to celebrate a birthday tomorrow night. Rest and relaxation on Sunday to get me ready for Round 2 on Monday. Third, the PICC line will allow me less pain, hassle and stress down the road. Bloodwork and chemotherapy treatments simplified. I will be much more comfortable and we won't have to deal with my veins hardening, with lifelong damage. If a PICC line was in my future anyway, might as well deal with it now then two or three treatments later on. 

Another positive is that my bloodwork did not show any major concerns. It definitely showed that my white blood cell count is quite low, in particular the neutrophils. All this means is that I need to be extra cautious about infection, hand washing and ensuring that I try not to come into contact with coughs or colds - while still maintaing a life and living in the community. It is an awareness not a quarantine. 

And so here I am. My experience today is one of learning. Learning to adjust my expectations, deal with disappointment in a healthy way, learn to not look too far ahead, embrace the positives and continue to remember that the nurses have my best interests at heart and that decisions will be made out of my control that I don't necessarily like. It's how I react to them that matters. 

Thank you to an anonymous card that arrived with a gift card in the mail, your words were just what I needed to hear when I opened the mail. Thank you to Michelle who continually shows me what a true friend she is. And to my care-giver Jason, you are the calm to my storm and I wouldn't be able to do this without you by my side. 

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