Wednesday, October 20, 2010

Clinic a.k.a. Our home away from home

Elena gets all her chemotherapy treatments at the Hematology/Oncology (Hem/Onc) Clinic - or just "Clinic" as all the nurses, doctors, patients and their families call it - at Primary's. Since we spend so much time there and it's such a big part of our lives now, we thought you might enjoy a look into what it's like.

Primary's
While we wait to get called back, we sit in the waiting area. There are almost always crafts out for the kids to do while they wait- one of the many wonderful things about having a children's hospital so close. I seriously love all the little things Primary's does to make the hospital more inviting to children- the "Nemo" display at the bottom of the elevators, the crafts, the murals on the walls, the child-life specialists, the awesome menu that the kids can order off of at practically anytime, the animals that come around to "visit" the kids, the fun statues all around, and especially the extra-special patience and understanding of the nurses, doctors, and staff. It is a great place!
Here is part of Elena's fan club. :) Elena loves her nurses. And boy, do they love her! (Pictured: Mindy, Lindsay, and Tiffany)
She's telling them about her birthday. :)



After we get called back, the first step at each visit is to get an ID wristband, and get weighed, measured, and to check some vitals (temperature and blood pressure).



Then we get sent to our room and wait for the nurse to come access her and for the doctor to come check her out.
Elena does not like having her port accessed. (Who would like getting a needle in the chest??) Lately, she covers it with her hands to try and protect it.
Last night, Eric had to access her to get counts (he accesses her at home, rather than our home health nurse) and while we were sitting at dinner, he told her that in a little bit he would need to give her a poke. She immediately covered her port and kept one hand there for the next twenty minutes while she finished her meal and ate with the other hand. :) Poor girl.

Cleaning prior to "the poke"

If you look closely, you can see where her port is accessed, all covered up with a sticker to keep it dry and in place. Here the nurse is giving her one of her chemos.
Awesome.
This is why we pray for her doctors and nurses - they hold her life in their hands. A reminder to everyone to go to work and give it 100% every day.


When the nurses give her chemo, they have to gown up in a special blue chemo gown and chemo gloves just to make extra sure that none of the chemo gets on them.
Waiting for the push to finish.

Having a snack back in the "Infusion Suite" a.k.a. the "squishy chairs". This is the normal place where she gets her chemo and blood transfusions. They have a couple of fridges and cupboards stocked with snacks and drinks for the kids while they're in clinic. Elena is good at working it. She gets the nurses wrapped around her little finger and always walks out with an armload of treats.
Talking with another one of her nurse friends.

This is Ben, the clinic manager (I guess that's what you'd call him.) He oversees things and makes sure we're happy with the care we receive in clinic. He is a die-hard University of Utah fan (BYU's rival) and Eric is obviously a die-hard BYU fan. They give each other a hard time every time they see each other. Ben always has his Utah lanyard and Eric always wears his BYU hat to clinic.
And this is Stan. Whenever Elena sees him she yells at the top of her lungs, "STANNN!!!" She loves Stan. :) He helps with research and is always there when we do special blood draws with her Oncaspar.

This particular visit was a "short" visit - only about two and a half hours. That is record time for us! The shortest it has ever been for us is four hours and it's usually more like five or six, plus two hours driving. The longest has been eleven hours - those are usually blood transfusion days or if there is a problem with the chemo they ordered. Thankfully those don't happen very often! :) We feel very blessed, though, that we live relatively close to the hospital. We have talked to people who come every week from St. George (5 hours away) and Idaho and Montana!

This visit was so short because she had easy chemo (read: short pushes and no observation time needed after) and no lumbar punture (LP) where she gets sedated (well those things and the doctor came in quick and the chemo was all ordered on time! :)). This visit was the last of her first month of Delayed Intensification. She is going back tomorrow for a check-up because she's had high blood pressure, a low grade fever for about a week, and we're still seeing heavy side-effects even though she hasn't had any chemo for over two weeks and any steroids for over a week. Her counts aren't high enough to start the next month of Delayed Intensification. Hopefully next week. I'll try and document a little more then - you can see a little of the LP procedure and hopefully meet "Doctor Eesh" (Dr. Yaish, her doctor) and Robert (the P.A. -her favorite).

16 comments:

The Copelands said...

Elena is such a trooper! Can't wait to see yall on friday!

Josh and Tara said...

You guys are my heros! I don't know how you do it--times are tough and you're still smiling. Love you guys!!! You're in our prayers.


PS-I just noticed that you have our adoption blog on your site. Thank you so much for that! We're hoping that our baby will find us soon :-)

Liz said...

Thanks for sharing your "home away from home!" I'm so glad Primary's is close and that they work so hard to make it a friendly environment for kids. So does this mean that next week will be "Day 29"?

Mireya said...

Definitely enjoyed a walk through your routine at the clinic. Thanks for sharing!

Christy said...

i'm so glad you posted this-- so good for documentation sake and nice for all of us to be able to picture it all when you talk about it. i love the pictures of the nurses talking to elena. the people at primarys really are so good at what they do-- work with children. if that place didn't have so many sick kids, so maybe if it was more like an amusement park or something, i think i'd love it. :)

Amy said...

Thank you for posting this! It was so great to be able to have a better idea of what you're all experiencing! You're all so wonderful, and such troopers!

Lisa said...

Thanks for posting this. I'm glad I could see what it's all about. I'm sure it makes it a much smoother experience having such great staff there. So medical question (because I know nothing about it) What is a port? Does she have a tube type thing permanently placed in her chest for meds, etc?

I'm now craving Doritos. Thanks, Elena!! ;)

Chelsea said...

WOW! 2 hours! I am jealous! That is great timing for clinic. I hope everything goes well for you guys tomorrow. Im sorry she is still having side effects. Blah. I am NOT looking forward to Delayed Intensification. We start in 3 weeks (if her counts are up, but we both know how that goes). Take care!

Hugs,
Chelsea and Cami

Courtney said...

Your family is amazing. Thanks for sharing all of this. I hope things continue to go so smoothly. I think of you often!

Eric said...

Port-a-catheter, a.k.a. "a port" - There are two types of central lines.
Central Lines are semi-permanent IV’s that feed directly into the heart. To place one, the surgeon enters one of the main returning veins (jugular?) in the neck, and then feeds it downward to the heart. Broviacs and Ports are both central lines with the difference being the other end of the tube.
1. Broviac – A central line where the opposite side of the catheter protrudes from the skin and is readily accessible to deliver IV therapy. These used to be the most common form of central line, but due to the open nature of the protrusion, they are prone to infection and difficult hygienically. Now they are mostly used in cases where near continuous IV therapy is necessary. They are uncommon with ALL, but more common with AML.
2. Port-a-Cath- In Elena’s version of the central line the opposite end of the catheter is basically a pin cushion that is placed under the skin above the rib cage in Elena’s chest. This hides the entire central line under the skin allowing for bathing, and protecting it from infection. We can then “access” it by sticking it with an IV needle. I generally do this when we need to draw labs to get counts at home. The not fun part is that it requires getting poked on a weekly basis, a very dramatic experience for Elena.

Joseph & Shaylee said...

Thanks for the peel into clinic, you are all such troopers. I hope all is going well for you, Eric, Elena and Lily. We think of you often and pray for you as well.

Piano Mom said...

Briana, I wish we lived closer! I need more time to talk to you. I am always amazed by you and your positive attitude and the beautiful spirit that I can feel when I read your blog.

I just think Elena is so sweet. Thank you for letting me use your picture in our video. One of the other pictures in the video (near the beginning) you can see Elena sitting on Eric's shoulders in the background. How cute!

Us'ens said...

Oh, you guys...what can I say! You all amaze me!
I so appreciate the tour of the clinic...it really helps me get a better understanding of just what ALL of you go thru...I'm sure for each of you it is different...yet you do it with such a wonderful attitude.
What you are doing with all of this documentation is absolutely fantastic! How nice that as Elena gets older, she will be able to look back on this & read the words of her parents regarding her treatments, ups & downs, etc.
I truly want to thank you, Bri, for opening up your blog for all to read...you do such a terrific job of writing!
We love all of you tremendously!!

Jenny said...

We love all of you. You are amazing! Thanks for the pictures!

Amy said...

I'm so glad you posted this! It's amazing to me what a positive place the clinic seems to be for Elena. That says a lot about you guys, the nurses and doctors, and especially her. That little video of Elena talking to her nurses is so CLASSIC Elena. I love it. Mmmm Pral-ly. I'm excited to hang out with all ya'll again soon. I'm grateful Elena has such wonderful medical people helping her.

Amy said...

P.S. The image of Elena trying to cover her port is very sad. Poor girl. Sometimes I forget how not normal her norm is.

Cedar Waxwing

Cedar Waxwing
by Eric Hoffman 12/23/06