Not such a smooth groove, this time.

We got to the D-F rather early for our 11:15 appointment, and were very pleased to be taken immediately by the lab nurse. The IV line was placed in my hand, as it was last time, but it wasn't quite as comfortable (more on that later). Blood was drawn, and as we were wafted to the 9th floor by the elevator, we were thinking, "And maybe the doc will take us early, too." I had had a bit of pre-chemo anticipatory nausea, and so was riding in on an Ativan, which may have aided this delusion.

No such luck. "Just so you know, the doctor is running about an hour and a half behind schedule."

When I was called for the taking of the vitals, I mentioned that I would be amenable to seeing the nurse practitioner. "She has a patient scheduled too," I was told, "but we'll see what can be done."

The urgency is that I have to have the Neulasta shot (I had nearly written "foolish Neulasta," but since my red and white counts are both fantastic, I will refrain from bad-mouthing the Wonder Drug) 24 hours after the chemo treatment starts, and so, since chemo was scheduled for 1 pm, I had scheduled the shot for 3 pm.

At 1:30, I saw the NP. Looks like I may not see the actual surgical oncologist ever again, based on the schedule for the rest of my treatments. We talked about this and that, and I learned a thing, namely that withdrawal from steroids can cause shakes and heart flutters. So, instead of using less decadron, I will use more, tapering off instead of stopping with an abrupt bump.

Then there was a half-hour wait in the infusion waiting room, while the infusion gnomes hand-mixed my particular kill-to-cure brew. We are now pushing 2:15, and I am starting to stress, because re-scheduling the shot will not be fun.

Finally, we were brought into a slightly less pleasing infusion cubicle than the last one, and that's where the fun started. See, the first chemo, the one they "push" is a  vesicant, so it's really important that it not leave the vein into which it is getting pumped. (I will ask how it doesn't damage the vein next time -- I do know that this one can damage your heart.) And as the infusion nurse began to administer the drug, my hand began to hurt. Not burn or sting, but really hurt, both downstream from the insertion point and around it.

• Analysis: The IV line is poorly placed -- probably nudging the wall of the vein. Best to replace it.
• Further Analysis: If you are having infusions at Dana-Farber, ask if Anne Lundquist can be your infusion nurse. The woman knows venous anatomy, people. She went for the large vein that curves around the outside of the forearm like it was a well-known street a few blocks from home.

And all went smoothly after that. Also, I learned another thing! (Two in one day!) It seems that:

• Some mouth sores can be quelled by chewing ice while the chemo is being administered -- but alas, not for this type of chemo.
• The mouth sores generally are worst when one's immune system has crashed. Therefore, they are a fairly reliable indicator of when one ought to be staying away from folk.

This fascinated me, and made me feel rather differently about the durn things.

I do feel both peculiar and queasy, but I was able to eat chicken-and-rice soup with a zucchini cut up in it. (I am not telling anyone how long it took me to type this entry.) And now, bed.

(Oh, do not be scared by the pictures in the Wikipedia entry. This is much more mild.)