After the infusion finishes

The line is flushed with saline, the cannula is removed and pressed until it stops bleeding, and your observations are checked once more. Then the medicines, the next date and the instructions. Most people are home within the hour.

If you have a port, the needle is removed and a small dressing goes on. Either way you walk out with nothing attached, which surprises people who expected to feel different at the end of it.

Do not rush this part

The end of the day is when questions get skipped and prescriptions get left at the pharmacy, because everyone is tired and wants to leave. The ten minutes between the bag finishing and walking out are worth spending properly.

A small dressing over a cannula site can usually come off after a few hours. Keep it clean and dry until then, and keep an eye on the spot for the next couple of days.

Bruising is common

Particularly as treatment goes on and platelets fall. A bruise that appears over the next day is expected. What is not expected is bleeding that will not stop, a bruise that keeps spreading, or a lump that is hot and painful.

Report a red, hot or painful site

Redness spreading up the arm, warmth, swelling, a hard cord along the vein, or increasing pain over the following days should be reported the same day. Infection at a line site during the low-count period is taken seriously.

Port sites need the same attention

Redness, swelling, warmth, pain or any discharge around a port is reported promptly rather than at the next cycle, because a port sits directly in a large vein. Keep the dressing dry for as long as you were told.

Protect that arm

No blood pressure cuffs, blood tests or injections in an arm where lymph nodes have been removed, and give a freshly used vein a rest. Say which arm to avoid every time rather than assuming it is on file.

Most people leave feeling much as they arrived, sometimes drowsy from the pre-medication, occasionally with a headache or a metallic taste. The dramatic reaction people brace for usually does not happen on the day itself.

The good evening is not the verdict

Effects generally appear over the following days rather than that night, and steroids can leave people unusually alert and hungry. Families read a good first evening as a sign the worst is over, and are then caught out two days later.

Start the medicines anyway

That evening, on the schedule you were given, whether or not you feel unwell. This is the single most important thing you will do after leaving the unit, and it is the one most often skipped because nothing has happened yet.

Eat lightly, keep drinking

Something small and plain rather than a celebration meal, and sips through the evening. Do not lie flat straight after eating. Keep the fluids going through the next few days as well.

Have someone with you for the first night

Not because anything is likely, but because pre-medication leaves people drowsy and poor at judging their own condition. Someone who can take a temperature and decide whether to go in is worth more than any preparation.