Category: Nurse

Bone Marrow Biopsy and Transfusions!

Today was Bone Marrow Biopsy Day. The biopsy was performed by a nurse practitioner named Rhonda. She was the best biopsy experience that my mom has ever had. Thanks Rhonda!

My mom’s hemoglobin counts dropped to 7.9, she she got two units of blood. I told her that Lance Armstrong would WILLINGLY get transfusions. So it’s a good thing. Not that she’s trying to enhance her performance to ride up any mountains anytime soon yet. We’re just trying to make it one mile down the street. ūüôā

UCI Health Chao Comprehensive Cancer Center

We love UCI! My mom and I had our first consultation at the UCI Health Chao Comprehensive Cancer Center in Orange County. This is a continuation of my search for a local oncologist for my mom now that she is past her 100 days post-transplant. I would love for her to stay solely at City of Hope (COH), but the drive takes quite a toll on her. ¬†Plus, if there is a real emergency, it would be good to have a local hospital that has her records. Thankfully, the entire experience with UCI was fantastic. ¬†I am very excited to get to know the hospital and the team. I took the first flight out of San Jose on Monday morning and last flight out of Orange County to return back home. It was quite a flashback to my consulting days. This time, my business objective was: “Establish good local oncologist for Mama Pham.”

We originally picked St. Joseph’s as her local oncology office. ¬†After our initial 2 visits, I did not feel at ease leaving her under the care of St. Joseph’s Hospital so I did some more research, talked to some more people and setup an appointment at UCI. ¬†Several factors contributed to my decision to move her out of the St. Josephs of Orange County care system. I may write more about that in a different post. The entire experience at UCI was so refreshing. Below are several key points that made our visit great and set me at ease as I returned to San Jose:

  • Complimentary valet with a great staff. ¬†This saves my mom from having to navigate a parking deck and is definitely a great perk for days when she feels particularly weak
  • A friendly reception desk with very competent receptionists and schedulers
  • An easy scheduling process. ¬†This is important because she requires many appointments, sometimes involving multiple departments and multiple doctors.
  • On-time appointment even in the afternoon
  • Great nurses
  • Easy navigation of the building
  • Most importantly, we loved our new oncologist. ¬†My mom was very happy; it is very important that she feels comfortable going to the hospital and seeing the doctor.

Each little battle won always feels great. Our battle this time was finding a good local oncology team to continue the great work of all the doctors from City of Hope, and be well-prepared if anything happens. Hooray for UCI!

PICC Line and Dressing

A PICC line is a Peripherally Inserted Central Catheter. Many chemotherapy patients have a PICC line put into their arm to make it easy to draw blood and give medicine without constantly pricking the patient. It’s great. The downsides include living with tubes sticking out of your arm and also the slight risk of infection at home. The PICC line dressing needs to be changed each week. The PICC Line even has its own sterilized cleaning it. It is serious business! There is nothing really holding the PICC line in besides the dressing so it is critical that the dressing is done properly. My mom has had a PICC line in her arm since her first admission into the hospital. They took it out when she left St. Josephs, but put it right back in again at City of Hope. She has never had any issues. This last time, however, she felt some irritation when the nurse cleaned it. The irritation just recently turned into a blister about the size of an inch. The triage nurse on call at City of Hope does not think it is a big deal, but since my mom’s white blood counts are dropping and infections are harder to cure, I emailed her doctor to check if we should do something about the blister. We went to a chemotherapy class a few weeks ago at City of Hope and the nurse emphasize that nothing is ever too small for chemo patients, so we are giving everything, even a 1 inch blister, attention!

Below is a photo of the PICC line and dressing right after my mom had it put in. They also gave her a waterproof arm cuff to wear in the shower. Apparently some people also take it swimming!
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Blood Pressure: Manual vs. Automatic

The automatic blood pressure machine has been giving extremely low readings so one of the nurses brought in an “old school” manual pump. ¬†They blame the inaccuracy on the fact that my mom has a very slim arm and the cuff is too big for her. ¬†My mom’s blood pressure reading has ranged from 77/48 to 110/60 in just one sitting, depending on who does the reading and which machine she uses. ¬†This seems quite arbitrary to me. ¬†Though I have always been wary of the nurse squeezing my arm tight with a cuff then relying on her counting to determine my blood pressure. ¬†What if her mind wanders? ¬†What if she blanks out for a few seconds? Does she just make up numbers? ¬† It doesn’t help to Google these questions because the internet is full of articles about how most blood pressure readings are wrong, how people’s BP spike when medical personnel walk into the room and how cuff sizes really do affect your BP reading. ¬†Thanks, internet.

The nurses and techs measure my mom’s vitals every 2 hours since at this point of her neutropenic state (<0.4 WBC count), she is at high risk for infection, which can also lead to sepsis. ¬†Indications of sepsis include high fever and low blood pressure. ¬†If her temperature ever reaches 100F, we need to take action! Therefore, she gets a visit from the Patient Care Tech (PCT) every two hours for her temperature and blood pressure readings. ¬†Since she is a neutropenic, they also leave her own machines in the room so they are not shared with everyone else on the hall. ¬†Below are the two machines. ¬†I think they make quite the cute cross generation couple.

IMG_6013Left: Manual Blood Pressure Machine, Right: Automatic Blood Pressure, Oxygen, Temperature Machine