Round 3 - Day 1

Many people have asked about chemotherapy - what do I have to do, how long does it take, how does it make me feel? So I'm going to attempt to capture the day by day for this round. Here we go:

Day 1 - Chemotherapy is scheduled for 10:30am at the Front Range Cancer Specialists Office at Poudre Valley Hospital. For the last 2 rounds, Husband has driven me down and back, but he's been really busy at work lately so I decided to see how it was to take myself.

First thing in the morning I got my "Chemo Bag" together: books, magazines, coloring books, food and snacks for lunch, kleenex, pens, chapstick, headphones and ipod, cup for water. I also take a Claritin and a Pepcid. These two normal everyday drugs apparently help counteract the mind-killing headaches I get from the Neulasta injection. I start them the day before to start getting my system ready. I jump in the car at about 9:15am and head down the hill.

When I get to the clinic, I check in with the receptionist (who sometimes remembers my name, but doesn't' recognize me this time with my koala bear face hat and lack of hair). The nurse comes to get me and weighs me in (my favorite part!). Ironically, before I got cancer I was very aware of my weight at all times and have been working on losing weight for the last, I don't know, 800 years. However, since getting the big C, I've been working out less and eating worse food, and have weighed the same at each session. Of course, I eat a lot less during the first week of each round, so maybe that evens things out. Either way, I try not to think about it too much - except at the weigh in.

After the weigh in, I'm taken back to the Chemo Clinic. It's a big room with 3 different groupings of big brown leather recliners. There are windows all around looking out at the surrounding fields and mountains. One wall has a long cabinet on it where people place snacks to share and things that they are passing on to other patients (hats, books, wigs, etc.) There is a refrigerator in the back part of the room for water and to stash lunch if it needs to stay cold. There is also a coffee machine that creates smells that I personally have trouble with when I'm going through my session. There are also about 6 private rooms where patients can go if they don't want to listen/watch others or if they have a bunch of people with them and they want to have some space to themselves.

I usually pick a chair in the back pod facing out at the mountains. This week there are a lot of people in the clinic. My pod has 3 other patients and 2 associated family members. The two ladies across from me are chatting away about their cancer journey - sharing their symptoms and side effects. They are both on their second to last session of Taxol (the drug I switch to in January). They are complaining about the muscle weakness, restless legs, and nueropathy that is causing them to lose feeling in their fingers and toes. They are also comparing how many nails they have lost to the drug. Super! Things to look forward to. The lady to the left of me has immediately fallen asleep and is snoring lightly. I find out later that she has been fighting cancer since 2009. Her breast cancer spread to her liver. She does, however, assure me that the mastectomy surgery was not that bad. I take what I can get.

So after sitting down, my nurse comes to "plug me in". You'll remember that I received a port in my right upper chest which I lovingly refer to as my alien. The nurse cleans off my alien with chemicals that smell really bad to me and make me slightly nauseous. My sense of smell has gotten really sensitive and picky during this process. Some strong smells are ok, but most turn me a little green. She tells me to take a big breath and inserts the needle for my IV into the port. There are three little bumps that you can feel through the skin that she aims for. Each time, the needle breaks the skin, but all it takes is a little band-aid when I'm done.

The nurse takes 3 vials of blood to send off for testing. My Complete Blood Count (CBC) is checked to make I'm handling the drugs ok. If I'm not, I would have to get a blood transfusion. I sit and wait (and eat my pretzels) for about 45 minutes until my CBC comes back normal. So now it's time for the drug therapy.

My first two drugs, Aloxi and Emend, are designed to block the signal that causes nausea and vomiting. The Aloxi also contains a steroid (Decadron) to help with general chemo symptoms. Possible side effects of these two lovely drugs include fatigue, headache, constipation, insomnia, hiccups, and loss of appetite. After the first round, I ended up with a horrible headache on day 1 so my nurse slowed down each of these drugs to be administered over about 45 minutes. It's important to be super hydrated during this who process, so I end up wheeling my little IV stand with me to the bathroom at least 3 times during this 90 minutes. I keep noticing people giving me side long looks and wonder about it until I remember I'm wearing my koala hat. It's so busy and there are so many conversations going on in the clinic that I have a hard time concentrating on anything, so I page through the magazines I brought with me, eat my lunch, and eavesdrop on all the conversations around me. Eavesdropping on cancer conversations is not good. It makes me kind of sad, actually, because it reminds me of all the things I have left to go through.

Drug #3 is my first cancer med - Adriamycin. This is one is delivered by IV push instead of IV drip, so the nurse comes and sits next to me and pushes the medication into the IV slowly through a couple big syringes. The side effects for this beauty are nausea/vomiting, bone marrow suppression (which causes a drop in red and white blood cell and platelet production, and makes you more prone to anemia, infection, and bleeding), hair loss (yup, got that one), mouth sores (I suck on ice chips during the delivery of this drug to shut down my mouth cells so they don't suck up the drug), heart toxicity (there is a lifetime maximum of this drug that you are allowed to be given so as to limit this side effect), urine color change (pink pee!), and fatigue. Needless to say, this one is a fun one. It only takes about 15 minutes to administer. I ask my nurse if it's hard dealing with cancer patients all day. She says, "No, dealing with my teenagers is worse." :)

The last drug is another cancer drug - Cytoxan. This one is another IV drip that is given over 90 minutes. By this time, the clinic is starting to empty out. I pull out my phone and watch an episode of NCIS on Netflix. Thank goodness for wifi! The side effects of this drug are nausea/vomiting, bone marrow suppression, hair loss, bladder inflammation, decreased fertility, and fatigue.

At this point, I've been at the clinic about 5 hours. Once I switch over to the Taxol, it will be a lot shorter, but for now it's a pretty long day. Once the Cytoxan is done, the nurse comes over to place my Neulasta injector. Neulasta is a drug that helps my body make more white blood cells and protect itself against chemotherapy complications like infection. Unfortunately, it comes along with mild to moderate bone pain (caused by your blood marrow going into super production). This is what caused my big headaches in round 1 and what the claritin and pepcid are supposed to help with. The Neulasta is given through an injection - or, in my case, through 2"x 1" auto-injector that it attached to the back of my arm. This makes it so I don't have to drive all the way back down to the clinic just to get an injection - which I appreciate. The nurse places the injector and about 30 seconds later is starts beeping like it's going to explode (maybe I've been watching too much NCIS). It shoots a tiny catheter into my arm so that 27 hours from now it can release the medication.

And that's it. Time to go. After my session, I feel relatively normal. It's hard to explain, but it's kind of like I'm buzzing.....or maybe like I've just been pumped full of drugs for the last 5 hours. Either way, I feel ok and walk back out to my car to drive home. It takes about 2 hours before I start feeling bad, so I have plenty of time to make my 1 hour and 10 minute drive home.

I've figured out how to handle the first day effects better and better as I have my sessions. Slowing down the anti-nausea drugs has lessened but not eliminated the first day headache, so I take an ibuprofen to help with that. I've been craving salty food lately, so I help Husband make some frozen Chinese food. My taste buds have been affected by this process, so spicy and salty foods have tasted pretty good lately. I eat a little food and then settle myself onto the chaise of our couch to await the shitty feelings I know are coming. I sip on club soda to keep my stomach from rolling too badly. Mostly I just try not to move. Even my eyes. If I just sit and not move, I can make it through with only mild discomfort. The nausea is almost always just right on the edge, but I just try not to think about it too much. I have a whole regimen of anti-nausea drugs they have prescribed me, but the only one of them that seems to work is Ativan, which knocks me out for about 8 hours if I take it, so I try only take it when I have to....especially when Husband is home. I try to stay awake for him to try to maintain some sense of normalcy. The dogs, too, seem to sense that something is up and try to squish themselves onto the couch next to me. With Bridger being 100 pounds, this is always a little entertaining to watch.

This week I actually stay up to a normal time and watch a few episodes of Top Chef and Survivor. When it's time for bed I take all my little bottles of medication into the bedroom with me and put them on the nightstand just in case I wake up in the middle of the night feeling sick. I also take 3 Senkot-S tablets to help with the constipation. I will not burden you with all the things I've learned about my digestive tract during this whole experience, but needless to say, it has not been a pleasant learning curve.

The one thing that hasn't been affected by this whole thing is my ability to sleep, so I drift off to sleep pretty easily and wait to see how the rest of this week will play out.

So there you go.....that's what going to chemo is like. On the whole, not too terrible, but not pleasant either. We'll see what tomorrow brings....

No cocktails for me today. Seems like it might be a bad idea. Husband bought some holiday beer on the way home. It's description says it has hints of cinnamon -which makes my stomach do a little flip flop just thinking about it. Sometimes just the suggestion of a particular food or smell is enough to set if off.

So I think you're on your own for a cocktail. Cheers!