A mammoth undertaking

By Gillian

So yesterday we handed back the Walkmed pump that Chris has been umbilically attached to since January. And now that it’s gone, it’s a huge relief to both of us.

The pump was about half the size of a paperback book, and came in a black padded “bum bag” that Chris kept around his waist at all times 24/7, (except when he took a shower, when it went into the boat bag). In the bum bag was also a plastic pouch containing an 8 days’ supply of 5-FU, which was delivered via the pump and a thin flexible plastic tube that was plumbed into the PICC line on the inside of his left elbow.

The odd thing was that Cheltenham and Worcester hospitals used different pouches. The Cheltenham one was larger, about the same area as the pump, and had a tube that was just long enough to go up inside his shirt, and down his sleeve to his elbow. The one from Worcester had a pouch half the size, a much longer tube (so much so that the excess had to be coiled up inside the bum bag), and also had a filter the size of a 10p piece which was taped to his upper arm using micropore. Chris was talked though the care and maintenance of the pump gubbins at Cheltenham as part of his first chemo cycle, and they emphasised the necessity of keeping the pump and PICC dry. But they didn’t mention the filter, as their kit didn’t use one. So for the first week after Chris got the bag changed at Worcester, he didn’t bother keeping the filter waterproofed during his showers. That was a mistake – a small amount of 5-FU leaked out and burnt his skin. We learned from that, and subsequently kept the filter inside the waterproof sleeve.

The 5-FU dosage was based on Chris’s weight. The Cheltenham dose was 0.63ml/hr; the Worcester dose being twice as concentrated was 0.31ml/hr, and the nurses triple-checked the programmed dose each week.The pump whirred for around a second every 30 seconds, day and night. It wasn’t a particularly loud whirr, but at first I found it very irritating. After a few weeks though I got almost used to it, but I have to say that I don’t miss it at all!

The really annoying thing though was the alarm. If the line got a kink in it (usually by Chris bending his arm too much) then the Walkmed would start beeping intrusively.  Once the alarm went off he had to take the device out of the bum bag, identify what the alarm was complaining about, stop the pump, rectify the problem and restart it. Tedious. At least it was fairly easy to avoid “occlusion” alarms once we’d learnt what caused them – it just limited how he could sit and lie, because he needed to keep his arm pretty straight. The one I always dreaded was the insistent “Battery Low” alarm. One had no control over when that happened and there was no audible early warning.  Even though we kept a spare battery in the pouch at all times, it was quite a fiddly operation to change it. I was worried that it would go off when we were out at the theatre, for example, which would have been very embarrassing. Fortunately, we always happened to be at home when the battery needed changing.

Chris was getting really really sick (both literally and metaphorically) of being plumbed into the Walkmed day and night for so many months. It’s great that it’s now done its job and we’ve handed it back. Life is much more peaceful now.