Several "lasts", in pictures...

On October 4, 2019 I parked at my local cancer treatment centre for my last cycle of chemotherapy. I was connected to the poisons that I had come to accept as part of my life for what seemed like forever. In reality, it had been about eighteen weeks from the start of my chemotherapy to my last cycle, but it was such a significant change to my life as I knew it that chemotherapy came to define my life more than I had wanted.

But that all changed that Friday morning. I received the nerve-damaging drug oxaliplatin for the last time, then had the last baby-bottle of the mucous membrane destroying fluorouracil connected for the last time. I would still feel the adverse effects of these drugs for the next few weeks - cold dysesthesiae from oxaliplatin and GI side effects and mucositis from the fluorouracil -  but that would be the last time I would experience them.

My life, my normal former life, will soon be given back to me.

I took a few pictures to commemorate the various "lasts" that I have experienced during this last cycle. It is often said that a picture is worth a thousand words, so here are several thousand words worth of photos of these lasts.

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Two thumbs up means this is the last time I have to sit in the admittedly comfortable treatment chairs and have carefully-measured doses of poison pumped into my bloodstream.

I already showed this photo, but this is me leaving the chemotherapy treatment room for the last time. Patients who complete their last cycle of chemotherapy are encouraged to ring the bell to celebrate. The plaque on the bell reads "May those who ring this bell live a long and healthy life."
It was *very* emotional.

This is the last hookup of fluorouracil just before I disconnected it from my PICC. The white cylinder taped to my bicep is a temperature-sensitive flow control valve that will stop the flow if it is not around body temperature (for safety) as well as limit its flow to around 5 mL/h, making sure that the 230 mL bottle infused over the 46 hours it was prescribed for.

This is a closeup of the (rather awkward) placement and connections of my PICC just before the last time I would disconnect the fluorouracil bottle from my body.

This is the last disconnection setup I will ever need; a pair of nitrile gloves (personal protective equipment or PPE), a Zip-Loc bag to contain all the components, a 20 mL prefilled syringe of saline to flush my PICC, two alcohol swabs to clean the access ports prior to flushing, and a blue protective pad to absorb any small spills and keep any remaining chemotherapy from our dining room table.

That's it - the last bottle of fluorouracil, now completely empty after it has delivered the last of the carefully-calculagted dose of poison into my bloodstream.

This is the last bottle of fluorouracil, along with the tubing and flush syringe needed to disconnect the poison from my PICC. It is about to be wrapped up like a toxic little burrito to be stuffed into the biohazard pail for eventual safe destruction.

This is the last bucket of biohazardous waste, including the last baby bottle of fluorouracil I would ever receive.

My smiling face and PICC site after the last bottle of fluorouracil is disconnected. Yes, I really was that happy.

This is the last time I would wrap my arm to protect my PICC when I showered. For nearly five months I used a plastic bag with the bottom cut out and four elastic bands over a white elastic tube to protect my PICC from water when I showered. Even with all that protection, I had to be careful not to spray water at the edges of the bag and limit my showers to only about five minutes to reduce the risk that water would cause the dressing over the PICC to come off.

This is my PICC, the last time that I would see it after it was pulled out of my upper right arm. 34 cm (about 13 3/8 inches) of its length extended up my arm, into my chest, and ended just outside the right atrium of my heart. 

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And that's it. My journey through the truly terrifying world of chemotherapy is now done; time to hop to the next lily pad and start recovering.