I start preparing for chemo the day before. By that time it's the very end of my previous cycle and I'm feeling pretty damn good. It start the day with my pre-chemo doctor's visit. I take the bus down to the cancer centre and meet with my chemo oncologist. Actually, before I meet with her, a nurse takes me over to a station where she asks me my first and last name and my date of birth. She weighs me, takes my blood pressure, and then she ushers me into the doctors office where I wait.
When the doctor arrives, she asks how the previous cycle went. Did I experience anything new? Was anything worse? Do I have any questions? I go over how I felt and any concerns I have. This time around I asked her when I should get the H1N1 vaccine and she advised to wait at least 2 weeks after my treatment so that my white blood cells have a chance to normalize. (And before you yell at me, yes I'm getting the vaccination. I've done A LOT of reading and this is my decision.) The oncologist also gives me my blood work requisition form. It indicates all the things she wants tested before my treatment the next day. The whole consultation rarely takes longer than 15 minutes. Then I'm off to tackle the rest of the day.
I spend the day doing everything I'm not going to want to do for the next two weeks - washing dishes, cleaning the bathroom, vacuuming, doing laundry, getting groceries and other must-haves. I go to the lab to have my blood withdrawn (yay! another needle poke!) and I also try to fit in lunch or coffee with friends and a trip to the gym. AND I do it all while getting to bed at a decent time. I accomplished all of that yesterday. Go me! (Well, if I'm being totally honest, I didn't make it to the gym. But still, go me!)
I also have to start one of my drugs the day before chemo. It's an anti-nausea drug called dexamethasone and I have to take 2 tablets twice daily for three days (day before, day of, and day after). These pills make me hyper and super hungry, which might explain all the energy I seem to have to accomplish all my tasks. Also? One of the side effects of my anti-nausea drug is...nausea. No, really.
The next day I get up early enough so that I have time for a healthy breakfast. This morning I had an apple and instant quinoa with cinnamon, ground flax, hemp hearts, and rice milk. Way tastier than it sounds. Then my mom picks me up and we head to the hospital. With chemo, there is no urgency to get there early. As long as you arrive within a minute or two of your start time, it's all good. I check in the reception and they send me over to the chemo waiting area. There are regular chairs and recliners to sit on. Usually there are magazines to peruse but this morning the tables were empty, save for a note explaining that, due to H1N1, all magazines and pamphlets have been removed.
Within a few minutes Mom and I are called into the chemo area. Mostly it's a big room with a row of about 25 stations, each with it's own reclining chair, IV stand, cart, blood pressure machine, and other medical paraphernalia. There are also a couple of other hidden corners with 2 or 3 stations and some private room stations. I've been in the big room once, the hidden corners twice, and today I was in a private room. I think I like the big room the best - more to see and hear to keep me occupied.
After waiting at my station for anywhere between 5 and 15 minutes, a nurse walks over and tells me about my blood work. Mostly they've told me that my neutrophils are higher than normal and that indicates I've been fighting infection. They then take my temperature and blood pressure to make sure everything's fine, which, after that first time when I was sent home, it has been. So despite the high count we proceed. The first thing they do is insert the IV. This is my least favourite part. I have lousy veins that don't stick up above skin level. They have to heat these two bags of green liquid that looks suspiciously like lime Kool-Aid and then put the bags on my hands to get the veins to pop.
I should mention here that I always have to have needles and blood pressure done on my left arm. This is because of my lymph node surgery and the need to prevent lymphedema. So each time I've been poked for blood work and an IV insertion or been squeezed by the blood pressure cuff, it's always been on the left side.
Finally after 10 minutes of hand-heating and tapping, my bad veins are ready to be poked and prodded for the IV. The first time it took the nurse two tries but every time after that they've got it in one try. Thank goodness. Then they hook up my 2 pre-meds. These have names which I've forgotten but have the delightful function of helping the dexamethasone in the quest to make me not barf. The nurse also gives me the small white sedative to slip under my tongue and let dissolve like it's supposed to dissolve all my irrational white coat phobias.
After about 30 or 45 minutes of pre-med dripping, the machine beeps. This means that these bags are done and it's time for the next. Every time I hear the beep, whether mine or a neighbour's, all I can think of is "Fries are done. Better take them out." Flashbacks to my Burger King job, I guess. So the machine beeps until a nurse notices and he or she comes over and switches bags.
Before I'm given the first chemo drug, docetaxel, the nurse asks me my first and last name and my date of birth. If I pass that test, she hooks up the bag and I wait. And wait. The docetaxel takes about an hour and half to finish. During that time I have to have the blood pressure cuff hooked up to my left calf and the machine takes my blood pressure every 15 minutes. (It has to be hooked up to my leg. They can't use my right arm due to lymphedema, and they can't use my left arm or they'll cut off the flow of the drug up my arm. It's all very annoying.) Docetaxel has a tendency to raise blood pressure and create other nasty reactions. I've managed to escape with nothing out of the normal every time.
Then my fries are done and a nurse comes over to flush the line with a saline solution. That takes 5 minutes. About this time I really have to pee, so the nurse takes off my blood pressure cuff and unplugs my IV machine and I trundle off to the bathroom. I attempt to pee elegantly and gracefully while using only one arm and then I trundle back to my recliner.
Next, What's your first name? What's your last name? What's your date of birth? Phew, I pass. Then they hook up the cyclophosphamide. It only takes a mere 65 minutes to drip in, but by this time I'm feeling incredibly antsy. Remember a few paragraphs ago when I said the IV was my least favourite part? I lied. It's the waiting. The IV hurts for a bit but then it's done. Each time I went in, the treatment seemed to take longer and longer. But because of my small white sedative friend, I couldn't really concentrate on anything - I couldn't seem to read or do sudoku, and even having my mom read to me got sort of annoying. This last time the nurse could see I was getting restless, so she came over to turn the timer towards me - only 6 more minutes! Whew.
Then my fries are done again and the nurse comes in and flushes the line. Another 5 minutes. And then I'm free! The nurse removes the IV, presses a bandage on my hand, and provides me with a print-out of my next pre-chemo doc visit and my next chemo visit. She also hands me containers of ondansetron (anti-nausea), prochlorperazine (anti-nausea), and ranitidine (anti-heartburn) drugs.
Mom and I are finally free to leave for lunch or shopping or both because the day of chemo I feel fine. The truck doesn't hit until day 2 or (more often) day 3. Then comes the achiness. I've never felt anything like this before. It hurts to move. It hurts to not move. It hurst to breathe and blink. Ibuprofen makes it so that I can mostly sleep through the night, which is nice, but it's still close to unbearable. I also have a sore throat, a mouth that feels like I ate too many salt and vinegar chips, extreme exhaustion, and the most painful and annoying diarrhea I've had to endure. Too much information? Hey, you wanted to know. (Or at least a handful of you wanted to know.) All the nasty stuff lasts a week to a week and a half but the tiredness lingers. How much it lingers has increased with the treatments, so much so that it seems like I'm almost always tired.
(You may notice that nowhere in there did I mention barfing. That's because all those wonderful drugs they gave me through the process actually did their job with me and voila, no barfing. I still haven't broken my haven't-barfed-since-I-was-eight-or-nine-years-old streak!)
But enough about the bad stuff. Why am I telling you all this now? BECAUSE I'M DONE! I had my last treatment today and now chemo, she is no more! I must go do my happy dance and not think at all of the 5 weeks of radiation coming up.