Wednesday, May 12, 2010

UW Clinical Trial - Visit 4

I got back home yesterday, after Visit #4 to the UW for the immunotherapy trial. Visit #4, as you might recall, was the visit where I had leukapheresis, which is a process to remove my white blood cells (AKA t-cells), or as I now call them, my Herminator-2 cells.

I was a little anxious about this as they decided that I would have to have a catheter inserted so they could remove the cells. I think I described what they planned in an earlier post - it involved going to radiology, so they could use an ultrasound and an x-ray to make sure the catheter was threaded okay down my jugular vein. To do this, they planned to use sedatives.

Anyway, I got to the hospital about 7:15am (was up too late the night before and didn't sleep well -anxiety) - and P., this wonderful nurse, drew my blood. P. does a great job as I can barely feed his needle sticks; this stick was on the top of my left elbow. Then, a little before 8am, I went down to radiology and the receptionist wanted my insurance info. I didn't want to give them to her because I didn't want me or the insurance to have to pay for this procedure - this was to be paid for by the study. So, I had her call the nurse upstairs to clarify it.

Apparently, they got it worked out and I was escorted back to one of the "bays" where a nurse named Walter started to prep me for the catheter insertion - he put in an IV line into my left hand. But then the doctor came in to explain the procedure and then they started saying that after the insertion, I would be taken to another floor where I would be under two hours of observation - because I was being given a narcotic and they didn't want me to crash. So, I had to explain that the clinical trial doctors told me that after I got the catheter, I was to go back upstairs for leukapheresis and not wait beforehand.

Walter talked to his charge nurse (or his supervisor) and they called upstairs yet again and worked it out. They compromised on waiting for about 30 minutes after the catheter insertion to make sure that my vital signs were fine.

So, off I went to the procedure room, where I was introduced to Ryan, Brian, and Joe (I kept thinking "Winkin', Blinkin', and Nod"), nurses and radiology techs who were helping with the procedure, in addition to the radiologist, Dr. P., and an intern.

By this time, I was a little nervous. They prepped my neck on the right side by painting this blue stuff on me (not betadyne - they don't use it any longer) that killed microbes on contact. Then, a shot of lidocaine. I laid on the table facing to the left. I was pretty tense and anxious, so much that my legs were shaking. Then, Walter gave me Zofran (an anti-nausea med), then the sedatives, Versed and Fentanyl. I didn't really want to have the sedatives - I tend to get nauseous with narcotics - but I didn't fight it. When I got the sedatives, I immediately relaxed and my legs stopped shaking.. It was enough to take the edge off.

I felt some pressure here and there when they inserted the catheter. The catheter went from my neck, into the jugular vein, and down to the top of my heart. Mostly I amused myself by watching my vital signs on the monitor. I could see my respiration rate - and if I started breathing too fast, I'd take some deep breaths and see that rate go down to about 13. My blood pressure was about 117/65 to 120/70.

Here are some pics from the day. Below is me resting in my room upstairs, hooked up to the machine that was processing my blood. You can see the catheter on the right side of my neck with tubes full of blood. One tube took the blood away and the other one returned my blood minus the Herminator-2 cells. The entire volume of my blood cycled through the machine over two times.

Me and my "double-lumen intrajugular catheter":

Here's a close-up - I think I might still be feeling some of the effects of the sedatives! What do you think? This was taken after they finished leukapheresis and before one of the doctors from the clinical trial removed the catheter:

And, an even closer close-up - if I didn't know any better, it looks like I'm turning into a Borg:

And, finally, my Herminator-2 cells. I posted this pic on my Facebook page and said "My Herminator-2 cells - go forth and multiply!" P., the nurse who drew my blood, monitored the leukapheresis project from beginning to end. What a nice guy!

Don't they look beautiful, those Herminator-2 cells? I think so. I think they're gonna go after those pesky cancer cells . . .

I wasn't discharged from hospital until about 3pm. My sister and I then drove to our new hotel room - a converted university dorm. The lady was nice, but I was hungry and wanted caffeine. I wasn't allowed to eat prior to the catheter insertion. P. let me snack a little bit, but I didn't have a full meal until about 4pm. I was feeling woozy. But we walked to dinner, and I began feeling more human after I ate. Then it was off to the UW bookstore - my sister wanted to find gifts for her in-laws in the Netherlands. I found a few things, including this wonderful bar of peppermint dark chocolate:

My sis and I had fun in Portland on Sunday - on our way to Seattle. We had lunch with a friend and colleague and his little family. It was a gorgeous day. Then we went to the Hawthorne District and did some looking around. On Monday evening, after the UW bookstore, we went back to the room and watched a movie. I got a decent night's sleep and then we took off for home about 9/9:30am. I got home in time to pick up Spagedward from school. I had a lazy night last night and tonight looks about the same. I'm yawning as I type this. Whew!

For now, no more visits until June. Yay! Now to concentrate on work projects . . .


Joanna said...

Once again, you show the strength and lack of self pity that sets you apart from many others. It sounds like the appointment was a success. What an adventure.

Dee said...

Hi Joanna,
Wow, you are too kind! I appreciate what you had to say . . . I guess I just try to think of it all as a learning experience. If truth be told, I am making anthropological observations as I go through the clinical trial process, which means that there's a part of me that's observing what's going on from a distance. That helps!

Anyway, thank you again, Joanna!