Wednesday, January 28, 2009

Is that a banana under your Cheerios?

I buried the banana in the Cheerios and put the peel in the trash instead of leaving it on the breakfast tray. It made me wonder if my brain is OK after all.

Explanation: I know that since I am now on the restricted transplant diet, I can't eat any fruit other than that with thick skin. Having gotten conflicting answers about whether I can eat even oranges and bananas at this early point, I took matters into my own hands and felt a little like I was hiding contraband as I did it.

The doctor said I could have bananas and oranges, but they are not on my official BMT menu. Diane brought me a few oranges and bananas, but one nurse said to wait until I get home to eat them and another echoed her. Of course it doesn't really matter if I have the fruit, but maybe wanting it is a way of trying to hold on to part of my old routine. So…I figured a little banana wouldn’t hurt me. When I cut it up, it reminded me of being home, when the dog comes running as I peel the banana and I share it with her. I miss the dog. Too bad she can’t visit.

I am getting a ton of IV fluids with the chemo. This morning when I woke up and looked in the mirror, I noticed that my upper lip had puffed up, Renee Zellweger-style. I know that for some odd reason women pay for collagen injections to achieve this look, but I found it disconcerting, since it isn’t me. A nurse confirmed that it’s from the fluids, and everything will go back to normal when the fluids stop.

My night nurse is often Sergie, a model-beautiful woman from Haiti. I asked her if she had considered modeling; she seemed flattered and said no, she hadn’t. When my teeth started chattering as my fever rose the other night, she got me Tylenol and warm blankets. She covered me with the blankets and tucked my quilt in over them. We chatted for a few minutes and the shaking subsided. She’s the opposite of the rude MRI techs from the other night. Amazing how far a little kindness goes.

Yesterday, though, I had a problem with an inexperienced nurse. A preceptor accompanied this trainee most of the day. When it was time to hang my chemo, both came in, and the teacher led the way. So far, so good.

The IV nurse had to remove one of my IVs and start another, because they’re good for only four days. (I am still waiting to get another PICC line, which should happen today.) After she removed the old IV, blood seeped through the dressing. She applied more gauze, and it seeped through that too. So even though they weren’t planning on it, they ordered platelets.

The bleeding had stopped by the time the platelets came, but I was still anxious to get them in. The trainee came in by herself with the platelets and some other medication, opened the IV pump, and then dashed out of the room saying she had to check on something. It took a while for her to come back, and she succeeded in hanging the platelets. She watched to see that they were running but never came back to double-check.

Meanwhile Nurse Ronni noticed that nothing was dripping into the tube where I thought the platelets should be entering. I have a lot of bags up there – six right now and about the same number yesterday afternoon – and I traced the platelet bag and discovered that sure enough, it wasn’t dripping.

So I put on my mask and gloves and went looking for her preceptor. Sure enough, the IV through which the platelets were supposed to drip had clogged up and gone bad. She and the trainee then came into the room, where the experienced nurse changed IVs and the platelets began to drip. The trainee said, “Thank you for telling us, that was helpful.” (How about, "Sorry about that"?)

I didn’t have anything against her, and she was pleasant and well-meaning, but I think it was too much for me to have had to monitor this. Plus what if I had fallen asleep and I really needed the platelets to stop the bleeding and she hadn’t double-checked?

Later I asked the preceptor to please accompany her trainee when they are hanging something, because “she doesn’t seem to have the confidence and knowledge.”

The preceptor agreed and said she would have been in there, but she had had an unusual situation. One of her patients had bolted out of the pod into the hall and was heading for the elevator, and she had to go retrieve him. Okaaaaay.

Today I have an experienced nurse, so I feel I can concentrate on other things without having to “supervise.”

It’s D-2, the last day of fludarabine. Tomorrow I get the double dose of melphalan. As I said before, my mind drifts into worry-land with the question, “What if the melphalan doesn’t wipe out the leukemia?” (The fludarabine is lower intensity and is intended more to lower my immunities to accept the donor cells, while the melphalan is more intense and has the job of going after the leukemia.)

I must constantly bring my mind back, without getting down on myself for worrying. I need to remember the title of the subtitle of blog: Fighting Cancer One Step at a Time.


PJ said...

Glad to see you're in charge! Anyone questions you about the banana peel or other suspect refuse, give 'em the pout lip and blame it on Novice Nurse.

Hope the double dose is tolerable. I'm sure it'll do the trick.

Mikha'el said...

Remember this too shall pass and keep moving in the right direction. Enjoy this video I put together in case you have a chance.

Be well

Anonymous said...

At the Hutch I ate all fruits the entire transplant and post transplant (both in the hospital and at home). They LOVED us eating bananas. Obviously I could not and still can't eat salads or fruits when I am out and don't know how things are washed.
I was on a neutropenic diet in the hospital but they were so diligent about cleanliness that fresh fruits and veggies were a go. It made me feel healthy if that makes sense.

Yes, the chemo is going to DESTROY the leukemia. Not a doubt in my mind!

susiegb said...

I have to wonder how long they think you're going to be in hospital if they think you can save bananas up to eat when you're out of hospital! They'd certainly be uneatable after a week here ... :)

Anonymous said...

You have all the bananas you want, Ronni. Anything you need to keep up your morale.

Cheering for you.

Ann said...

Fludarabine and melphalan were not my favorite cocktails. I can only imagine how you're feeling right now. I was restricted from fresh fruits while stuck in the hospital and it made me crazy. If your doctor says you can have bananas, then you should have all that you want.
You're so close. Hang in there.

Susan C said...

He, he. That title is hilarious and I love the photo you found. It looks like the bananas are glad to see you.

Good for you for staying on top of those nurses.

Ronni Gordon said...

Thanks for the video, Mikha'el

It was very beautiful.

Paula said...

LOVE the title & the picture !!!
I think that your blog should be required reading for everyone. I am deeply touched, and learn something new, each & every time I log on.

Let the "Banana Count Down" begin !

Carol said...

Ronni, hi from Granby. is true, no longer employed with the paper, 25 years later. Not to worry. I'm thinking about you, tomorrow and know that this will do the trick, for sure. My niece Ann, sends her prayers. Can't wait to see you walking around the college, soon. Well, after the snow and ice melt. This will be OK. I feel it.
Sorry for the huge lapse, resumes, cover letters, job search engines, blah, blah....
love you...c u soon! Carol

LR said...

Great blog!
You keep eating them nanas. When I was getting my transplant in Scotland they almost forced me to eat them!

You will get through this, Roni, I know you will.

One Mother with Cancer said...

I hope everything goes well from here on out. Good luck!!

Wendy S. Harpham, MD said...

Dear Ronni,
You bring up so many important points with this post. I'll respond to the last one first:

Your mind wanders to wondering if this regimen doesn't knock out the leukemia. One thing that has helped me is sorting certain questions into categories. So any questions that are different ways of asking if this is the best course for me are okay to ask when making a treatment decision. If that decision is already made (and it is because you've started the treatment), I "dump it" and remember that I've shifted gears to hoping it will work well and planning on it working well.

If the question "What if?" is looking for the reassurance of a backup plan (and, Ronni, after going through my first five or six recurrences, it's not an unreasonable question), I don't need to know the backup plan right now. I can learn about next steps IF I ever need it, especially since my choices in the future may be different (i.e. better).

More than wanting to know exactly what the next course of action would be, I think I wanted to be reassured that the current treatment wasn't my last hope. It is easier to stay calm when you know there is a Plan B.

It is so understandable that your mind would wander to these questions. We've talked about shooing away hope-draining thoughts on my blog.The challenge becomes finding ways that work for you to shoo away yours.

It helped me when I found ways to build my hope that "this treatment I'm getting is going to work just as we hope."

We can tackle the other ideas you brought up another time. With hope, Wendy

Jim said...

Eagle Eye Ronni,

Glad you're watching things so closely. It matters. Not in the paranoid way, just trust and verify, as someone once said.


Wendy F. said...

Hey Ronni. Thanks for sharing the details of your experiences. Glad your getting your bananas and keeping an eye on the hospital staff. We're all sending good thoughts your way. Big congratulations on the blogger award!!

Tami said...

And not only is the chemo gong to DESTROY all of the leukemia your new cells are going to be bigger and stronger than any nasty cells. Positive thoughts and lots of love are going up the Turnpike straight to you.



Terri said...

Hi! You have a wonderful blog and I'm de-lurking to wish you the very best. As a former nurse I'd like to add that you are very smart to watch what goes on and be your own advocate. You absolutely have to these days. At the same time, you were quite patient with the rookie. Hope they find the escaped guy. Maybe he was running away from the rookie.

Don Treeger said...

Just think... when this is all over you will know more about this disease than most nurses and probably most doctors. I see a nice consulting business for patients in your future ( non-profit of course). You are missed Ronnie.


Don Treeger said...

Just think... when this is all over you will know more about this disease than most nurses and probably most doctors. I see a nice consulting business for patients in your future ( non-profit of course). You are missed Ronnie.


Don Treeger said...

That was so good I had to send it twice!! DOH!

Wendy S. Harpham, MD said...

Hi Ronni,

When you are in the mood for a fun post about authority figures, skip over to the Feb 1,09 blog post in "A Pastor's Cancer Diary."

with hope, Wendy