Moving in at Stanford Medical Center

The view outside our room

The second I set foot through the doors at Stanford Medical Center, I knew it was the place we needed to be.  Although it was 2:30AM and the hospital was eerily quiet when we arrived, I could feel that it was a place of skilled Dr.s and quality care.  Willie had arrived 15 minutes before me and was already in his room answering questions about his health history to a student Dr.  Stanford is a teaching hospital so a lot of the doctors are young students being supervised by seasoned professionals.  This young Dr. asked the intake questions and gave Willie a quick exam.  He left close to 4 AM and told us to get some sleep before the day began.  We got a quick hour of rest before the day began at 5 AM with lab techs coming in again for more lab draws.  Soon after a man arrived to do an electrical heart exam.  When he finished, Dr. Mitra arrived.  He introduced himself as part of the hematology team that will be overseeing our case.  He is a young MD who is currently at the level of Fellow which is the last step before becoming an attending physician.  He is very educated, yet delivers information in a way that is not overwhelming or condescending to our lack of intelligence in this area.
"You've got a little bit of a bad thing going on here Willie." He said soon after he introduced himself "Leukemia is a tough thing to deal with, but I want to reassure you that you are still the same person you were yesterday and you will still be the same person tomorrow.  We are going to treat this cancer and have you feeling like your old self in no time."
You can see why we instantly liked him!  He talked us through the procedures that were going to be happening throughout the day and explained that the goal of the day was to first of all, confirm that the diagnosis was correct, then secondly review all of Willie's bodies systems to find out which type of chemo he could tolerate best. 
It was about 8 AM by the time he left and we were both riding on one hour of sleep.  The second he exited, a man arrived with a EEG machine to do an ultrasound of Willie's heart.  Everything was perfect and there were no concerns there.  He left and was replaced by Choon, a cute Korean nurse who placed Willie's PICC line.  A PICC line is like an IV, but it is inserted in the upper arm and a small catheter is fed through the vein toward the heart.  The point of this line to to provide a port to administer medication more effectively.  They can also draw blood from the port so he won't have to be stuck multiple times a day.  Choon joked and talked with us as she did the procedure.  In the quiet moments where she was concentrating, she would hum a little tune that transported one into a scene of tranquility and brought to mind visions of coy pools and sand gardens.  She was a bright spot in our chaotic morning and we were sad to say goodbye to her when she finished the line and left us.  The door had barely closed behind her when a new set of people came in to take Willie for a chest x-ray to confirm the PICC line was inserted correctly.  Choon wasn't surprised that her work was perfect, and she told us so when she returned to give us the news and compliment herself.  She never places a bad PICC line, she said. 

Choon inserting the PICC line

By this point it was close to 3PM and we were starving.  The dietary system here is phenomenal!  I used to run a kitchen in a skilled nursing facility and know the challenges that hospitals are faced with in providing quality meals that meet California code and fit in a tight budget.  Stanford manages these challenges beautifully.  Willie has a menu with an incredible amount of choices that he can order from any time he wants.  It feels like room service at a hotel, and the food is fantastic!  We ate lunch that day and relaxed for a moment knowing that the only thing left to have tested that day was a CT scan of his tooth.
We had just finished lunch when we received news that Willie would need to have another bone marrow biopsy.  It was like someone hit a panic button and we both began to breath harder.  Why wasn't the first biopsy good enough?  It had only been two days since his first one, didn't they say he wouldn't need another biopsy until after treatment?  The hospital wanted their own sample to confirm the diagnosis so before we could talk our way out of it, the team arrived to perform the procedure.  It was almost comical when the Dr. who would be performing the biopsy introduced herself.  She was a small 4'10" Asian woman who was as big around as Willie's bicep.  The bone marrow biopsy takes a lot of physical strength on the Dr.s part in order to hand drill the piece into the bone and we had little faith that her tiny frame could handle Willie's hip bones. Most bone marrow biopsies are done on older adults or young children who have softer bones, and we weren't sure that she had what it takes to break through a power lifters hip.
"I was told at the last hospital that I have thick bones." Willie warned her as she began pressing on the back of his hips to find a good spot. "That's OK," she said "I've done a thousand of these and I've never had any problem."
We joked about how we wanted to be repeat customers and hoped she would do a good job so we would be happy to come back again.  She joked back and we felt more at ease as she began to numb him up and start drilling.  The whole procedure should only take 20-30 minutes, but it was clear from the first few moments that this was going to be a long one.  She started to drill into his hip and immediately started to strain. 
"You do have strong bones" she said as she gritted her teeth and put all of her 80 lb. weight down on the device to help drill it into the bone.
She continued like this for about 10 minutes and when I looked at her again she was dripping sweat and breathing hard.  She stepped back from the bed and shook her hands out saying she needed a little break. The device had hardly moved and we were all getting discouraged.  Willie couldn't see what was going on so we assured him that we were getting closer and he was doing great.  In reality we had gone no where.  She removed the instrument and started drilling in another place with no luck. 
We were all getting antsy and soon the Dr. gave up and went to get some man power.  She returned with Dr. Mitra who we had met earlier and he took over the manual labor portion.
It was equally hard for him to get drilled into the bone.  He too had to take a few breaks to rest his hands while drilling the bone.  At one point, about 40 minutes into the procedure, with the frustration in the room at its peak willie said,
"Is this like Dominoes pizza? 30 minutes or less or its free?"
There was a pause before everyone laughed.  It seems unimaginable that a guy who is being drilled on a table could be making a joke, but that's funny stuff right there.  The quick laugh revived the Dr. and he started drilling again. About 15 minutes later he finally made it in the bone.  Willie had agreed to give some of his bone marrow aspirate fluid to the research department and they were planning to take 4 extra tubes.  When he started pulling the fluid from inside the bones we all realized this was not going to be a good idea.  It was not coming out very easily and the extraction was causing Will to have pain down his back and leg.  They settled for the samples they needed and two extra for research then they pulled out the instruments and moved Willie to his back.  Over an hour had passed and everyone in the room was exhausted.  Willie's hip bones had given the Dr.s a good work out!
I have never been so exhausted.  It's selfish to say that I needed a rest after that event, but the emotional strain of watching my husband endure that procedure exhausted me to tears.  I felt guilty for crying; I am supposed to be the strong one, the one who holds herself together and continually waves the flag of optimism.  Willie simply reached out, took my hand and reassured me that we are going to be OK.  And we are.  I know that.  He knows that, but it's supposed to be my job to tell him that!
Trial brings out the true character of human beings.  I have always known my husband has a strong and beautiful character, but this trial has brought a refining glow out of him that makes me proud to call him mine.  It is an honor to be on this journey with him.
We had a few moments to recover from the bone marrow biopsy before they whisked him away for the CT scan.  When we returned to the room it was around 5:30PM and we were still working on an hour of sleep.  Needless to say, we were spent.  Dr. Mitra showed up again and informed us that the diagnosis had indeed been confirmed and we would begin treatment soon.  They don't start chemo at night so we were told to plan to begin Saturday morning.  The hold up would be in deciding whether the infected tooth he still has in his mouth needs to be pulled immediately or later down the road.  There is a great risk in leaving the tooth in his mouth in the infected state because the chemo will destroy his immunity and a simple tooth infection can become a life threatening ordeal in this scenario.  He assured us that an oral surgeon would consult with us the following morning and that our job that night was to get some rest.
They brought in a fold out cot for me and I can't remember a time that I have ever been so happy to see such a thing.  I had been sleeping on hospital floors and chairs for the past three nights so that cot was like the gift of water in the dessert.  Willie was exhausted, and rightly so.  We marveled at the amount of tests that had been administered in one day.  He took them all like a champ!  That night was pretty relaxing, as far as hospital stays go.  We ordered dinner and watched the Giants baseball game, and for a moment while the game was on, it felt like our normal life...