Yesterday was Herceptin and blood draw day. Since surgery is done, I have been able to resume taking Coumadin, a blood thinner (taken to prevent further blood clots from forming in my body). I still have not reached a therapeutic dosage of Coumadin, and the latest instructions I had was to take 17.5 mg of Coumadin until yesterday's labs. When I have a chemo treatment, I typically have an appointment with the doctor as well. That appointment was nice and early (8:40)--presumably early enough for me to get labs, see the doctor, get the Herceptin infusion, and be out the door before noon. Not so fast....
The labs and doctor's appointment went as planned, and I was ready for chemo by 9:30. My attending nurse had planned ahead and had the drip ready for me. All she had to do was to access the port (stick the needle in), make sure the port was not blocked and connect me up to the drip.
After the nurse puts the needle in the port, she typically flushes the port with Heparin, an anticoagulant that cleans out the port to make way for the drugs. After the Heparin goes in, the nurse then draws back on the syringe creating a suction that should draw blood through the port. It's a confirmation that the port is completely open. It wouldn't be good to be putting chemo drugs into a port that's plugged up.
The problem came in the blood return phase. The nurse just couldn't get any blood return, an indication that the port was plugged. Since this was not the first time this had happened, I knew the drill: get up and move around, bend over, raise my arms to see if that would coax the blood back into the syringe. No luck. Next came the Cathflo--a drug to dissolve the coagulation that might be blocking the port. One problem--you have to wait 1-2 hours after administering the Cathflo to allow it time to work. OK, I thought, no problem. Watch a little TV on Hulu. By 11:30, we were ready for another try at a blood return. No luck. Another dose of Cathflo. Another 1 1/2 hours of waiting. More Hulu. Another try at a blood return. No luck. Next up is a port study with contrast, a test that shows if the port is actually open or plugged. They inject the port with dye and take Xrays of the port. Results? The port was open and working. Think of a straw going into a flexible tube. If you suck on the straw, the wall of the flexible tube may collapse. That's what was happening with my port and the artery it goes into.
Bottom line? I started the drip at 2:30 and left the chemo center at 4:30. What a waste of a day!
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