Today I had my first maintenance Herceptin appointment. It took a lot longer than I anticipated, which wasn't a problem, but good to know for future scheduling purposes.
My appointment was at 10:30 in the infusion room. As far as I knew, I didn't need blood drawn, and I didn't have my usual appointment with the port nurse. After checking in, I went directly to the infusion room, where a medical assistant took my vitals, and I got settled into a bay.
My appointments are usually on Fridays, but today's appointment was moved up a day for scheduling reasons unknown to me. I didn't have my regular infusion nurse, but one I had seen before during previous visits.
There was a bit of confusion because apparently I have a standing order for blood work "every 7 days", but since this appointment was a day earlier than when it was supposed to be (only 6 days from my last appointment), it wasn't clear if I needed my blood drawn or not.
The infusion nurse came in to access my port around 11:00. I get an orange wrist band every visit because of my allergy to chlorhexidine, and the nurse did ask me if I had any allergies. I told her about the rash I get from chlorhexidine, but when she set out the supplies for accessing my port, I didn't see any Betadine, the skin disinfectant my port nurse uses instead of chlorhexidine. I decided to mention it. She said, "Oh, that's right!" and left the bay to get some Betadine. Getting a rash isn't the worst thing in the world, but I'm glad I was paying attention.
The infusion nurse decided to go ahead and draw blood for lab work, just in case.
Around 11:30, the infusion nurse brought me my pre-meds. I said I thought I didn't need pre-meds when getting only Herceptin (no chemo), and she said it was just for the first maintenance Herceptin, because the 3-week dose is bigger than the weekly dose. As before, the pre-meds are meant to prevent an allergic reaction.
The prescribed pre-meds were all pills: 1 Claritin (loratadine), 1 Benadryl, 1 Pepcid, and 2 Tylenol. She asked if I took a Claritin this morning, and I said I did, which means I didn't need to take it again. But when she handed me the little plastic cup with all the pre-meds, I counted 4 different types of pills. I asked which pill was which, and she realized she gave me the Claritin by accident, even though we just talked about how I didn't need it! Again, an extra dose of Claritin isn't terrible, but it's a good thing I was paying attention.
About this time, my physical therapist came in. I told her how my nurse last week had commented on my right arm being swollen. She looked at my arms, held a thumb to each forearm for a minute to see if the skin responded differently when released, and decided she couldn't really say for sure. She said it's normal for the dominant arm to be up to 10% bigger. She took something like 8 circumference measurements along each arm, and said there's a computer program she uses that will make calculations and quantify how much bigger one arm is compared to the other. She said even if it's not swollen, it's good to have these measurements as a baseline, just in case, since having lymph nodes removed does put me at risk for lymphedema.
Just as the physical therapist was finishing up the measurements, around 12:00, the infusion nurse came in to start the Herceptin. I forgot that sometimes we have to wait a while for the hospital pharmacy to prepare and deliver prescriptions.
My physical therapist worked on my cording, and it definitely felt a lot better afterwards. It's still not gone, though, so even though I'm not coming in for weekly infusions, I'll still be back next week for physical therapy.
I finished the Hercerptin at 12:30.
The Lupron shot was quick.
I asked for a copy of my blood work results. Since the duration of my appointment was shorter than with chemo, some of the results were still pending and not available yet. The results I did get, related to my blood cell counts, were all values within the range of what I've seen before.
I ended up spending just over 2 hours in the Cancer Center today.
I'm so glad you're making sure of your meds and allergies. It's important to be our own advocates.
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