This Machine Killed Cancer

Sleep is awesome.  Not only is it an easy way to pass the time, it is also one of your body’s main methods of healing.  Everyone from scientists to your grandmother agrees that, unless you’re one of the kids in Nightmare On Elm Street (or, god forbid, the recent remake), sleep is good for you.  So, naturally the hospital staff seems hell bent on making sure that nobody there goes to sleep ever.  Well, that’s not completely true - they encourage going to sleep.  In fact, they’ll give me all kinds of drugs to help me along that little journey.  But there seem to be strict rules about letting a patient stay asleep for more than 30 minutes at a time.  Here’s a typical night at the hospital for me:

11:00pm - I decide it’s late enough and I should try to get some sleep, so I call the nurse and dose up on Oxycodone and Benadryl. 

11:30pm - Amidst the whirring and beeping of various machines and the ambient light from the hallway, I drift off.

12:00am - My IV starts beeping because I’m out of Sodium Bicarbonate.  Call the nurse, wait for her to change the IV bag.

12:30am - I start to drift off again.

1:00am - Time to check my vital signs.  A nurse’s aide comes in to take my blood pressure, temperature and pulse.  If I’m lucky, she’s quiet while she does this.  If I’m really lucky, she doesn’t turn the light on.

1:30am - Drifting off again.

2:00am - Blood draw!  They have to monitor the level of Methotrexate in my system (I get to go home when it drops below 0.05), so the nurse comes in to take a vial of my blood.  I still don’t understand why this has to happen at 2 in the morning.

2:30am - Ah, sleep.

3:00am - I roll over onto the port in my chest.  The pain wakes me up enough to realize I have to go to the bathroom (because they’ve been pumping me full of fluids all day and I have a bladder the size of a small mouse).  I gather my IV stand, unplug it from the wall, and make my way to the bathroom.  This simple process takes at least ten minutes and several curse words.

3:30am - I lie awake wondering whether Rebekah and I will be able to dig our way out of debt, if I’m going to die in the next year, and why Fox would cancel a show like Arrested Development but allow a travesty like So You Think You Can Dance to continue on into a seventh season?

5:00am - The nurse comes in to give me my morning meds.  This is usually some combination of chemo drugs and drugs to counteract the other chemo drugs.

5:30am - Time to check my vital signs again.  Blood pressure, temperature, pulse.  Nurse determines that I am still vital.  I’m not sure about the nurse.

6:15am - An adult patient in room 17 is having a Code Blue.  I don’t know what that means, but I know it’s happening because they announce it over the loudspeakers.

7:00am - Shift change.  The day nurse comes in and, I kid you not, introduces herself.  At 7 in the morning.  Consider how much coffee she had to drink to make it to work on time this morning and how that might effect her ability to keep her voice below a light shout.  The rules also say that she has to take this opportunity to listen to my heart and lungs with a stethoscope that she keeps in the freezer.

7:30am - Food and Nutrition Services brings breakfast.  They don’t even attempt to be quiet when they come into my room to do this.  Also, I never eat anything that they bring.

8:00am - One of the oncologists stops by to see how my night went and tell me my Methotrexate levels.  He will come by again with the oncology team in about an hour, so this is just a pre-check-up check-up.

8:30am - Food and Nutrition Services again, just wanted to take my lunch order.  I’ve learned to mumble “the special” because it is the least amount of words that will make them go away.  It doesn’t matter what I order because I never eat anything that they bring.

9:00am - As promised, the oncology team stops by.  This is 8-12 awkward young doctors standing around my bed, where I am lying in my underwear, trying not to wake up completely.  They ask me questions about how I’m feeling and if I have any serious questions about my care.

9:30am - Someone delivers a newspaper.  Last week, the young man who did this glanced around the room and decided the safest place to toss the paper was on top of my sleeping body.  So I woke up in the Metro section.

10:00am - Food and Nutrition Services again, yay!  They want to know my dinner order.  Same deal: mumble “special,” do not eat.

10:30am - An elderly man comes in, identifying himself as a patient advocate and wants to know if everything is going well with my stay in the hospital.

10:45am - Vitals.

11:00am - Food and Nutrition Services, in their fourth and final appearance of the morning, comes in to collect my untouched breakfast tray.

Usually I would be up well before 11am, but since I never got to sleep in the first place and I’m fighting off the effects of the incredibly harsh chemo treatments, I’m still trying to sleep at this point.  By 11 o’clock though, I’ve given up and get up to start my day.  I should note here that every time someone comes into my room, they knock first.  I think it’s in the rules that they have to, but I don’t know why.  I’ve tried saying all sorts of different things from “ok” to “come in” to “no” to “go away.”  They come in regardless.  Anyone who knows me personally, knows that I go out of my way to be kind to people, especially people who are in the service industry or control my access to narcotics.  I hate having to be a jerk to anyone.  But I’ll admit that when the eager young nurse’s aide asked me at 8am the other morning if there was a story behind the tattoo on my arm, I did take some pleasure in answering, “Yep,” before rolling over and going back to sleep.* 

This cancer experience has been a swinging pendulum between sleeping a lot and not sleeping at all.  When I first started getting sick last fall, the tumor next to my heart was making my heart beat extremely fast at night.  It was like trying to go to sleep after doing a line of cocaine (not that I know what that’s like if you’re reading this, mom).  Coupled with the coughing and terrible leg itch (one of the stranger symtpoms of lymphoma), I spent many New York nights awake on a futon, trying not to lose my mind.  Once I started getting treatments, things didn’t get any easier sleep-wise.  The steroids would cause the same rapid heartbeat at night that sent me into the hospital in the first place.  During the day, I would be so tired that I’d fall asleep anywhere.  Or, more likely, I’d have to lay down on a couch not sleeping, but not moving either.  There are a lot of instances of cancer in today’s TV drama’s.  They always show a few heart rending scenes where the patient and his/her family tries to come to terms with cancer.  If the show is really brave, they might show the patient throwing up or having weird visions.  But I think that if they were going for any kind of accuracy, they would show a dude lying on a couch.  For half an hour.  The whole show would just be that dude lying on the couch.  Not sleeping, but not moving.  Because that is what cancer is like.

* I started writing this post a few weeks ago.  Since then, we’ve been able to work out a plan with the nurses while I’m in the hospital and they’ve gotten much better about not waking me up as often.  They also stand guard outside my door and keep the Food and Nutrition Services people from coming in (mostly…one snuck by their defenses and woke us up last week.  My plan is to find out where she lives, go wake her up at 6am and ask her what she’d like for dinner.)