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Writer's pictureKelly Diaz

Getting Under My Skin

Updated: Apr 17, 2021


 If you haven’t eaten at Slim Chickens [https://slimchickens.com/], you’re missing a treat. It’s quite possibly my son Keifer’s favorite fast-food restaurant, and it rates right up there with Chick-fil-a, although theirs is a very different take on the chicken sandwich. On Thursday, Keifer drove me to my appointments with the lab and Dr. Joudeh because John had an appointment of his own that conflicted. I thought it would be a good opportunity for Keifer and me to check out the new restaurant for lunch.


This past week, I haven’t felt very good, having managed to develop a bit of a sinus infection, most likely from an allergic reaction to all the pollen floating around and coating everything with a soft yellow blanket. You know how I feel about complaining – I hate to do it – but I figure you might wonder about these things. There have definitely been other issues that are no doubt due to the myeloma or one of the handful of drugs I’m taking either directly for it or to alleviate a side effect from it. My back has been hurting; my legs have ached mercilessly; the neuropathy in my feet and hands seems to have worsened; acid reflux has reared its ugly head, making it difficult to sleep; and perhaps oddest of all, I have felt dizzy and off-balance. The latter symptom is why I choose to be chauffeured nearly everywhere I go these days.


Dr. Joudeh always listens patiently to my complaints and makes an effort to address every one of them so that I might find relief, as he did on this occasion. We also discussed my numbers, which is always fascinating to me and provided the inspiration for the title of my next post, which I plan to finish on Monday during my chemotherapy session. For now, I invite you to join Keifer, John, and me at Slim Chickens.


As luck would have it, John’s appointment ended at the same time mine did, so he met us at the restaurant in Pensacola for lunch. Cars in the drive-thru lane circled the building and out the driveway of the bright new restaurant, but we had already decided to dine inside, where we ordered and were seated immediately. The only thing better than the food was the company.


We had just finished our meals when I asked John for my purse, which was tucked next to him in the corner of the booth. As he handed it to me, I felt the vibration of my phone, which I had forgotten to unmute after my doctor appointment. I quickly took note of the words scrolling across the top of the phone’s screen: “Dr. Joudeh — The Woodlands Medical Specialists.”


I hurried to answer, “Hello?” I honestly can’t remember if he addressed me as “Ms. Diaz” or “Kelly,” but I heard him say, “This is Dr. Joudeh.”


I believe I have previously mentioned that it always unnerves me a little when my actual doctor himself calls me. There is always a heightened sense of alert that something is amiss, something potentially serious. While it may create a brief moment of anxiety for me, I can’t adequately say how much I appreciate when a physician takes the time and effort to relay important information personally. It definitely carries a special emphasis.


“If you are not too far away yet, I would like for you to return to the medical center. Your calcium level is high, and that is what is causing the dizziness you are feeling. I have ordered IV fluids for you in order to dilute the calcium in your blood.”


“I can do that,” I said. “We’re only about eight miles away. How high is my calcium?”


“It is 13. The normal range is between 8.6 and 10.3. Are you still taking a calcium supplement?” he asked, to which I answered, “Yes, 1200 milligrams a day.”


“You should stop that,” he replied.


Fine with me. Two fewer big honkin’ pills to swallow every day, I thought. “I will be on my way back momentarily. Thank you, Doctor.”


With that, I was on my way back for a previously unscheduled visit to the infusion suite where I endured my last IV stick in my arm, at least at that geographic location. The very last one, at least for the foreseeable future, I hoped, would happen in the Surgery Unit the next morning at Eglin AFB Hospital.


Because of my heightened awareness of the calcium issue, I did my best to drink water and Pedialyte during the rest of the day Thursday. In spite of that and the hour-long IV drip of saline solution, I still felt wobbly at 4:15 a.m. Friday morning when I stepped into the shower. My bathroom is outfitted with chrome grab bars in both of my full bathrooms, the type that are installed for people who are disabled. I have never had to use them until that morning when I was standing under the shower spray and rotated my body 180 degrees to let the warm water hit my back. It felt like the room was tipping slightly, just enough that I felt off-kilter and instinctively reached for the bar. Whoa, I thought. This is funky! I wonder if that’s what an earthquake feels like. You guys in Oklahoma should know.


I should have asked Dr. Joudeh how long it might take to feel normal again or if I might need additional hydration besides what I was able to drink. I will ask on Monday when I go for my Darzalex infusion, if the dizziness is still an issue.


Thankfully, I was feeling a little better when I climbed into my car at 4:55 to drive the 1.9 miles to John’s house so he could take the wheel for the 40-minute or so trip to Eglin Air Force Base. The cold front that swept through on Thursday had turned the air a brisk 40-something degrees, but I was so preoccupied that I forgot to grab my jacket that I keep on a coat tree by my front door during the cooler Florida months. Fortunately, I was wearing a long-sleeved shirt over my green Tek Gear tank, and that turned out to be adequate.


When we arrived at the hospital, we entered through the Emergency Room entrance, which was all but deserted. Of course, it being Good Friday, John pointed out that they were probably running on a skeleton crew across the base. I checked in at Admissions and sat down with the pager the young Airman handed me to wait for it to buzz. I had arrived early, and as one might expect at a military hospital, the pager began to vibrate at 0600 on the dot.

I’m not going to go into a great deal of detail about the prep except to tell you I was on a gurney in “Station 12,” and I was returned to the same curtained station following my procedure. I also want to recognize the young tech who took care of me, as well as the members of the surgical team and the captain who I assume was the supervisor who oversaw my care. The Medical Technician, an airman named Ben Sowers, gave me thorough, step-by-step instructions; started my IV expertly (there is almost no mark or bruise where he placed it); and chatted with me about his own experiences through the entire process, which helped to lessen my anxiety. It didn’t hurt that he had a quiet, soft-spoken voice and was around the age of my own sons. Those factors made him endearing to me from the get-go.


It occurs to me that it might offer me an advantage as well. These trained, professional young people surrounding me might imagine their own mother when they look at me, as I see my children in them. My dad often speaks of how courteous, respectful, and helpful people have become to him as he has grown elderly. Perhaps there is hope for our species after all.


Something that I have found mildly amusing is the number of times a nurse or med tech has expressed his or her own aversion to needles. Ben told me about how much he abhorred being stuck by a needle, but he certainly had no qualms about sticking me. A few of the nurses and lab techs at The Woodlands have expressed the same revulsion, some of them almost to the point of horror.


I can tell you why I have little to no issue with needle sticks. It’s because of my sister. I don’t think Shelly would mind me telling you that she hated getting shots of any kind when we were kids, probably still does, and I remember how she would sometimes be so full of dread that she would cry. Well, as a younger sister, I couldn’t let a chance to show her up go to waste. When it was my turn for a vaccination, for instance, I would watch without flinching as the needle punctured my skin or on the rare occasion when I had blood drawn, I sat stoically and stared as the nurse tap-tap-tapped on my arm in search of a nice vein to assault. Nowadays, I don’t generally care to watch, but it still doesn’t really bother me. I think there is definitely a measure of irony that makes me smile about healthcare professionals who are terrified of needles.


I also want to recognize the other members of the team of medical professionals who took care of me. In addition to Ben, they include my surgeon, Lt. Col. Christopher Mahoney, M.D.; Jeffrey Burbidge, M.D., Anesthesiologist; Captain Brayden Jolley; OR Nurse, Mr. Nathan Fulcher; and two physicians who assisted, Dr. Levin and Dr. Getzlaff. I met the anesthesiologists first and interacted primarily with Dr. Burbidge, with whom I felt immensely comfortable, just as I had Dr. Mahoney during our consultation. Consummate professionals, all of them, they managed to convey an affability that instantly relieved some of the apprehension I was feeling about the impending procedure. I was like a steaming hard-boiled egg suddenly plunged into icy cold water. They were refreshing and upbeat.

When Dr. Mahoney appeared to say hello and answer any questions I had, he was wearing a unique surgical cap covered in Jolly Rogers. It was similar to a do-rag that Roy would wear during his open water certification dives with his students because the skull and crossbones would glow underwater, making him easier to spot. Of course, I couldn’t think of the term “surgical cap,” so I told him how much I liked his do-rag, which drew a chuckle out of him and the other two doctors. That also made me recall the only question that had been nagging at my mind about the mediport.


“I’m a scuba diver myself and hope to be able to get back in the water maybe late this summer. Can I scuba dive with the port?” I asked.


“There shouldn’t be any reason why you couldn’t,” he answered. Then he told me everything was ready for me and he would see me in a few minutes. (I know he saw me, but I certainly have no memory of seeing him!)


After he left, Dr. Burbidge went to the computer mounted on the tall stand next to my IV pole and told me he had an excessive number of questions to ask me before we could proceed. I honestly don’t remember most of them. They involved the usual ones: some specifics about my most recent lab results from the day before, when I had eaten last, what medications I had taken, etc. Then he turned his attention to my IV and said, “I’m going to go ahead and get started.” He inserted a syringe into my IV line, and that’s the last memory I have until I was being wheeled back to Station 12 with a new mediport implanted under my skin near my left collarbone.


That ride back to the curtained room for recovery apparently wasn’t without incident, and I’m more than a little embarrassed to tell you what happened. My first conscious memories came in fits and spurts, mostly pieced together in a somewhat backward sequence: Dr. Burbidge’s masked face and jovial voice asking as my gurney was positioned back in Station 12, “How is our foul-mouthed patient?” My own voice responding in embarrassment, “Did I curse?” Recalling a voice some moments before in my hazy state of half-wakefulness tell me to “Go for it.” A feeling of intense aggravation as I yanked a tube from my right nostril. I can only assume I prefaced that particular gesture with a colorful metaphor; hence, the reference a few moments later to my foul mouth. I was mortified. They were amused.


I take comfort in the knowledge that one cannot be held accountable for what one says while under anesthesia.


As my mind began to clear, I asked Dr. Burbidge about the tube in my nose. They had obviously had to ventilate me. He explained that with some patients who may have sleep apnea or other breathing issues when they’re asleep, it is sometimes necessary to insert the tube to keep the airway open and ensure oxygen is flowing without restriction. All I know is it must have been incredibly uncomfortable because I was intent on removing it as soon as some part of my conscious brain was aware of its presence in my nose.


It was around 9:00 when I fully came to myself and was ready to change into my clothes and be on my way home. Once we tracked John down, who we learned wasn't receiving phone calls because the AT&T network is apparently worthless on Eglin Air Force Base, one of the doctors covered the discharge instructions with him, and we were free to go.


I will spare you the image of my port in the picture I took. As Dr. Mahoney explained, I will have a bruise, which has turned out to be minor, for a while, but otherwise, the port is good to go. The nurses will even be able to use it on Monday morning for my Darzalex infusion.

You may be wondering about how they will access it since it is subcutaneous. I wonder that myself, as I have never watched them with another patient in the infusion suite who has a port, though many do. The discharge instructions I was given following my procedure are similar to what is provided in the pdf in the Reference section. It’s very interesting and easy to read, if you’d like to take a look.(1) I do know from what Amber, the charge nurse at The Woodlands Infusion Suite, has described about the process. Patients are provided with lidocaine cream and clear patches with adhesive around the edges. An hour before infusion, I will squeeze a generous blob, say, nickel- to quarter-sized, of the cream onto my skin covering the port and place the patch over it. In lieu of the patch, I can also use a piece of plastic wrap from my kitchen drawer. The lidocaine will deaden the nerve endings in my skin so I shouldn’t feel discomfort when the needle is inserted into the port for chemo.

There are a lot of things that have been getting under my skin lately, but none so literally as this new “PowerPort.”(2) It feels strange, but fortunately, I have had little discomfort from the procedure. What is more, I did what any woman would do in my situation. I used it as an excuse to buy myself some jewelry. I found a stylish medical bracelet that I could customize so that in the event of a medical emergency where I am not conscious or otherwise able to tell someone about the port, my pretty new bracelet will.

 

As I wrap up this post to my blog, my mind reflects on this special day of remembrance that Christians observe every year – Easter Sunday. As a Christian, I celebrate this day every day of my life. The account of Christ’s death, burial, and resurrection is why I have hope in this life. As I travel this journey with each of you, I pray that if you do not know Jesus Christ and what He did for you…if you walk a path that is lonely, hopeless or bitter, full of hardship, or empty of promise, I pray that you will consider His suffering and how He overcame death, choose to live as He lived, and know with full assurance what I know: “…that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” Romans 8:38-39.

Prophetic in its timing, I received an email this morning from and old and dear friend, who also reads my blog consistently. It contained the following short essay from a podcast to which he subscribes.(3) I hope it touches you as well on this special day.


May God bless you all.


 

In the year 33, a man was put to death in a way that expresses the full cruelty of Imperial Rome. He was beaten. He was killed—on full display, after being forced to carry the weight of the tools of his annihilation to the site of his ultimate demise...

No, not Cicero, whose head, hands and tongue were put up in the Forum by Marc Antony. Or the Stoic Gaius Rubellius Plautus whose head was cut off and mocked by Nero, or Seneca who was poisoned, had his wrists slit and smothered at the orders of the man he had tutored into adulthood. Or even Justin Martyr, who during Marcus Aurelius’ time, was beaten, whipped until the skin was torn from his body, and then beheaded. This man, referred to as Christus in Tacitus’ writing, was brutally crucified and entombed. Then, three days later, he rose again.

Now, whether or not you consider the events of Jesus’s death to be holy to you or not, there is nevertheless a powerful lesson in them. A man went bravely to his death. A man with his last words said, “Forgive them father, for they know not what they do.” A man died willingly, believing he would absolve mankind for its sins. And then, from this loss, he and mankind were reborn.

We should take this day, Easter Sunday, as a moment to reflect on the beauty of rebirth and redemption. Especially this Easter, as we begin to see light at the end of the long dark tunnel that has been our collective journey through the COVID-19 pandemic. No matter what has happened, no matter what we’ve done—none of us are beyond redemption. Even in the brutality of Jesus’ execution there is evidence of this.

Well known is the story of the Roman soldier, Stephaton, who as Jesus was writhing on the cross, offered him a sponge soaked in vinegar. This has long been taken as an example of extreme cruelty—in fact, it is the opposite. The Roman legions drank vinegar wine to reduce their thirst. This was an act of mercy, quite possibly at great risk to the soldier.

There is good in all of us, even those of us who have done bad things. There is hope for all of us. The future can be brighter, as dark as the last year has been. Let today, regardless of your beliefs, mark a moment of rebirth. Of rejuvenation. Of reemergence. Tell yourself, as Epictetus said, that you’re not going to wait any longer to demand the best of yourself. Don’t, as Marcus Aurelius reminded himself, choose to be good tomorrow. Choose to be good today. For it is a new day, and it can be the beginning of a new you, too.

Happy Easter.

 

References:

(1) “Implanted Venous Access Port (Mediport Placement).” n.d. https://www.sclhealth.org/-/media/files/shared/services/surgery/mediport-placement.pdf?la=en.

‌‌(2)“What Is a PowerFlow® Port?: Infusion Therapy Port Device Information.” n.d. Bard - Port Ready. Accessed April 4, 2021. http://portready.com/infusion-therapy/what-is-a-port/.

(3) “Today Is a Day of Rebirth.” 2021. Daily Stoic. April 4, 2021. https://dailystoic.com/today-is-a-day-of-rebirth/.

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4 Comments


yardner
Apr 05, 2021

As always, a very engaging post. I am thankful for the device that got “under your skin” will hopefully make things easier for you in the future. I had to giggle a bit about you one-upmamshipping Shelly about needles! Sibling relations are a funny thing eh? And I know, neither one of us would trade the ones we have for any other. Blessings my friend!

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adee_ellis
Apr 04, 2021

You are the bravest person I know and your ability to write these lovely posts shows what ever chemo brain you think you have- it’s minor. You are in my prayers every day

and I hope you had a blessed Easter .💗

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Kelly Diaz
Kelly Diaz
Apr 04, 2021
Replying to

Thank you, Angie. It‘s all so unreal to me still, even though I’m going through it. As for the chemo brain, some days I have to concentrate really hard to put my thoughts together in any coherent way. I love you!! 💕

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mamodio54
Apr 04, 2021

I’m glad you’re feeling better today. Happy Easter to you too!

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