Every six weeks, I go back to the KU Med/Cancer Center in Kansas City.  The appointments alternate between brief ones, where I have blood tests and a consultation with the oncologist, and full days with the complete battery of tests, including CT scans.  These are usually draining, not because of the tests themselves but because I can't eat or drink for four hours before the CT scans and then there is always a long break before the consultation while all the tests are analyzed.  On these days (the next one is January 25th), we can either get up very early so that all is over by mid-afternoon or go later in the morning but not get home till much later--neither an attractive option.

Yesterday we went to KC for what should have been an easy day.  The bloodwork was scheduled at 11:45, so we didn't have to get up early and rush to KC.  I could eat breakfast and drink coffee.  And then the consultation was at 12:20.  I was sure we'd be out by 1.  The day didn't, however, go as planned.  We got there on time and were called by an overly cheerful young woman to review my address, phone, insurance, and next of kin (Mohamed).  I think I'm quite mobile, but as I got up from that brief interview, she said, "I see you're having trouble getting around, so why don't you just wait in the anteroom of the lab?"  We sat there and were quickly called for the blood work.  The guy who drew the blood is my least favorite phlebotomist.  I don't mind needles (as witnessed by the roughly 600 shots Mohamed has been giving me in the stomach every morning), and I have, as I'm always told, great veins.  But somehow this tech always makes it hurt--not a lot, just enough so that I'm aware of the needle going in.  And then we returned to the lobby for what we thought would be a 20-minute wait to see the doctor.

After 50 minutes of sitting (and we hadn't brought anything to read since we thought this would be fast), I went to the desk to see about the delay.  The receptionist checked and assured me that I would be the next to be called.  Another 45 minutes passed; at least a dozen people were called.  I was becoming increasingly tired and grumpy and hungry--as I hadn't eaten anything since breakfast.  I glared periodically at the receptionist, who clearly had no control over what was happening.   Finally I heard my name, and it was my turn to have my vitals taken (everything was fine) and to be shunted into the small exam room, where there is always another long wait.  Dr. Van stuck his head in and said he's be with us in a second.  "No, you won't," I said.  Finally, Dr. Williams, the same Fellow that we'd seen last time, came in.  Luckily, he is very relaxed and friendly, and he seems both competent and knowledgable.  When he asked how I was, I was tempted to say "tired and grumpy," but I perked up.

The blood results were all close to normal range.  Of major decisions to be made in January, Dr. Williams said that while he'd always defer to the surgeon, he thought the benefits of surgery to remove the kidney would outweigh potential harms.  And then we talked about the more immediate problems of the chemo side effects.  Although I haven't blogged about it, the last few weeks haven't been good.  Until last Saturday, I hadn't left the house for a week: the fatigue was too overwhelming and unpredictable (except for its inevitability), and the diarrhea had returned with a vengeance (ditto).  At the urging of a friend, I brought up the possibility of taking tincture of opium to calm my stomach.  I had mentioned this previously to the physician assistant, but I don't think she was familiar with it and didn't give it serious consideration.  Dr. Williams, however, said he had used it before, and if I wanted to try it, he'd write me a script for it.  So as soon as I get to the pharmacy, I'll stop the Imodia (which I've decided is the correct plural of Imodium) and try the tincture.  He asked about the anti-nausea medication, which I said worked, but took time to take effect.  He said it was available in suppository form, which worked more quickly, but I decided to pass on that.  The pills work to quiet the nausea; the problem isn't really the speed so much as that even once the nausea has passed, I still don't have an appetite.

By the time Dr. Van entered, it was nearly 3 p.m., and he was clearly flustered from running so late, so his visit was very brief.  He always runs behind schedule, but this was the latest he'd been and the first time I felt as if I was getting short shrift.

I left the office with two prescriptions, neither of which can be phoned in but have to be presented in person: one was a refill of the Percocet (Oxycodene plus acetomeniphen), the other the new one for tincture of opium.  The next time I show up at Walgreens, I'm going to seem like a serious druggie.

By the time we left, we were exhausted and hungry.  It was the wrong time of day to go to a nice restaurant, and I didn't have the patience for a long meal (Mohamed is much more patient than I am), so we stopped at Panera's, where I wolfed down (rare for me these days) a turkey and avocado sandwhich, and then we headed off to Topeka, me sleeping, Mohamed staying awake long enough to drive.  When we got home, we both crashed for 90 minutes, much to the displeasure of our dog who missed her dinner time.  She should complain!  And so it's back to the routine, the "new normal," which after 18 months isn't so new anymore.  Tests will be over for Mohamed on Thursday, and we have lunches and dinners on tap for Friday and next Monday.  Both of us are looking forward to a nice, four-week break before school resumes and the next, longer appointment is on the calendar.