Chemo aerobics

"The most difficult thing is the decision to act, the rest is merely tenacity. The fears are paper tigers. You can do anything you decide to do. You can act to change and control your life; and the procedure, the process is its own reward." - Amelia Earhart

A cloud of dread crept over the tail end of last week. I knew that the week - which started off very emotionally - was going to wrap up with my third chemotherapy treatment. Just when I start feeling close to normal again, it's time for another dose of poison. The more I thought about why I felt uneasy and apprehensive, I realized I should share with you all a bit about what "chemo day" entails. So, as I went through Friday's chemo aerobics, I took notes and pictures so y'all could share in the experience.

The port is all hooked up for
the chemo infusion

Even before leaving for the cancer care center, there's preparation to do. We pack snacks, popsicles, and items to distract my attention. I have to make sure I pick an outfit that will both be comfortable for a few hours of sitting and provide access to my port for the nurses. I try to remember socks and a jacket, just in case I'm cold.

Once we arrive at the center, the steps are fairly routine. The first stop is to have blood drawn for lab work. I put a numbing cream on my port before leaving home to help eliminate the pain of being poked. And yet, I'm a wimp, so I also have the nurse spray the port with a freezing cold solution to further deaden the sensation. This time, as we were gearing up to flush the port, I told the nurse I'd been feeling anxious about the saline taste that I get during that process. She said she'd heard that from several other folks and suspected that taste might come from the preservatives in the pre-packaged saline syringes. So, she filled fresh syringes for me, and - magically - no yucky taste! Now, we've added that I should get syringes filled-on-demand to my chart, which should help for future visits.

After labs are drawn, I head upstairs in the center to the infusion room. First stop is always the scale to log my weight, followed by the pulse and blood pressure checks. Then come the medication questions - are you still taking X, Y, and Z? Are there any changes? My chart gets updated by the technician, and then I'm set up in my chair for the infusion.

Pole dancing, chemo style

Before the chemo can begin, my lab work has to come back. As I wait on the labs to show my systems are strong enough to take on the chemo cocktails, I get a chance to meet my infusion nurse for the day. She asks more pointed questions about how I've been managing between the chemo sessions. I need Sean's help remembering things, since I have been experiencing "chemo brain," meaning I'm a bit more forgetful of details because of the drugs coursing through my veins. I get to talk about my bowels (oh, the joy!), my sleeping patterns (pretty disrupted), any nausea (on the regular), my breathing, my mouth (no sores!), my skin, my nails, tingling in my fingers and toes, and so on and so forth. More waiting means another saline flush and a little snack time. Finally, around the same time we begin with the steroid drip, I get a visit from Ruth, my oncology nurse whom I get to see each time I come in for chemo. She's a bundle of positive energy, and she even compliments me for having the kind of face that doesn't need hair around it. After running through all the details (again talking about how the side effects along this journey), I get a new script for heartburn I've been feeling. Ruth tells me my "labs look great, weight is stable..." Of course, I mutter that I'd prefer to see the number of the scale go down a bit, but Ruth chides me, "This not a weight loss program!"

As Ruth jets off to tend to other patients, I sit through the three steroids being piped into my port. Each of these is intended to fight nausea and boost my energy levels. Since these are running into my system, I'm feeling full of liquid. Time to take the IV pole to the restroom. As I make my way, my nurse says we should take advantage of me being up and moving to find a private room for my Lupron shot. Of course, Sean joins me - since I need him to hold my hand every time someone pokes me with a needle. The Lupron is intended to put me into a chemical menopause (which hasn't fully taken yet, much to my chagrin). I lean against a windowsill and pull my waistband down enough for the nurse to put freezing spray on my backside and give me a shot right below my oh-so-wise tattoo.

Icky adriamycin

Hours into the experience, it's finally time for the chemo meds to flow. Step one is what I call the "Push and Pops." The push is adriamycin, a drug the nurse sits and pushes through a syringe into the line to my port. It's a bright red poison, so the nurse gets dressed in extra gear to do the deed. This drug has a really acrid taste and can cause mouth sores, so it's recommended that patients eat ice while having it infused. I opt for popsicles, but since it's been several hours since we arrived, my pops are smushed in their wrappers and only two of the three are still edible. I supplement with juice in a full cup of ice. Now that we've eliminated the saline taste from the earlier part of the cycle, this is my new least favorite part of the process (in fact, recalling the flavor makes me a little nauseated even now writing about it).

After two full syringes, the adriamycin is done and we can start the cytoxin drip for an hour. By this time, I'm pretty well over the day and have trouble focusing to read a book or even peruse social media. I can feel a little nausea setting in, and a glance in the mirror shows the color rapidly is draining from my face. My body is being sapped of its energy, even as I sit through these last steps.

Neulasta patch

The nurse comes back by, and since we're nearing the end of the treatment, we needed to on-board the Neulasta OnPro. It's a patch with pedometer-looking box attached to it. We find a fleshy part of the backside of my left arm to place the patch, and, with the pinch like a rubber band being snapped on my skin, the patch shoots a little needle and catheter into me. The light on the pedometer-like thingy flashes green every 10 seconds for 27 hours before unloading the Neulasta into my body. When this hits my system, it provides a boost to my white blood cells so my immunity is less compromised by the chemo treatment.

Finally, we've whiled away the hour, and I have one last flush of my port. Unfortunately, this concoction is saline plus something else in a pre-filled syringe, so I have a few mints to wash away the preservative taste. And, like that, it's over. Sean's mom Pat and aunt Mary Louise are with us to provide extra support and love through this cycle, so we head out to the truck to go enjoy a meal before I crash hard for the night.

Feeling so very loved! Sweet gifts from Graziella, Sylvia,
Aunt Kathy & Uncle Chuck, Jen, & the Braun family.
Plus, endless cuddles with Lizzie kitty

By morning, the nausea more fully arrives. And, the medicine go 'round commences to keep all the side effects under control - I take 5+ pills each morning, depending on how bad the nausea seems to be. Toast and 'taters sustain me throughout many of my meals. I drink lots of water, Gatorade, and juice to stay hydrated. Coffee is practically verboten, since even the smell of it makes me gag for several days post-chemo. Fortunately, I've discovered that a partial packet of Starbucks peppermint mocha gives me enough caffeine to ward off headaches. I've been sleeping more than 12 hours a day since Saturday, and I'm finally feeling like I can eat cereal instead of toast this morning - on day 5. [Sigh.]

I'm trying to remember that I must endure merely one more cycle of the adriamycin and cytoxan, two days before New Year's. In mid-January, I get a new chemo regimen (weekly infusions) that is supposed to be a bit easier on my body. I suppose only time will tell!

Most importantly, between now and the next chemo, I get to go home to be with my parents, sisters, brothers-in-law, nephews, aunts, uncles, and cousins. It's Christmas, and - even through I'm bald, fatigued, have a frequently upset stomach, etc. - I'm looking forward to being with my people for a few days of merriment, however dampened it may be for me.

And then, we'll keep on chemo-aerobically making our way through this process. No way to go but forward from here...