Infusion 72 in a pandemic

When I arrived at Huntsman Cancer Center's Farmington Campus this afternoon , I noticed that the staff had gotten more consistent with their mask standards since my last visit. All staff were wearing procedure masks over their noses and mouths, although most had not tightened the nose band to restrict air gaps. My temperature was taken when I entered, my hands washed with a liberal dose of cleaner, and I was interrogated regarding my potential exposure to COVID-19. Four weeks of panic about the Coronavirus seems to have made a bit of an impression. Utah's total number of cases is only about 2600, with 21 deaths, so the risks for me personally remain very low. I continue to have mixed feeling about the one-size-fits-all response to the pandemic, but understand the public health priorities. 

I am grateful that the personal impact of the Coronavirus restrictions has been relatively small. The biggest thing is that I have not been able to personally visit with Jennifer, since all long-term care facilities have been locked down for weeks. I fully support that decision, but it is strange to go from seeing her daily to only being able to waive to her through the doorway or window. The small grace, perhaps, is that Jennifer's temporal abilities have been so adversely affected by her frontotemporal dementia that she doesn't clearly recall the fact that I have been unable to spend time with her. She continues to slowly decline, and lives very much in the moment, frequently unable to regulate the impulses shooting through her brain.

I likewise have limited my interaction with my daughter, son-in-law, and grandchildren, even though they live next door. Chelsea has dual concerns: she continues her medical practice as a hospitalist, caring for admitted patients at the local hospital, and is in her last weeks of her pregnancy with grandchild no. 5. We're in agreement to limit the risk of potential exposure both ways. I still get together with my two sons on a regular basis to share meals and play family games (several variations of Settlers of Catan, Azul, and Dominion).

The pandemic shutdown also has caused us to cancel the Utah's 2020 BCAN Walk to Fight Bladder Cancer, which had been scheduled for May 30. Salt Lake County's event's staff called me last week to warn that the county had cancelled all events through May 11, and would almost certainly cancel all events through the end of May. BCAN also had advised us to pull the plug on in-person walks in May, and to publicize a virtual walk on May 2. You're welcome to make a donation under my team (Team Kbros), or an individual donation. Thanks!

Back to today's infusion. Maybe it was the masks, but it took 4 sticks by three different nurses before they get a good blood return (on the back of my left hand, which will likely leave a painful bruise). Oh well. The lab said that first set of blood draws were unusable because the blood had coagulated. Eventually all got straightened out, and my labs were perfect, as usual. I spoke with Lindsey, the PA, who had consulted with Dr. Maughan. She confirmed that present plan to go through June, then suspend therapy. She let me know that, if I was not comfortable with coming into the cancer center because of Coronavirus fears, they would be ok with my not having my last three scheduled infusions. We kicked around the pros and cons, and I decided that I'd go forward with today's treatment since I was already here. I also said that I was leaning towards going forward with my treatments in May and June, as we previously planned, since the risk of COVID-19 infection was very low. Lindsey also noted that the rash on my face and scalp was getting more visible, and that continued to reinforce the decision to suspend therapy soon.

The lab rapidly prepared my dose of nivolumab, and I had it pumped into my hand in the usual 30 minutes. I'd forgotten how much more temperature-sensitive it is to pump fluids through the veins in the hand as opposed to the arm. This was my 72nd infusion of Opdivo, and my 28th during this round of therapy. I'm glad the drug continues to work, but I'm not going to miss these events.