Walkthrough of chemo day for a cancer patient
When I was first diagnosed with breast cancer, I was terrified. But as I proceeded through treatment, I slowly started to realize that I can do this. For years I had heard horror stories of chemo and it's side effects and my imagination took hold and made those stories even worse. I found out, however, that the reality when I finally faced it, did not live up to the terror in my imagination. I wrote up this walkthrough of a day of chemo in with the idea that maybe it would help give some newly diagnosed cancer patient some hope that, although it sucks, they can get through it. I'm cross posting this in full from my blog in hopes of helping even more readers. Please pass this along if you have friends or family members that are facing cancer treatment.
Ever wondered what a day of chemotherapy was like for a cancer patient? I thought I'd bring you along today, and give you a snapshot of what cancer treatment looks like. I hope its helpful to the newly diagnosed. Obvious disclaimer: of course, every patient's treatment is different, and each cancer treatment center is different.
Alarm goes off. I'm supposed to get up and take my pills. I'm on a new type of chemo that requires me to take a pill 12 hours, 6 hours, and 1 hour before the chemo infusion starts (the first pill was taken care of last night). I hit the snooze button.
7:00 AM Actually get out of bed and take the pill. Oops. Time to get the baby and myself ready to go.
7:45 AM Mom shows up to take us in for treatment. She even packed me a lunch for my long day. Thanks Mom.
I arrive at the Seattle Cancer Care Alliance. Mom takes the baby with her for the day. Check in for Port Access. (Instead of having an IV put in every time I go in, I have a port that is installed under the skin near my left collarbone. I know a lot of people hate having the port, but I love it. It's so much nicer than the IVs and for some reason, getting an IV going on me is really difficult.) After the port access is installed I go around for the rest of the day with these tubes dangling from my chest.
Break into moms lunch while I'm waiting.
9:30 AM Blood draw for MUGA scan (Multi Gated Acquisition Scan). They take my blood, make it radioactive, and later they will return it to me, then they can track the blood as it makes its way through my heart to determine it's efficiency. Several of the agents in my chemo are known to cause some heart damage to a small percentage of patients. This scan is scheduled periodically to determine how well my heart is handling the chemo, and whether we need to make any adjustments. This isn't part of my normal chemo routine.
waiting . . .
waiting . . .
waiting . . .
The machine that does the MUGA scan is a long narrow bed (generous term) with an arm holding a 2"x2" tablet that looks something like a small film holder for an x-ray machine. When I lay down, the radiologist attached leads and wires to my abdomen and chest, then another tech came in and they both verified that the blood they are giving back to me, now radioactive, actually belongs to me. The the treated blood goes back in through the port. Then she covered me up with a warmed blanket, they have blanket warmers all over the place here and they are really good about making sure you don't catch a chill. After covering me up, she help up a wide vinyl loop to stick my arms through so I could relax them and wouldn't have to hold them in the air at my side throughout the test. Seriously, when I say a long narrow bed, I mean maybe a foot and a half wide, not enough room to rest your arms at your side. The radiologist positions the tablet just above, but not touching, my chest. Then it's a matter of just laying still for a long time, repositioning the tablet to get another angle, repeat... you get the picture. No pain, just boring laying there and trying not to move - plus I had a bit of a cough, and it was really frustrating trying not to cough.
Stop by the pharmacy to pick up a prescription - to be honest, it's a refill of the pills I'm supposed to take 1 hour before chemo because I forgot them at home. I'm really on a roll today. I'm blaming it on chemo brain.
Take the pills and meet with my Oncologist's nurse, Martha. I usually meet with either the nurse or the doctor before each infusion. We discuss my symptoms and any questions I might have. I confess I took my pill late this morning, she said it's no problem at all, I just needed to get the pill in the general time frame. She also said that my blood counts are awesome (yay me!), and my heart is operating well within normal parameters. That's what I like to hear.
Check in for my chemo infusion. They give me a pager like the kind you get at restaurants while you're waiting for a table.
Pager goes off and I head back to my chemo room (Bay 39 this time) and get settled in. I follow my nurse around, so the bay I'm in depends on the section she's working in. Joy is so awesome I'd happily sit on a speed bump in the parking lot if that's what it took to have her do my infusions. Joy orders my meds and then we compare notes on our babies while we wait for the meds to show up (ok, not the whole time, she did check on her other patients).
Start Herceptin infusion through the port.
The husband finally arrives. Yay! He tries to be here with me for most of this stuff, but he had a critical class this morning, and I really prefer that he not miss his classes.
Benadryl and Zantac, pill form. Zofran pushed into the line in the port by hand. These are premeds to help prevent nausea and help prevent an allergic reaction. Now we are getting ready start the real chemo: Taxol. Another nurse came in to verify that the meds and the patient both match the Doctor's orders. They don't do this for every single medication, just the really big guns. The nurse also puts on a plastic apron, with full length sleeves and wrist cuffs, before handling these really harsh meds.
Sent The Husband to procure treats from the Infusion Unit kitchen: specifically mac'n'cheese, and chocolate ice cream. Please no lectures on health food, it's chemo day.
nearly 3:00 PM The Husband returned with the ice cream and tortellini with pesto, they were out of the mac'n'cheese. Totally appropriate substitution.
play around online for several hours . . .
Zoladex: this is a little pellet that is inserted into my abdomen with a needle. The lidocaine shot they give me before hand hurts more than this shot. Then the port is removed and I get a little bandage, and we head out of the building where mom and the baby have arrived to give us a ride home.
Symptoms: The first evening of chemo I usually feel great. The meds they have been giving me to combat nausea are awesome, almost no nausea at all. The biggest side effect for me has been fatigue. It's just really hard to stay awake sometimes, or to get off the couch at any time. It sounds counter-intuitive, but exercise does help with fatigue. Generally the symptoms accumulate through the course of the week. Tuesday is more foggy than Monday: Thursday and Friday I'm much more exhausted than Wednesday. It's interesting that there is such a long (several days) delay between getting the chemo and when the symptoms hit their peak. I'm curious to see how my symptoms will change with the Taxol. Many people I've met say the Taxol was easier for them to tolerate than the AC I was on before, although there were a few that had a more difficult time. I'll report back next week with an update.
And for those of you who have been anxious to see a picture of my bald head:
If you have any questions about cancer, treatment, symptoms, side effects, or how I'm dealing with it all, please feel free to ask in the comments. I'm happy to answer questions.
And if there is anyone out there who has just been diagnosed with cancer, I hope this post will be helpful for you. Hang in there. Bear in mind that every treatment plan is different, and everyone experiences and tolerates their treatment different. I found that most of the worst case scenarios my imagination conjured up were much worse than the reality when I finally faced it. I hope the same is true for you. Best Wishes.