I don't identify people in my stories, but this one is complex enough that I provided several fictitious names.

After the earlier meeting with the oncologist I was given a card with the phone number to contact my own nurse, Jessica, in case I had any questions.

A couple of days later the patient portal had a note from her saying she had arranged to have the mediport installed. She said that since I lived in Arlington, she chose the closest location available, Inova Alexandria Hospital. Although Alexandria is adjacent to Arlington's southeast corner, we live at the opposite end of the county, which is closer to Inova Schar Fairfax.

So I called Jessica's number, which was answered by Ashley, who said she was the triage nurse on duty at the time. She said she would text Jessica, who would call me back. I had heard that Jessica was on the West Coast, so I thought maybe she was not available at the time. The next day when she did call back I mentioned that, but she said she keeps East Coast time; however, the office day ends at 4:00 PM, and I called at 4:05. (A triage nurse is accessible around the clock.)

When I told her I would prefer Inova Hospital Fairfax, she said they did not accept my insurance. I was surprised by this, since my insurance had been acceptable almost everywhere until now, but in any case, Alexandria it was to be. Her message also provided some instructions of preparation for the procedure – which would begin at 11 a.m., but I was to arrive at 9:30 – directions of how to get to the hospital, and that I would be notified of more details by a nurse from there a few days before the procedure.

On Tuesday, December 24th, Sarah from Alexandria Hospital called. Her instructions included that I was not supposed to eat anything after midnight or to drink anything within eight hours of the procedure, which would be 3 AM. She also said that there would be parking across the street from door #6, the patient entrance, but there was also free valet parking. Once I entered I was to turn right, walk past the Starbucks on the right and the Interventional Radiology area would be in the area with a glass wall to the left.

Friday morning, December 27th, before we left I took another look at Jessica's instructions and found an italicized notice near the bottom that said that since there was an IV shortage, I should stay hydrated by drinking clear fluids up until two hours before the procedure! Since that was so different from what Sarah had said I called the Alexandria Hospital number that Jessica had provided. and was answered by a message that that they were closed for the holidays!

So I tried to call Jessica to see if she might have an alternative way to contact Sarah and clarify which instructions I should follow. But this call was answered by a message saying they were busy and to leave amessage.

Then I called the Alexandria Hospital main number and asked if there was another number for Interventional Radiology, which she did give me. Which was answered with the same message. However, it did give me the option to leave a message, which I did.

I called back the Alexandria operator and told her my situation, and she put me on hold for five minutes or so. When she came back, she said Interventional Radiology would open at 8:30, and to call then. At 8:35 I did call, but the message was the same. A few minutes later, I got a call from Inova, which I assumed was from them. However, it turned out to be Patricia from Inova Schar, who this time did not offer to contact Jessica, but was not at all helpful.

Since we had to leave by nine to get to my appointment in time, I decided to follow the advice of being more hydrated, which is what had been specified before my operation at Johns Hopkins and I drank more water.

I had thought that this close to Christmas the hospital would not be that busy, but a pass through the parking lot found anything near the entrance to be full, so we pulled in front of door #6 to have the valet park us. No one was waiting outside, so Betty Lou went inside – and was told that they did not have valet parking! Fortunately, as we were entering the parking lot the second time. we were able to take the space of someone who was leaving.

We entered the hospital, walked past the Starbucks, and found on the door of Interventional Radiology a sign saying that we needed instead to check in at the other end of the building. Fortunately, I was in their system and they printed out a sheet with my information. Stapled to it was a strip of eight stickers that included my data and bar codes. The last time I had seen a strip like this was when each such sticker was removed and attached to each of six vials of blood they took from me, so I was not looking forward to an even greater blood draw.

We entered the Interventional Radiology waiting room and found a few people already present and no one behind the reception desk, but there was a sign saying they were closed for the holidays. As time went on others entered, and we began to wonder if anyone was actually around. Eventually a nurse entered from the side door and called my name. She had a wheelchair ready for me, but I told her I thought I could make it on my own and followed her to a cubicle.

I asked about the stickers and was told they had nothing to do with blood draws, they were in case more of my items needed to be identified. After the formalities of who I was and why I was there, the nurse gave me a gown, a plastic bag for my clothes and said she'd return later to insert an IV.

The surgeon came by and asked if I had any questions about the procedure. I told her I had received a mediport in the past, on the right side of my chest and had been told that perhaps the next one should be in the left. She took a look and said she thought it seemed okay to use the right side again. I asked how long it would take, and she said the procedure would take about an hour and I could leave about 15 minutes afterward. I was glad to hear that, since Sarah had said I might have to wait an hour.

Since this was only 10 o'clock and I was not scheduled until 11, I asked about the delay. She said she had another surgery before mine. I closed my eyes and perhaps dozed a little, while Betty Lou finished Ina Garten's memoir and caught up on the Washington Post on her tablet.

Finally they came to get me, and Betty Lou asked if she could wait there. They said she was supposed to return to the waiting room, but the nurse pulled the curtain closed and she stayed. They wheeled me in to the operating room, and, the visit report revealed and added some Fentanyl to the IV to provide moderate sedation. At one point, I seemed to drift further into the twilight zone for a while; perhaps that was when they were injecting lidocaine and making an incision to place the mediport under the skin.

I had no idea how long it took, but I did hear various discussions about a wire. The visit report noted that a wire was not able to penetrate a vein on the right side, so the left side of the chest had to be prepared, and the entire procedure took two hours.

Returning to the cubicle, my mouth was very dry and I requested some water. They asked if I would also like something to eat, and I visualized peanut butter crackers, but they said a turkey sandwich! That sounded good, and in fact it was the highlight of the whole visit. Lettuce, tomato, and mayonnaise on whole wheat bread, it seemed to have been freshly made, and was large enough for the both of us.

This time I did allow them to wheel me out.