Do you have good veins?

I have been asked this many times in the past week. It's quite a puzzling question and the more you think about it, the stranger it becomes:

How do I know if my veins are good?
What distinguishes a good vein from a bad vein?
Could just an average vein do the job?
What if you don't have a good vein?
WHY IS THIS IMPORTANT???

Well, no one has ever told me I have bad veins and I've never had trouble with IVs and having blood drawn so I decided I have good veins. So that's what I reported, "I have pretty good veins."

I was wrong.

Here's how my first chemotherapy session went:

Obviously the nurses need a good vein (i.e., a vein that doesn't collapse) to put the IV in. But it's so much more complicated than that - because of course this is Heidi going through the medical system so of course it can't be smooth sailing. I'm always causing problems somehow, for example, by lying about the status of my veins.

For one of the drugs I'm getting in Part I of chemo (Drug A), it's very important that it not get out of the vein into the surrounding tissue because it can cause permanent tissue damage. I didn't ask for further details b/c I kinda don't want to know. So, Drug A must be administered by the nurse through the IV a bit at a time, not through a drip bag. If the vein collapses, sneaky Drug A will escape and the nurse must stop administering Drug A immediately (so its little friends can't help do larger tissue damage).

Now, the IV can only go in the lower part of the arm - not above the elbow (I forget why). It shouldn't go in the main vein in the arm by the elbow because they want more "meat" around the vein. And because I had lymph nodes removed on the left side, I can never have a needle inserted in that arm again (for fear of developing lymphedema). So we were limited to the lower part of my right arm.

The veins were not showing themselves - apparently my nervousness was rubbing off on them (this is truly what the nurse said). She told me to relax - AH HA HA HA! Funniest thing I had heard since yesterday when my Junior Editor decided to switch to IP/IT instead of employee benefits. You actually think intellectual property and technology will be more exciting than benefits? Ah ha ha ha. Oh darn, you're right. Ok, back to the story.

Also, the room was cold so that made the veins shrink up, too. The nurse put heat packs on my arm and I had to open and close my fist to help coax them out. Finally one of them seemed ready but after a bunch of painful poking she declared that it wasn't good enough for the job. Now she had to find one that was higher than the insertion site and still below the elbow. But none of the other veins were willing to step up and do the right thing. CURSE YOU BAD VEINS!

So what to do? I was freaking out thinking they would send me home to try some other day and I was already emotionally invested in getting the first chemo treatment over with today. A delay would mean more and more anxiety buildup and I didn't think I could handle that. I ironically go from not wanting to have chemo to wanting to have it RIGHT NOW!

It was somewhat of a conundrum. The answer was to pull in the big gun: the nurse with more than 21 years experience. She rubbed my arm and investigated the veins carefully and eventually agreed that none of them was ready. The only possibility was the main vein in the crux of my elbow; the one that has always been used before but was initially rejected for this project due to lack of surrounding "meat" (nurse's term, not mine). Due to her experience it all worked perfectly and we were back on track.

To prevent this from happening during the next 7 treatments, the nurses suggested I get a "port" which is an IV line permanently hooked up under my skin. It requires minor surgery (which I am always against as it involves needles and other nameless, scary-looking medical equipment) for insertion and removal. However, there was another woman who had the same lumpectomy/lymph node removal/chemo treatment in the chemo suite and she had a port. And she was much younger than me. She told me the surgery was no big deal and it was totally worth it. So I think I will actually go for it.

To sum up the lesson from today's events, I urge you all to go figure out whether you have good or bad veins! Just try not to go the chemotherapy route when doing your research.

As to how I'm feeling, so far so good. I'm very tired and have been getting nauseous off and on but it seems to be relieved by eating something. Meanwhile it's only been about 6 hours so we shall see what the days ahead hold for me.