Session One, Day One

8:50 a.m.--I'm sitting in Room 10 of the clinical trials infusion area, where I've been since 8:30. We're on the seventh floor of the Main Building here at Georgetown University Hospital. I've met my technician, Jameela, and my nurse, Mercedes. Jameela put in my shunt (or whatever it's called) and filled 10 vials with blood. I hooked up the computer and am now waiting for my Rituxin (I think we're starting with Rituxin) to be cooked up by the on-staff on-site chemopharmacologists. They don't mix your chemo until you show up. I'll do my best to give periodic updates as to how I'm feeling etc.

While I'm waiting for the juice, let me describe my surroundings. I'm in a nice, beige hospital suite--suite because it has its own bathroom. There a standard bed (now supporting my computer), a nice comfy chair covered in blue naugahyde (in which I'm currently sitting), a visitor's chair, a television, and a bed side table. The wall opposite the door holds a nice double window with a great view of the hills of Georgetown. The pinks, whites and greens of impending Spring are really beautiful, even given the overcast sky.

There's a refrigerator in another room we can use that has juice and cookies, etc. Pretty nice, actually. I'm wearing my street clothes and waiting. I have hooked into work and have already worked a couple of issues.

10:25 a.m.--Still waiting. I guess they're waiting for the lab work to come back before we start the festivities.




10:43--I have officially begun chemotherapy and can type while doing it. In fact, I watched the first dose entering my arm as I began typing this. I get the fludarabine first. This should take about half an hour and should have very few side effects. When this is done I get lunch, then the Rituxin. Also the Benedryl, Tylenol, and the anti-nausea drugs--apparently Rituxin is the fun one. Jim Bjostad is on standby duty to pick me up this evening if needed, but I'm hoping for the best..


11:10 a.m.--Fludarabine's done. I now get intravenous Benedryl and hopefully lunch. Also, not sure if between the IV tube and the electical cord on the pump I have the range to make it to my personal bathroom. This could be exciting.

11:16--One mystery solved. I asked Mercedes about the bathroom issue. Turns out the pump has a battery backup, so I can just unplug the whole thing and go for a walk. On a brighter note, the sun's out now.

12:08--I'm hooked up to the Rituxen and waiting for the side effects.

12:20--Lunch! Chicken salad sandwich, chips, an apple, milk, cranberry juice, and chicken soup (got to love the chicken soup). Appetite is still fine. 7.1 ml's of Rituxin in, 242.9 ml's to go.

1:55 p.m.--So far, so good. They are increasing the flow rate every 30 minutes or so. Currently at 81.9 ml infused, or about a third of the way through.

2:55 p.m.--Math problem. Tim has had 168 of 250 ml of Rituxin pumped into his body (with no apparent side effects.) If the pump is dispensing the Rituxin mix at a rate of 122 ml per hour, how much longer does Tim have to sit in the comfy blue chair? Answer will be provided in about 40 minutes.

3:30 p.m.--So far the only negative reaction I'm having is an increased heart rate, and I only know it because they check my vital signs every 30 minutes. Apparently this is very common with Rituxin. 15 ml's to go to an empty bag and putting it at a rate of a little over 2 ml per minute. Should be done in the next ten minutes.

4:00 p.m.--Psych! My calculations were based on a 250 ml bag of fluid. The nice grad student showed me how to read the bag, and it turns out the volume was actually 332.5 ml. But seeing as how I've had 316 ml already and the flow rate is now at the max 162 ml/hour (or 2 2/3 ml per minute), I should be done in another six or seven minutes. Still feeling great, but with a hint of a headache.

4:09 p.m.--The machine says it's not pumping anymore stuff and the "nurse alarm" is going off. I think I'm done. Getting a little saline now while Jameela gets Mercedes to confirm that the party's over. I've got to go down and get my long term parking pass, but I think that's it for the day.

My apologies to anyone (Pat Kohli) who was hoping for more drama (or at least a lost lunch), but I'm pretty pleased with a dull blog entry.