Bubbles

 I got to the infusion center yesterday and found it completely deserted – nobody behind the desk and nobody in the waiting area either, like the rapture had hit just one floor of this outpatient building.  Eventually one of the receptionists showed up and issued me the standard bracelet.  

I have a couple of favorite nurses, mainly because of their IV starting skills – after so many years of medical crap, some of my veins are just done.  Yesterday it was Kayla, an energetic woman whose slight build and pixie cut remind me of Kess, a character from Star Trek Voyager.  I’m not the only one who had this kind of reaction to her – a few cubicles down an older man getting chemo told her how much she resembled a character from a 1960s movie.

Kayla had a trainee with her, a nurse who told me she had previously worked at Presbyterian so told her about Project Stay, the youth clinic we work with at Presbyterian.  Nurses have a lot of tricks for setting up IVIG because it’s not a watery liquid like most IV drugs.  IVIG is viscous, and when they hang it, it develops a lot of small bubbles, like the glass bottles is full of small transparent round beads.  The bubbles can cause the IV pump to go into error mode, so they do a lot of flicking and arranging the tubing to try to minimize that.  The other complication is that they can’t start it at the fast rate and just leave it – to prevent reactions, they have to start it slowly, and then raise it a little every half hour.

I was sitting there, dripping and thinking, when a woman in a red jacket with a logo and arms full of red folders came by.  “I’m from the Red Door, an organization that provides support for people with cancer,” she said.  “I don’t have cancer,” I told her, “But I’m glad you’re doing this.  My mother had breast cancer, so I know how difficult it is.”  She asked about my mother, so I told her the story of her lack of insurance, late diagnosis, and death at 56.  She looked kind of horrified.  “When was this?” she asked. “She died in 1999,” I said.  “But now that the subsides for the ACA have been cut, people will be back in the same position.”  “People are living a lot longer now,” she said.  “I know, my grandmother had breast cancer too and she was one of the first people to take Tamoxifen and she lived into her 80s.  Her doctor published a case study about her.”  “How long did she have cancer?” she wanted to know.  “I don’t actually know.  People in Kansas don’t talk much about important things.  It wasn’t until my mother was diagnosed that they told us Grandma had it, too.”

By then, she felt comfortable enough to ask me about the bubbly stuff heading into my arm.  “It’s IVIG, antibodies from a lot of donors because different people have been exposed to different germs so this way I get antibodies to all of them.”  She was a little amazed by this.  “How long do you have to do that for?”  “The rest of my life – my body isn’t going to start making antibodies.  Like, if you vaccinate me, it doesn’t work.”  At that point it dawned on her that she was supposed to be finding cancer patients.  “This is really interesting, but I have to get back to work,” she said, a little guiltily.

     The next person who came along woke me up.  I don’t know why, but something about absorbing these exogenous antibodies makes me really tired.  She was someone I have met before, an elderly lady with a small grey poodle in a carriage.  The poodle sniffed my sleeve, checking out the cat hairs.  “She has cats at home,” said the lady, “but she chases them so they don’t like her.”  I gave her curly coat a few pats, but she seemed distracted. “She’s looking for her favorite nurse, I don’t think she’s here today.”  “Have you been doing this for long?” I asked, thinking that this dog is not that good at engaging with patients.  “We’ve been doing it for seven years, except for COVID.”

     I would have gone back to sleep but Kayla and the guy next door, a black man in a bright orange pants and hat, were having a very loud conversation.  “I know you always come here styling, but I didn’t know you made the jewelry,” she said.  “Yes, I’m on Youtube,”he said, giving her the details.  “I got rid of the car service,” he announced.  “They were lying, telling my counselor they were here when they weren’t.  I don’t like that.”  “Your counselor should believe you,” said Kayla but in my work I have seen so many agency staff who consider the client the last person worth believing.

     Kayla comes back to adjust the rate again.  “I’ll be here next time, too” she says.  “I’m going to be in a neck brace next time.”  She asks about the details of the surgery.  “Neck stuff makes me nervous,” she says. “My spine surgeon looked at the MRI and gave it to this other surgeon,” I tell her.  She nods, “the pro called in the bigger pros.”

     When she leaves, I think about her anxiety.  Neck procedures are delicate.  I’m not afraid of not surviving the surgery, I just figure if I’m dead it’s not my problem anymore.  But paralysis is terrifying.  I think to myself that I need to update my advance directives, just in case.