Friday, November 23, 2018

Your Personalized Fulvestrant Shot: Every Nurse Has Her Own Style

Each nurse, I have learned, is unique. Each knows just how comfortable she feels about giving shots in general and that shot in particular, the one with the very long needle and the fluid that has to enter excruciatingly slowly.
"Wouldn't you like to stand?" said one nurse. "All the other ladies do!" She gestured to a medical machine sporting a small, apparently decorative railing where I might rest my hands as I waited, pants down, feeling very dignified as she drew imaginary lines on my buttocks with a finger, trying to find the exact right spot pictured on the diagram she was probably holding in her other hand.
Neither of us anticipated me needing that railing for support when I started to faint. The only thing that prevented my doing so as everything went black before my eyes was awareness of that dagger-length needle deeply embedded in my right gluteus maximus.
Next time, I asked "the other ladies" which nurse knew how to give the shot. Two nurses are reputed to be particularly skilled and they have the same name, let's say Susy. One is short, the other tall, so they're known as Big Susy and Little Susy. 
When I go for my monthly shot I ask if either is around and if I'm lucky I get to lie on my stomach and forget the shot after the initial brief stab. 
That was before I read some medical literature and discovered that many nurses don't know that Fulvestrant is supposed to be administered intra-muscularly, not sub-cutaneously. In the muscle, not just under the skin. This is just one of the several worrying info-sheets I discovered on the topic: https://voice.ons.org/conferences/best-practices-for-im-injection-of-fulvestrant
Every time I go for my shot, I introduce the term "intra-muscular" into the conversation, but of course I have no way of telling whether the shot's being served up that way. 
My last CT scan was clear.  Is that a clear sign the medicine's muscling its way through, well, muscle?
Meanwhile, yesterday's nurse insisted I lie on my side with one leg, the one with the targeted buttock, in front of me. I've been told to lie on my side before, but the leg-in-front was a first.
"But this is the correct way!" insisted the nurse. "This way, the muscle is relaxed!" If you say so, nurse. Definitely hurt more that way. As she administered the shot (takes a few minutes) she noted that I seemed to have very strong muscles. She seemed rather surprised. The other ladies don't do, or didn't do, ballet. I did do ballet. My muscles are not the relaxed muscles she was expecting to see. But then who's relaxed while experiencing a needle halfway up her butt cheek, through which a liquid battling cancer cells is pinching its way forward?

3 comments:

  1. Great that the CT scans are clear! Worth a needle that's a foot long for that result. (I think I'd be taking a valium before those shots, or something to keep me from tensing up too much.)

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