Before my chemo treatment began, I had a long video call with Dr. K.’s nurse practitioner where she walked me through chemo logistics and side effects —from nausea all the way to the risk of heart failure and nails falling off. Sigh...
At some point in the conversation, a chest port (that is, a device usually placed under the chest skin to administer chemo infusions directly into a vein near your heart) was mentioned as a fait accompli. Not a good idea...
I am not a fan of not having options, neither am I a fan of important information being glossed over in the hopes that it will just stick . This glossing-over strategy triggers me, and the chest port incident did exactly that.
In fairness to the nurse practitioner, a chest port makes each chemo infusion easier (no need for searching and poking) and it protects your veins. Having said that, although a chest post is standard protocol, it is not always a must-have.
That is where options come into play and that is where I get mad.
So… how will this chest port be implanted under my skin? —I asked.
You will need a procedure —the nurse practitioner replied.
And will this be local or general anesthesia? —I inquired.
It is a one and half-hour procedure, so it will be general anesthesia —she further replied.
No —I said without even blinking.
It is really a sedation —she tried to explained.
No —I said again breaking down in tears. No, no and no —I doubled down.
An awkward silence followed, only to be interrupted by words like advisable, common practice and having nothing to worry about. But we were talking about general anesthesia, a quarter-dollar-size device, a thick chunk of metal under my skin and a scar. Really?
Have you seen my veins? —I asked firmly. All I was hearing was standard practice and convenience, but nowhere was I hearing this was a must-have.
Then, I continued (while still crying). I am not questioning the chemo treatment, what drugs I am being given or how many infusions I am getting, BUT, when it comes to veins, I am every nurse’s dream patient. I don’t have veins. I have pipes!
Another awkward silence followed, and then the nurse practitioner agreed to consult with the nurses in charge of the chemo infusions. A few hours later, I was asked to email a few pictures of my forearm and, later in the day, it was agreed I could (at least for now) skip the chest port and get the chemo infusions through regular IV into my arm.
I smiled and I was relieved but, deep down, I was still scared and mad.
Why wasn’t I presented with options? Why didn’t anyone bother to check my veins and only then decide? Why was I being pushed into a cookie-cutter invasive procedure and not being given the chance to have part of my treatment customized (dare I say, Lauralized)?
There is a lot about a chemo journey where a patient has no say, as most things are protocol-based and standardized. However, while chemo protocols and standards are largely a good thing given the wealth of research and data supporting them, at times they can be—at least for patients like myself— a drawback.
I did not choose to have breast cancer and, if I could have it my way, I would have passed on chemo. But, again, since it was doctor’s orders, chemotherapy is part of the plan. Having said that, my take-away on this one is to keep asking questions and listen to the answers.
If something is not a must-have, one has (in chemo and in life) the ability to opt out.
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