First Infusion

Today has been a long day. 10 hours and 10 minutes from door-to-door long. Thankfully, though, we are home.

We left at 9:30 this morning for a 10:45 check-in and 11:00 blood draw. The inability to draw blood through KK's port at the MRI last week did not resolve itself and the more-experienced-with-ports clinic nurses were not able to draw blood either. They ordered tPA (tissue plasminogen activator) to see if that would declot the line. 

While we waited for tPA to arrive from the pharmacy, we spoke with the nurse practitioner, Mary Ann, and our new oncologist, Dr. Manley. There was confusion when the next round of chemo would start when we were at the clinic last week. Originally, I thought it would start today; after last week, I was under the impression that we would start next week. Believing the latter to be true and knowing we would need to be at the clinic every two weeks for the Avastin infusion, I planned a little get away for the week of August 17. The nurse practitioner was under the assumption that KK would have an infusion today, but she said we could do it next week instead. I asked if it was possible to do the infusion today then the next one in three weeks rather than two. I am so grateful that they agreed to this (one less trip to Boston...yippee!). 

After our meeting, our nurse, Jill, inserted the tPA, then we waited an hour to see if it would work. 

Nothing. 

Not a single drop of blood.

They decided to order a second dose of tPA from the pharmacy.

Calculating how long it would take for the tPA to arrive from the pharmacy (approximately 30 minutes), how long the tPA needed to sit (at least 60 minutes), how long the infusion would take (90 minutes), and how late in the day it was, they realized that we couldn't wait to do the infusion through the port. They explained that the Avastin was already ordered and that it had to be administered the same day. This meant that they would have to insert an IV for the blood draw and infusion. We asked for the Lidocaine spray that we were introduced to last week at the MRI, but they didn't have it at the clinic. KK cried. The nurse did a great job though and she was able to get a vein on the first try. It drew blood very slowly, but it worked. So, KK sat back and read for the next 90 minutes. By the end, she was completely exhausted and ready to be home.

They gave KK the second dose of tPA while she was receiving the infusion through the IV. Unfortunately, it didn't work either. At our next visit, they will access the port and try to draw blood when we arrive. If it works, KK will receive the next infusion of Avastin right away. If not, we will head over to Children's for a line test. They will inject a dye into the port then use an X-ray to see what is going on. If they aren't able to fix it, KK will have to have another IV for the blood draw and infusion.

KK would really appreciate your prayers for the port to work on August 25.