Round 2 – The Lay of the Land

The seventh floor of the Center for Advanced Medicine features a large open area in the center of building, ringed by the offices of the medical oncologists on one side and the cancer treatment center, lab and pharmacy on the other.  There is a large sitting area, comfortably arranged, and often very crowded, especially later in the morning.  Although it was fairly quiet Monday morning at 8:00, it can often be like Grand Central Station at rush hour.  There are generally pairs of people, one of whom is there for treatment and a spouse, significant other, child or friend there for support. It is often hard to tell one from the other, but in some cases it is clearer: the woman wearing a head covering – hat, scarf or turban, or the man in the wheelchair or walker or carrying a tank of oxygen, or occasionally someone who is obviously not well. 

The unusually uncrowded waiting area

The cancer center has made an effort to make this space friendly.  There are several tables along the edges set up with partly done jigsaw puzzles or chess sets.  There are library carts with books to borrow and magazines of all kinds are placed throughout the area.  They also provide free coffee and hot chocolate from machines that are impressively fancy. 

When you enter the area you sign in at one of two reception desks and receive an electronic pager, such as you might get at a restaurant while waiting for a table. Then most people, myself included, just sit and wait their turns, conversing quietly with a companion, reading, or just watching the world go by.  While most of the group appears to have mastered the etiquette of communication in public spaces, others seem to be completely oblivious.   Occasionally there is a thoughtless person among the crowd who talks too loudly on a cell phone or entertains his or her companions with loud tales of little interest to the rest of us.  Fortunately, these people seem to be in the minority.

On Monday I went to labs first, where I had blood drawn through my port – this funny Frankenstein bump protruding from under my skin, just below my left collarbone.  From there it was across the way to see my doctor for a check and a chat about how things were going, side effects I had experienced and whether there needed to be any adjustments in treatment or follow-up to deal with some of the range of rolling side effects I’ve had.  Fortunately, none of my side effects were unbearable, though she made some minor tweaks in my post-treatment plan.  She was pleased with my status and most surprised to see me sporting my own hair, which had thinned but not enough to call it quits yet.  She said I had “strong” hair!

I was cleared for take-off, so back across I went to the treatment side of things where I signed in once again and got another pager, and waited my turn to be called in for chemotherapy.  I was scheduled for 9:30, and it wasn’t long after that before I was buzzed and then escorted to my “pod” where I had a choice of a bed or a reclining chair.  During my weekly “30 minute” infusion the week before, I had discovered that, although all the recliners are comfortable, there is one deluxe model scattered throughout the pods.  It was vacant on Monday morning, so I grabbed it and settled in.

The pod

Two nurses and an assistant are assigned to each pod with room for six patients.  The assistant does the initial check-in, taking blood pressure, oxygen levels and temperature – again.  It’s interesting to see how one’s BP can vary from hour to hour, as all of these readings were taken an hour before on the doctor’s side.  The change wasn’t dramatic from a medical standpoint, but both numbers were up just a touch.  Anxiety, perhaps?  Fortunately, I am blessed with healthy, low blood pressure, despite my love of salt!  After taking your numbers, the kind assistant provides little luxuries, such as warmed blankets (a favorite of mine), pillows, juices, sodas and snacks for the asking to both the patient and her companion. 

After a bit of settling in, an RN comes in and again checks to see how you’re feeling, whether you’re having any side effects, answering questions and providing tips and advice.  Although I had discussed these with the doctor, not everyone sees the doctor every week, and the RNs have an incredible wealth of knowledge and techniques to share.  They are on the chemotherapy front lines and have seen and heard it all.


Then the next wait begins.  There is a pharmacy based in the treatment center so they can dispense the drugs right there.  They don’t prepare your drugs until you are there, seated in your chair and have been checked and cleared.  The center is a very busy place, treating 160 patients on an average day and 200 on a busy one, so it takes some time for the medicines to be prepared, delivered to the pod, checked and rechecked before they start to administer the IV drips. We started at about 10:30. First in: some IV steroids and anti-nausea drugs to help with side effects, and IV Benadryl to battle any possible allergic reactions.  The Benadryl knocks me out for a bit, which is a lovely way to pass some of the time.  Then a one-hour drip of Taxotere, followed by thirty minutes of Carboplatin and finished off with a chaser of the weekly thirty minute dose of Herceptin.  

Hooked up and ready to go

At least that’s my mix – it varies from cancer to cancer and patient to patient.  When we’re all done they flush the port with saline and then inject some Heparin to keep blood from coagulating and clogging the port.  It is therefore primed and ready for its next use.  At 2:00 p.m. we were ready to head home, where still a bit dopey from the Benadryl, I promptly sank into my bed and took another nap!