Breaking Bread
Every admission comes with it’s own pieces of good and hard. This is methotrexate one of cycle three.
Liam experiences significant anticipatory nausea. We’ve developed a lot of strategies to keep his day clicking and get it over with as quickly as possible to minimize his wait time and suffering.
Thursday was our best day yet. We arrived early, labs were drawn and fluids started immediately. He got emend in clinic. Usually he likes to walk to the hospital, but since getting IV emend makes him lightheaded, he gets a wheelchair. Because he was getting a wheelchair I suggested he gets his periferal IV in clinic instead of waiting and he agreed. (It hurts to use crutches with a periferal IV.)
His labs looked fabulous and everything was clicking. We even had a bed assignment by 1:30 and he met urine lab parameters for methotrexate administration. We were in his bed minutes after 2 ready to go.
And then we sat. For HOURS . as Liam struggled with nausea because the person who transfers patients from clinic to inpatient in the computer clicked the wrong thing and none of his orders transferred. I was so frustrated and upset I started crying when our favorite nurse stopped by to visit. “Don’t do that,” she said all business. You can’t do that because then I’ll do that, too, and then we’ll all do it.” I pulled myself together as she continued. “You have every right to be upset. I would be, too. And I’m so sorry it happened.” Liam’s assigned nurse was at the door. “Stay strong, Mama.”
Ped’s nurses have a tough job. They walk in the door bringing positivity with them … even in dark days. And when mamas fall apart, they know when to pull them together so they can be strong for an awake child and when to hand them a box of tissues and offer to stay while they go on a walk for a sleeping child and a mama crying in the corner.
Chemo finally got hung an hour before I projected we’d be finished.
Thankfully, we’ve figured out his best drug regimen. Emend IV before anything starts, kytrell and benadryl IV push through his port thirty minutes to immediately prior, a BAD (benadryl, dexamethasone, ativan with less ativan than the typical solution) IV infusion during and after until the nausea abates.
Liam only vomited once during the night. My goal is to someday do a chemo infusion with zero episodes of vomiting. We’re close and I’m so happy to see the enormous progress we’ve made.
He was so down emotionally this admission. It’s getting harder and harder to be locked away for days. The oncologist covering inpatient today is every inch a gentleman. His appearance is impeccable every time, even after a night on call. Monogrammed, perfectly pressed shirts. Shoes that probably cost more than my entire wardrobe. Liam shot him with saline on one admission and he pretended to get him back but barely dribbled a few drops on Liam’s sleeve.
Liam didn’t have the nerve to do it at first but one of the nurses told him he has two boys at home and can handle it. 😉 This admission Dr. P walked in Thursday evening and said he thinks he better come with an umbrella or poncho in the morning.
Friday morning when they did rounds, Liam faked sleep and then shot up in bed, aimed, and squirted. He mostly missed. Dr. P expected it and sent the rest of the team in first. The sudden movement from Liam sent him ducking around the corner. He returned with a towel shield. However when all seemed calm he walked around the corner to return the towel and the nurse sneaked Liam another saline under the covers. Dr. P walked closer. As he wrapped up the talk he said, “Do you have any questions?”
“Actually, yes,” Liam said, sat up straighter, and nailed him with saline. His shirt was soaked! The room erupted in laughter. “You better watch your back,” Dr. P said. “Looks like my back is pretty safe against the bed,” Liam responded.
That evening Dr. P walked in. To his surprise I was in the bed with Liam and being the gentleman he is, it gave him pause. But he pushed through and nailed Liam with saline man to man. It was the BEST medicine ever! They fist bumped, called a truce, and Liam’s sparkle returned and stayed.
Later that evening my mom dropped off dinner at the door. Because of Covid we can’t have visitors. Even our kids can’t visit. But I can go out and meet people outside if they drop things off. I was back upstairs with fried chicken, mashed potatoes, and green beans that smelled amazing! One of our favorite residents was in the room and Liam offered him a piece of chicken. He looked like he wanted one and said, “I have some work to do, but save a drumstick for me and I’ll come back for it later.”
I thought he was joking, but I hoped he wasn’t.
At 8:00 he returned. Liam gave him the drumstick and Auggie said, “Do you mind if I stay a bit?”
“We’d love that!”
He pulled up a chair, then backed it up a few feet as he realized he was about to take off his mask. And there he sat. Eating the chicken, chatting away with Liam about football for probably thirty minutes.
I still almost cry thinking about it. He was at the tail end of call which means he’d probably been in the hospital for almost 48 hours straight. He had wrapped up for the night and could have walked home. Instead, he chose to sit and chat with a twelve year old boy who had cancer, to share his food, and offer friendship.
I don’t know what inspired him to become a doctor, but this much I know. He’s going to be one of the best ones out there. Because even as an intern, he’s seeing people, not a diagnosis.