June 8
John did very well yesterday. They had trouble with his IV line all day. His blood was clotting and blocking flow near the needle. The IV needle is in a plastic joint with a female adaptor. Once the needle is in and taped in place, nurses screw in a catheter with a male adaptor.
In this picture, the pink part is the needle adaptor (the needle is already in the arm). A short catheter with a male adaptor is attached to the pink needle adaptor. The short catheter ends in another female adaptor. The meds can then be connected to this extension. This gives the nurses an additional means of controlling the flow through the IV and makes attaching multiple meds, one after the other, more comfortable for the patient. Over the course of the day there were more than a dozen different fluids attached and detached.
Between each med they would attach a syringe filled with saline. Pushing the syringe plunger forced any meds still in the catheter into John's vein. Then they would pull the plunger to get blood to come into the catheter. This verifies that the tube is not clogged so the next med will go into the vein.
All day the nurse, Regina, was having trouble pulling blood back out into the catheter but she managed it every time.
We were so tired and he was ready for his last med. Regina went to lunch and someone new was trying to flush the line and it wouldn’t pull any blood. Three different nurses worked on it. We told them that Regina was able to eventually get it working. The problem was blood was clogged in the needle adaptor. If the clog had been anywhere in the catheter they could have easily replaced it. If they couldn't get the needle adaptor cleared they would have to remove the IV and insert a new one. Thankfully, they are very conscientious about not doing that.
They sought out a good “sticker” named Matt who I think was willing to be a little more aggressive with the flushing and was able to get the clot cleared.
June 9
John trimmed his beard down last night. It’s falling out pretty rapidly now.
We both had a good night’s sleep and were back at the center today to get his follow up Fulphila shot. It stimulates the bone marrow to produce white blood cells.
It’s a pain to have to drive all the way back and wait for a ridiculous amount of time just to get a shot but insurance wouldn’t pay for an auto-injection patch and created a big hassle with filling the prescription to send the shot for us to administer. I told John, driving to Duke and waiting for a shot was better than spending hours on the phone with insurance to get the injection.
The shot was kind of painful this time. We had a great brunch at Big Bag Breakfast. John said it was the first meal he's entirely enjoyed in a long while. He had french toast and bacon. We both took a nap when we got home. The shot can cause bone pain and he was aching in the evening.
