Chemotherapy 101

I met Rose today, one of the oncology nurses at the breast center. We laughed and joked our way through most of her “this is what it’s really all about” teaching session. I was reduced to tears just once.

We discussed everything from fluid intake, nausea medications, constipation and diarrhea, meal ideas (small and frequent), to avoiding people who are coughing and sneezing and children who have recently been vaccinated, the need to watch out for cuts and scratches, and the need for contraception (in my case that’s unnecessary, not for lack of interest, rather because my baby-making machine is not longer in place).

Looks like I won’t be hanging around in bars over the next seven weeks.

Here’s the deal. Chemo starts on Friday of this week and will be delivered in four sessions, each two weeks apart. That assumes that my blood counts are high enough to warrant a treatment. Chemo sucks the life out of red and white blood cells and messes with platelet counts, so I have to have a series of blood tests done the day before each chemo treatment. Assuming the counts are where they should be, I’ll be able to go ahead with each session.

Actual delivery takes about four hours. Here is the sequence:
• two (or so) hours of hydration (saline by IV)
• several drugs in pill form (Zofran for nausea and Decadron, a steroid for nausea and as an anti-inflammatory)
• then a few syringes of the first chemo drug, Adriamycin (red on color, says Rose, "don't be alarmed if it turns your urine red")
• then a bag of the second chemo drug, Cytoxan
• then the remainder of the saline

That evening I'll take the first of five Zofran (one every 12 hours through Sunday night). There's another prescription for Compazine, for break-through nausea that occurs between the Zofran doses, or for other times up until the next treatment.

On Saturdays after treatment I have to go to the lab for an injection of Neulasta to boost my immune system.

So my new friends are Adriamycin, Cytoxan, Zofran, Compazine, and Neulasta.

It’s all a little overwhelming. I have a lot of material to read and a lot of thinking to do, not about whether to go ahead (because I’m going ahead with everything I have to give). It’s more about getting my head around everything that is likely to happen, how it’s all going to affect me, and then putting plans in motion to manage everything that’s about to happen.

I also need to think about how this impacts my family. I know they’re all with me, whatever I need and whatever it takes. It would be a whole lot easier if I could do this out of town someplace and reappear in two months with it all behind me. Given that option, I think they’d have me stay here, even though it’s pretty much assured that it’s not going to be much fun.

I need to think about friends, colleagues, and my ability to go to work and be a more-than-simply-functioning member of my department. That’s all a good distraction from the seriousness of the situation.

All of that comes well down the line, after I put myself first and put the business of taking care of myself as my first priority. That’s new for me. I’ve been trying. It’s not easy for me, but I’m trying.

As usual, let me know if you have any questions. If nothing else, your question and my reply might make the road easier to travel for the next person forced to pull out onto Route Chemo.