David Ashleydale (randomlife) wrote,
David Ashleydale

A complete physical

On August 21, I took BART to the Ashby station in Berkeley. There, a shuttle met me and took me to the Alta Bates hospital where the apheresis procedure will take place. They needed to take some more blood samples, take a look at the veins in my arms to determine their suitability, give me an EKG, give me chest x-ray, and a physical.

The doctor hadn't arrived yet so an assistant took the necessary blood samples from my left arm. I watched as she consulted a sheet of paper, preparing a small vial for each test. The number of vials grew rapidly.

"How many of those are there?" I asked, my eyes growing wide.

"Oh, looks like about sixteen to eighteen," she replied.


I had no idea they would need so much of my blood just for testing.

After a nice conversation with the assistant about her family in India, and much blood drawing, I went into the bathroom to pee into a small cup. It's not an easy task, but I'm sure it's much more difficult for women.

I always feel strange handing over a urine sample to someone. Here's a little cup with my piss in it. Thank you.

I drank some orange juice, then waited for the doctor. When she showed up she introduced herself as Suzanne and said, "Oh good, they haven't drawn your blood yet."

"Um, yes they have." I showed her the little cotton ball on my arm.

"Oh." She had a box in her hand with more vials in it. "Actually, we need to do these ones too. Do you mind?"

I hesitated slightly. "You need more?"

"Yes. Well, let me go check. Would it be all right with you if we have to take more?"

"Sure, that's fine," I said. As she walked away, I wondered about how much blood I could give them before there was a danger of passing out. I figured they must know what they're doing.

When she came back, she took me to the apheresis room and told me that they didn't need any more blood today. Suzanne introduced me to Marianne who would be taking a look at the veins in my arms.

I sat down with Marianne and rolled up my sleeves. She examined both arms thoroughly and said that my veins don't look too prominent. She said that there was probably only a thirty to forty percent chance that they would be able to do the apheresis using those veins. Most likely they would have to go through a central line -- either right under the clavicle or the femoral vein in the thigh.

They told me that using a central line is a little more risky and I would have to sign a separate consent form for that. But the risks are minimal and mostly it's just uncomfortable. Or I could opt to have them take bone marrow instead.

I told the doctor that it's probably easier to just go for the central line since I would be ready for the apheresis right then anyway. She agreed and mentioned that there are pros and cons for doing it either way.

One of the least common accidents that can occur with central line placement under the clavicle is a lung puncture. But it's a very rare occurence and easily treatable since I'll be right there in the hospital surrounded by trained professionals.

You know what? I think I would almost rather not hear about every little thing that could possibly go wrong. I realize that the hospital has to disclose everything for legal reasons, but I think it causes unnecessary worrying. And if a patient is worried or nervous it seems more likely that complications will occur.

So I may have to lay down with a catheter in my thigh for six hours. I jokingly asked Marianne if there were any vein exercises I could do. And she said actually there are. I could get one of those squeeze balls to workout my forearms. Also, I should be completely hydrated on the day of the procedure, warm, and relaxed. She asked if I had eaten lunch yet and I said no.

"That probably has a lot to do with it," she said. "If you haven't eaten and you're nervous, then your veins will hide."

So I'll try not to be nervous. But it's hard to be relaxed when you're telling yourself, if you're not relaxed they're going to stick a tube in your chest.

Next came the chest x-ray, the EKG, and then a brief physical exam from another doctor.

It all seemed to go well and the doctors were all nice and helpful. I was somewhat nervous throughout the visit and the doctors actually asked me a few times if I was all right or if I was nervous. I tried to just brush it off because I don't know why I was nervous. I should be able to put up with some discomfort in order to save someone's life. When I think of that or when I think of this woman's family and friends, then I calm down and I feel better.

Since I hadn't eaten lunch, Suzanne recommended that I go to High Tech Burrito just a few blocks away. It actually was pretty good.

She said she would call me and let me know the results of the tests when I get back from Boston on the 31st. They're going to shoot for having the procedure either during the week of September 11 or September 18.
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