Sunday, March 12, 2017

My wife disconnects me from my Dosi-Fuser

This morning Teresa disconnected me from my Dosi-Fuser (described here) for the second time. Everything went fine, as it had the first time – but I thought the process might be worth describing.

It’s an intimate moment. Not that kind of intimate moment: I take off my T-shirt, but that’s as wild as it gets. But nevertheless it is an intimate moment. Things could go wrong. We have to work smoothly together. And what happens is that my wife injects me with stuff, and then pulls a needle, quite a thick needle, out of me.

So in more detail: I lie on the bed, minus my T-shirt. Teresa folds a towel and puts it on me, and on the towel she lays out the tools for the process. These include two injectors, one containing saline solution and one heparin (a blood-thinner); alcohol swabs; a bandaid; and gloves. Sloan Kettering sells us this equipment, which seems a bit unfair – they also don’t compensate Teresa for her time – until you consider the alternative, which is that all this would be done by Sloan Kettering at their office with greater expense and much greater inconvenience.

Then Teresa puts on a pair of gloves; this first pair can be non-sterile. With these gloves on, she opens all the packages that these tools come in and puts them back on the towel. Then she changes gloves; the second pair has to be sterile, and the sterile gloves come in their own package, nicely labelled “Left” and “Right.”

Then we’re ready to go. What am I doing? Well, two things. First, I try to keep Teresa’s iPad open to the page with Sloan Kettering’s very detailed instructions, and to scroll up and down the page as she requests – because she can’t touch it now that she has her sterile gloves on. Second, at various moments I hold part of the tubing while her hands are full with other steps. So far I’ve done okay with these two tasks.

Meanwhile, first, Teresa removes the tape that holds a sensor on my abdomen. The sensor’s function is to pick up my body heat, and based on that to instruct the Dosi-Fuser to continue to send the medication out through the tubing and into the port. Removing the tape hurts a bit; Teresa apologizes but it’s completely unavoidable – and that’s so even though Sloan Kettering already uses its “sensitive skin” tape on me.

After that she clamps one part of the tubing from the Dosi-Fuser shut. At this point, if there were any medication left in the Dosi-Fuser, it couldn’t get to me – but in fact I seem to run a bit fast, so the bottle’s been completely empty a few hours ahead of schedule anyway. (That’s okay.) Then, above that point in the tubing, she screws in the injector with the saline solution, and injects that, three pushes each sending about 1/3 of the total into me. Next she does the same thing with the heparin injector.

Now we’re ready for the actual removal of the needle. First Teresa closes a second clamp, so now nothing can get into me (though there’s also no longer anything attached that could go in). Then she removes the tape around the needle’s entry site. (More pain and apology.) Then with one hand she holds the base of the needle apparatus down onto me, and with the other she uses the attached handle to pull the needle out till it clicks into place. This is of course the most dramatic moment, and so far seems completely painless. And then we’re done, except that she gathers up the Dosi-Fuser itself plus the tubing and puts it into a container we supply. We’ll bring this back to Sloan Kettering at my next treatment date, and they can dispose of it as medical waste.

Oh, and one last thing: gauze and pressure on the needle site just in case there’s bleeding (there wasn’t any today), and then a bandaid. And then I’m free to take a shower for the first time in two days.


Thank you, my dear Teresa!

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