PICC line

Breast cancer lesson 128: An arm without a PICC line is a wonderful thing

Tonight is a momentous occasion. Tonight is the first night since 31 March that I will be able to shower without a plastic radioactive-style sleeve covering the best part of my left arm (see below for a reminder of my recent shower style). Tonight is the night my arm gets lathered in something other than alcoholic swabs and Cavlon. And, most importantly, tonight is the night I get another step closer to the normality I so desperately crave. And, you know what? I think it might just be the most exciting shower of my entire life!

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Apart from a hard bit of, I guess, scar tissue, surrounding the entry site, the area is already healing well. Gone is the dry skin and going are the blisters and the sticky plaster residue. I thought I’d be walking round with the feeling that something is missing. In truth, the memory of the plastic tubing, the clip and the valve stopping the blood leaking out has already started to fade. I love my body’s amazing ability to forget.

We’ve had some good times (namely stress-free chemo sessions) and some not-so-good times (saline flushes and heart palpitations come to mind). But, I have to say, we’ve had a fairly uneventful relationship (I often forgot it was there) and the advantages have more than outweighed the disadvantages!

Tonight is also the night I hoover up the last of my steroids. That’s means an end to the crazy highs, swollen hamster cheeks, water retention and unfair weight gain. Woohoo! The only downside? The house might not be as tidy for a while.

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Who needs alcohol, when I have the opportunity to enjoy a lukewarm shower and feel the water trickle over ALL my weary limbs? Us chemo bods sure know how to celebrate! I’d say ‘let our hair down’, but there isn’t much of that!

I may be some gone for some time… 🙂

Breast cancer lesson number 118: Keep running to that finish line

I have in my possession a blue oncology appointment card on which the words: ‘PICC flush and dressing’ have been written for THE LAST TIME! While it doesn’t actually mean an end to the PICC line (that comes later), it does mean that this time next week there won’t be any more scheduled trips to the hospital just for a shot of saline and a nice clean piece of tubi-grip. I could go as far as to say, this could be my last PICC line flush appointment EVER! But I won’t (just in case).

Ok, so I appreciate this flimsy piece of paper is not much in the looks department. But this card (which the unit lost at my last visit and have only just posted back to me) means a lot to me. For those of you following my #100happydays project, I described it as a reminder of the fact that, whatever race you are running, there will always be a finish line (and if there isn’t, you should ask for a refund on the entry fee!). And, every finish line, however small, is worth celebrating.

Sometimes in life, we are too busy running to make sense of it all. A finish line gives us hope, focus and the reassurance we’ve been running in the right direction all along. I feel like I have been running for my life for the last six months. Reaching the end of a stage (albeit a small one) is a great feeling. It is life’s way of saying the end is in sight and there will come a time when all that is left is you, the memory of an epic struggle and an invisible medal of honour, awarded for just making it through each day.

So whatever it is you’re running for right now, don’t lose sight of the finish line. Enjoy the run if you can, but remember, even if you’re climbing a hill right now, that hill will end – along with the pain.

Who knows? I might have just enough energy in reserve to make the end of the big race a sprint finish!

Breast cancer lesson number 115: Think positive and positive things will happen

Strange as it may sound, I am starting to enjoy chemo day. This has nothing to do with being hooked up to toxic drugs and a saline solution (oh yes, the beautiful saline) or visiting the hospital (third day in a row) and everything to do with the positive routine I have established for myself.

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It starts – after a steroid-fuelled restless night – with the baking. Today, we tried out a chemo cookie recipe from one of mum’s beautiful friends alongside an experimental lemon and ginger muffin recipe (complete with ginger and rhubarb jam tucked away inside). Both were topped off with a drizzle of melted lemon chocolate. It always feels good to do something for other people and the thanks I got at the unit today meant the world to me. I know some of the cookies ended up as one nurse’s lunch (she was too busy for a break). I also got a wonderful phone call earlier thanking me for my latest pink heart, so I have pretty much smiled all day long.

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Next up is a good walk. By Sunday, I will probably find it increasingly hard to get round Greenwich Park due to the bone and muscle pain, so today is a good day to make the most of my legs while they are still working! In the absence of tastebuds, exercise has been my comfort eating. I do it to feel better and it is certainly does wonders for the waistline and the soul.

People often worry about what to eat before chemo. For me, I like to keep things simple. A bran-based brekkie keeps the constipation at bay and a simple lunch (with an afternoon appointment) means you go well fed, but without having eaten anything you’d avoid for life if you saw it again. My time at the chemo unit is always packed with planned-in treats!

By the time I reach the hospital, I am ready for action.

For those who have never been to a cancer day unit (and I hope if you haven’t, you never will), here is a quick glimpse behind the scenes:

1)     First you arrive, book in, hand over your appointment card and receive a hospital wristband in return (printed out of special wristband paper).

2)     Next, you wait in the lounge (this time in front of Wimbledon) until the drugs have been delivered and the chair is ready.

3)     Once in the chair, the nurse allocated to your zone takes your blood pressure and checks the oxygen levels in your blood.

4)     Providing all is well, the anti-sickness meds (Emend and Domperidone in my case) are administered.

5)     Once they’ve settled in the stomach, the PICC line is flushed and the drugs are hooked up to both a pump (so they can be released over time) and the PICC tube.

6)     Then (with Docetaxel), you get a good hour to eat (lollies and muffins), drink (tea, water and hot water) and chat.

7)     Summoned by incessant beeping from the pump, the nurse comes back to do a final saline flush.

8)     After everything has been disconnected, the rucksack-sized pharmacy bag arrives, complete with eight injections, and enough pills to make your stomach rattle.

9)     Before being released, the last job is to pick up the appointment card. We think mine may have gone home with another Jackie, so I had a nice new one to take home today.

And that’s it. Providing you don’t have an allergic reaction to the drugs, it is a fairly pleasant experience.

Back home, I am happy in the knowledge I have five behind me and just one poison to go. I have started planning my last chemo day (let’s ignore the fact I have radio and 10 years of hormone therapy for the moment) and I am pretty excited. This is the last cycle that ends with another poisoning. And that means the end of chemo (albeit six weeks away) is finally in sight.

It’s been a happy Friday for me. And, I hope it has been a happy Friday for you too!

Breast cancer lesson number 110: See the everyday in a new way

On the train yesterday, when I realised the girl opposite was drinking something that smelled just like the sugary sweet pee created by injecting Docetaxel into your veins, it suddenly hit me. Life will forever be filled with both obvious and surprising triggers waiting to transport me back to cancer in a heartbeat.

Joining this turquoise-coloured soft drink (goodness knows what it was but I hope I never smell it again) is the smell of mouldy oranges. For me, I will now always associate that not-so-fragrant odour with the smell of saline. For anyone who has their PICC line flushed weekly, my thoughts are with you when that little solution goes in. I can taste it and I hope, once the line comes out in a month’s time, to never taste it again. I certainly won’t be going anywhere near a mouldy orange, that’s for sure.

Of course, it’s not just smells. Then we have sounds. I can no longer look at my fridge in the same way. Leave the door open just a second too long and it beeps like a chemo pump when the drug bag is empty. For anyone who has visited a chemo unit, the sound of pumps beeping (always at slightly different times and never in unison) is something that stays with you long after the PICC line valve has been closed. And don’t get me started about my cancer anthem. I love Pharrell William’s Happy, but why do I have to hear it (other than through my iPod) on important cancer days (diagnosis day being the first). Don’t get me wrong, as anthems go, it’s a goodie. I am certainly grateful it’s nothing morbid, like Hurt or Sister Morphine. 

And what about those sights? The Shard, The Houses of Parliament, Southbank, the Thames Clipper (a commuter boat on the river) and the lamppost opposite our house. Once just London landmarks (ok I appreciate the lamppost won’t be making it onto a city tour any time soon), they are now markers in my cancer journey. Even Big Ben is no longer just a bell (yes, folks not a clock or a clock tower, a bell). It’s the bell that kept me company on those long nights after DIEP surgery.

Cancer has even given activities, such as painting my nails, a purpose. How will I ever paint them again without reminding myself of the darkened and brittle nails I was once trying to cover up.

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Maybe it’s no bad thing. Maybe, instead of fearing the smells or launching at the fridge when I am unloading the grocery shopping, I should embrace them, safe in the knowledge that the everyday is still the everyday and I am lucky enough to be here to enjoy it. Maybe I should hug the freezer rather than shutting it, reminding me every day to keep embracing the little details of my life, knowing how quickly and how silently they can be taken away. 

A sound many trigger a memory of cancer, but a memory is all it will be.

 

Breast cancer lesson number 48: Short-term pain, long-term gain

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Meet PICC. He’s my new best friend for the next four months (sorry body corset, but you’re history as tummy is pretty much sorted). Otherwise known as a peripherally inserted central catheter, he’s my ticket to the pain-free (and finding-a-vein free) administration of chemo drugs and collection of bloods. He’s not much to look at, but he’s better than a needle (or eight) and that’s all that matters.

There’s nothing like getting 42cm of flexible tubing inserted into your arm to make you feel like a real patient. One more consent form and another plastic wristband down and I was lying on a bed staring at an ultrasound machine, a syringe full of local anaesthetic and a lot of wipes and tubes. The good news? I didn’t have to wear a gown!

It started well. The nurse found a vein with the ultrasound while I was quizzing the nearby student nurse about all the operations she’d observed. (She was quite forthcoming about the details, including the time she watched a surgeon connect blood vessels from a tummy to a chest as part of DIEP surgery. It was fascinating and certainly a strange distraction from the procedure). The local anaesthetic went in well and then the tubing started to enter my arm. I heard the word ‘kink’, then a pause, then a ‘could you bleep the other nurse?’ and a ‘I’m sorry it’s got to come out’. She had done so well and got so far, but when the pressure turned to pain (it’s not supposed to hurt) we both knew it was time to abort. Another vein thrown on the vein scrapheap!

Round two was a complete success. Vein located, anaesthetic in, and 45cm of tubing later and I was off for a chest x-ray. I say 45cm, because the x-ray (an interesting experience in its own right and another x-ray first ticked off the list) highlighted that the tubing was in about 3cm too far. So, I was back to the Cancer Day Unit to get it pulled out a little bit. The tip of the PICC line sits in the big vein just outside the heart, while at the other end, there is about 4cm sticking out of my arm. Don’t worry, for those of you concerned about whether it will come out, the line is held in place by something called a ‘statlock’ and a transparent breathable dressing. Golf and tennis are now on the ‘temporarily banned’ list (along with swimming due to chemo), but I should be able to use it as normal once the initial tenderness has subsided. For those of you who’ve been unlucky enough to see my golf swing, you’ll know this is no great loss. The Olympic Park swimming trip on my Brighter Life list, will just have to wait.

Tucked away neatly under a piece of tubing, it wasn’t until I reached for my cardigan that I stumbled across challenge number one. At the moment, bad arm is right arm, so bad arm goes in to the sleeve first. But what happens when you have two sensitive arms? Let’s just say, it was a pretty good comedy sketch and, after a quick wrestle, I managed the cardie. The coat is a challenge for another day!

One other thing I didn’t consider in this battle against bad veins was that, like all good cannula-like devices, it needs looking after. That means weekly dressing changes and line flushing. More nurses, but thankfully no more needles! That’s a price worth paying. 

Today I have learned a good few things. One, the Cancer Day Unit is lovely (more on that tomorrow). Two, my right arm is now straight enough to pass arm testing for the clinical trial. (It took six attempts and the nurse and I were laughing by the end, but we got there.) Three, PICC line insertion is an interesting procedure (as is a chest x-ray) and really isn’t that uncomfortable if you’re considering getting one. Four, details of the acute oncology assessment unit must now travel with me everywhere. And, five, my blog URL is (amusingly) blocked by the hospital WIFI (probably deemed as dubious, but given the amount of boobs currently on show in most hospitals, I find it so funny. Mine just includes the word). The hospital does do a good egg sandwich though, so I’ll let them off.

I’ve seen the unit. I’ve seen the chemo chair (looks quite comfy). I’ve seen the suite and I’ve got the line. There’s only one thing missing. Those cell-destroying drugs. Just two sleeps left.

First, I have to work out how to have a shower without getting the PICC wet and then I need to look at just how many more clothes are now off limits due to my new arm accessory. Just when I thought I was getting my wardrobe back.