Christopher Court - Chemo Clinic

Chemo Clinic

Clinic days were on Tuesdays, every other week.  The family would normally leave the house around 7am in order to be at CHOP around 9am.  The first few visits, Chris was not at all anxious, but the anxiety grew to the point where he would vomit on the way to the hospital or on arrival.  The clinical term for this is "Anticipatory Vomiting".  Most times he would occupy himself on the car journey with his Nintendo DS, or the iPad.  On arrival at clinic, Chris' mom would fill out the paperwork to check him in, and his dad would take him to the bathroom to produce a urine sample and to apply numbing cream to his port.

Once checked in, Chris would go back to the play area where Miss Meghan would find activities for the children to do while they waited.  Often this would be an art project and Chris would usually draw dragons.  One particularly fine specimen was chosen to be framed and hung in the children's art gallery at CHOP.  After being there a short while, Chris would be called to "Triage" where his weight, blood pressure, temperature and height would be recorded.  Then it would be back to the play area for a while.  Next he would be called by a nurse to have his port accessed.  There was no part of this procedure that he enjoyed; he didn't like the smell of the cleaning solution and he didn't like the feeling of pressure when the needle was pushed into the port.  The numbing cream ensured he didn't actually feel the needle penetrate the skin.  He would rate the nurses on a scale of 1 to 10 based on their ability to access his port quickly and painlessly.  Only one nurse ever scored 10, Marla, Dr. Phillips' nurse, but unfortunately she was not always available.  

Once the port was accessed, they would take a blood sample and send it off to get his white cell counts.  On a couple of occasions,  Chris hand delivered his own specimen to the lab.  The staff there were very pleased to show Chris around and to show him what blood looks like under a microscope - he was fascinated.  The goal was to have an ANC (Absolute Neutrophil Count) higher than 1000; below this number, they would not give him chemo therapy as his immunity against infection would be too low and the chemo would lower it further.

Christopher Court with Dr Peter PhillipsAfter the port access and blood test, it was back to the play area until the doctor was ready to see Chris.  When called by the doctor, Chris and the family would go back to the doctors room where he/she would perform a neurological function test.  This would involved testing muscle strength over a range of movements and comparing the left and right sides of the body.  It would also involve following the doctors finger with his eyes, walking a straight line on his heals and then on his toes.  There would be a discussion of any side effects or complications since the last treatment and any adjustments in dose or prescriptions would be made.  The doctor would then order the chemo and Chris was free to go back to the play area.

Christopher Court playing guitarThis was Chris' favorite part of the day.  He would usually go out to the waiting room where Mr. Mike, the music therapist, would be with all his instruments.  Chris loved playing the instruments - a drum kit, electric guitar, keyboard, tambourine and various strange percussion instruments no-one knew the name of.   His favorite was the electric guitar; Mr. Mike would tune it so that it would play a cord without needing to use the fret board.  On several occasions Chris would get called away shortly after starting to play and sometimes Mr. Mike would go and find Chris in the Day Hospital and have a one on one jam session with him.