My cancer diary:
Thursday - May 17, 2001
[total: day 102][chemo-cycle 3: day 0]

"As Andrea is working early today it's my father's turn to drive me to the hospital. We arrive at the private outpatients' department and learn that the lady at the inhouse registration is ill today. So we have to leave the building again to go to the central registration office at the main entrance. There I learn that the computer system has crashed and I will neither be able to get all the printed paperwork for the ward nor to load my phone card.

Nevertheless we return to the department of urology. It's again the sick bay on the second floor, even the same room I was in during my first stay. I have a neighbor, a fine man in his fifties recovering from an operation at his kidneys. I pray to God that he is not a passionate snorer.

I know that day zero of a chemo-cycle is always watering: getting the kidneys run at full capacity. I will have an arm catheter and at least five liters of sodium chloride will be injected. Tomorrow I will get the central venous catheter for the cytotoxica.

After three hours of waiting I am quite surprised when being asked to walk down to the operation area to get the central venous catheter already today. The nurse tells me that I should walk and she will pick me up with the bed afterwards.

So I do and am relieved as it turns out that it's M.'s turn again. He has already laid my first two catheters and I hope that it's just routine today. The last two were laid into the right part of the neck so I presume it will be the left vein today.

I have to get onto one of the mobile operation tables and am driven from the operation lock into the internal wake up room where the surgery will take place. I am not that nervous because I hope that the problems of the second time will not occur as there is no previous prick of a needle visible on the left side.

I am right. Also M. suggest to go for the left neck location. A nurse is his assistant today. They prepare everything, clean the neck, put the sheet on my face and anaesthetize the area. I ask the nurse to hold my hand. It hurts when M. does his first attempt to get the catheter into the vein: missed it. The second attempt is in, but the catheter can't be pushed forward deep enough. Maybe it's not in the correct vein. Off again. The third attempt misses the vein itself again. It hurts not only in the neck, but the pain also expands into the whole arm. I start sweating and need more anaestetica. The forth attempt hits the vein. My body shivers. It hurts in the left hand this time. M. explains that there are nerves of the arm where he tries to get the catheter into the flesh. He pushes the catheter into the vein, but again he can't fully get it in. I start moaning. M. suggests to change the side and try the right neck location.
He puts a plaster and a compression bandage onto the left location and we start all over again on the right side. Cleaning, anaesthetizing and pushing. Thank God it's in the first time. He is also able to push it forward the required 16 cm. He stitches the catheter to the skin and we are done.

Seconds later I notice that I am no longer able to fully inhale. My left arm is completely immobile and I can't feel my shoulder. M. explains that this is due to the amount of anaesthetica he used. It will take three to six hours until it disappears. It's not dangerous at all. He adds that it might be that the radiologist diagnoses a lop-sided diaphragm. I should tell him about the problems we had.

When I am pushed back into the operation lock a young assistant of the ward expects me with my bed. I am returned to my sick bay.
Fifteen minutes later two assistants enter the room and drive me to the radiology department on ground floor. The x-ray reveals that the catheter sits correctly, not too deep in the heart. Puh!

We return to my room. For the next few hours I get a feeling of what it means to be partially paralyzed. I can't move my left arm at all.

The nurses start with the infusions.

Later in the afternoon B. comes in for the round. He is alone. It's a very careful and sensitive conversation. He does his routine questioning for the World Health Organization's statistics. Before he leaves again I ask him about his remark on Tuesday: why he wouldn't go for the thoracotomy. He explains his confidence in the local radiologist's experience and opinion. He would definitely focus on the RPLND. This should have top priority for me.

I feel quite comfortable when he leaves. As I always said: If he is not in hurry, he is quite a good doctor."

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PS: This diary reflects just my very own opinion. - You might be also interested to read further details in doerings.net general section about testicular cancer.