Tuesday, January 12, 2010

Meet Downstairs Eve.

The three letters that make my heart race more than any other are as follows:




Put them together and I throw up in my mouth just a little.

NPO (nil per os) is Latin for best of luck not sticking a fork in your eye today, sucka!

Yesterday we arrived at the clinic a bit before 8:00 in order for Eve to have her port accessed and get her blood work done. We headed downstairs to Nuclear Medicine so Eve could have an injection of radioactive material for her DMSA renal scan. The results of the scan will tell us how much of Eve's kidneys are actually functioning. So, the DMSA is the material that was injected into Eve, but apparently is so long that none of the doctors could tell me what the letters actually stand for.

We had an 8:30 appointment to get the injection, which would need time to work it's way through to the kidneys, so the scan was scheduled for 10:30. Which was just perfect when the injection wasn't given until 9:50. And by perfect, I mean I could have stuck a fork in someone else's eye.

Since the scan takes 30-40 minutes of the patient lying completely still, Eve would have to be sedated. And you mustn't eat or drink (NPO) before sedation, lest you want to puke up while you sleep and choke to death. So, Eve was slowly turning into Downstairs Eve while her scan got pushed back to 11:20 on account of the material needing 90 minutes to work it's way down to Wilmsville.

Upstairs Eve is far nicer than Downstairs Eve. Upstairs Eve is very cooperative and friendly. Downstairs Eve spews out pea soup while her head rotates 360 degrees. It's not her fault; it's just that Eve does very well when she's upstairs sucking on lollipops in the hem-onc clinic. And doesn't like to be starved and sedated downstairs in radiology.

Matt and I decided to be proactive and head back up to the clinic for chemo while we waited the 90 minutes. We had originally planned to take Eve to clinic last Friday for treatment, but just before we were packing up the van to leave, her doctor called and said something along the lines of, It's probably a better idea to wait until Monday to give Eve the Vincristine since she just had it a few days ago.

At least they didn't call while we were on the Durham Freeway. That would have been a whole other post.

Her ANC was 561. No toxicity issues with the previous dose of Vincristine. So, Eve got her chemo before the scan. (11 down, 1 to go!) In retrospect, this was one of the better decisions we as a married couple have made. Giving chemo to Downstairs Eve after the scan would have bordered on sadomasochism. Back down to Nuclear Medicine.

Downstairs Eve did a lot of crying and whimpering for food and/or drink, stickers, movies, shoes on/shoes off, her blanket (which we did not think to bring), and being held in a standing position ONLY. Eve is the single reason my arms have any definition. Yesterday was a very simliar experience to the CT scan I took her to five weeks ago, but this time Matt was with me, so I got to share the pain.

Eve got into the room for her scan and was given some kind of barbituate that seemed to work in about 60 seconds. Seemed being the key word here. Let's put her down on the table...oh wait! She's awake. Let's give her more anesthesia. Ok, she's asleep again...oh, snap! She's still awake. Let's give her some more. Wait, why is she screaming? Oh yes, because in all her thrasing about, the needle has come out of her port and the drugs are burning her under the skin.

So, Eve had her first port re-access, with no magic numbing cream, and was promptly given the max amount of anesthesia she was allowed. And as long as Mommy held her, she stayed still and feigned sleep. And as soon as Mommy tried to move her, she would wake up. Well, only one solution to this problem...

Mommy, lay on the scanner with Eve on your stomach while we take the pics. And don't move.

Dang, this table doesn't even have a place to rest my elbows. I can do this, though. It's only half an hour.

So, basically, this radioactive material has made it's way into Eve's kidneys and there is a special crystal lens that absorbs the radiation that the kidneys are giving off. I'm no doctor, but from my limited vantage point I could see that the left kidney was almost completely neon, and about half of the right seemed to be glowing, as well. Maybe this is indicative of kidney function...I mean, what else could it be? Is it unreasonable to assume that gray kidney = no function and bright green kidney = save me? So yeah, I'm thinking of taking up radiology when this whole oncology pursuit gets old.

Some of you may be disappointed to learn that despite my neon green shirt, I was not, in fact, radioactive.

Anyway, we made it through the whole scan with just a puddle of drool on my chest to show for it. Off to recovery!

It was already nap time and Eve did not care to wake up and eat or drink for the nurse. She woke up crabbier than before she went down, so the nurse suggested we let her go back to sleep in hopes she'd wake up later in a better mood. Well, once again, this was Eve's nap time. She would have slept on my chest in that recovery room until the next morning if we had let her. What we did let her do was sleep for another 20 minutes before asking if we could be discharged.

Downstairs Eve was not pleased waking up in the middle of being buckled into her carseat. She wasn't pleased when we left the parking lot. She still wasn't pleased when we were driving on the freeway. She especially wasn't pleased when we stopped and walked around with her, in a last-resort attempt to calm her down. No, no, no. There was no pleasing Downstairs Eve.

She fell asleep after a good 20 minutes of wailing and whipping around. Enough time for us to make a Taco Bell run before we got home, because honestly, when your child is NPO, you are also NPO. And you really deserve some nachos supreme.


  1. sorry I can only laugh. seeing as I have a distinct vantage point on this situation, and have made a similar taco bell run. Josh starts crying the minute I slow down near the door of radiology. he's either getting an IV yammed in his foot with no anesthetic or a tube shoved down his nose. Josh, not a fan of radiology. Radiology Josh and Downstairs Eve, they could overthrow governments if put in the same room.

    I hate NPO, NPO is the sucksorz. And yes as a parent to a young child it damn well means you are NPO because they can sense it and it makes them bitter if you've had a tic tac when they can't even sip juice.

  2. I tell you what... Downstairs Eve does way better than Downstairs Amber would do and she is only 2. I have had a few surgeries where I couldn't eat after midnight and you would have thought the world ended. :-) You all amaze me once again. Can't wait to hear the results of the scan.

    Oh, thanks for the Taco Bell craving. I am addicted to the cheesy beef and potato burritos!

  3. Haha! Radiology Josh and Downstairs Eve could probably be helpful if we locked them in a room with insurance bureaucrats.

    Amber- if you only have a few cents in your pocket next time you're near a Taco Bell, try a crispy potato and cheese soft taco with some taco sauce. It's carb-on-carb goodness!

  4. Dimercaptosuccinic acid (DMSA) -- geesh these docs need google bad :o) hang in there girl.. I had downstairs H for 9 months and he wasn't being treated for anything and is way older than Eve, which means he should have been able to control his nasty self.. oh, and just in case you're wondering.. now the only thing I can think of is a burrito supreme and my hips say "thanks for that" LOLOLOL