Chemo Begins

TW: I'm going to write about cancer some more because that's what's on my mind. Honestly, I get a little queasy talking about some of this stuff, so I totally don't blame you if you'd rather skip this one. 

here are some cats to look at instead

I keep thinking I'm going to write a kid-friendly version of this whole thing for my nephews and nieces, but I haven't gotten there yet. I assume it will be an epic battle involving super-fast growth rates, toxic red pee, and, apparently a bad guy called "constant nausea man."  Today's not-for-kids version does feature toxic red pee, so read on if that's your jam. 

Chemo Begins

I had my first round of chemo last Wednesday. Monday was probably the first day that I felt mostly normal, though by the time I finished drafting this post, that was no longer the case. So much of this process is wrapped up in fear and anticipation and uncertainty, that it's a little hard to gauge what normal is anymore. Is my low-level headache and slight nausea a result of the chemo, nerves, stress, or is it my imagination? When I think about some of it, I get scared or anxious, is that the cause of my slight tummy ache and headache?

during my first infusion

This is really what we're doing, huh? 

The chemo I am doing consists of three different "medicines" (aka poisons) taken in two separate cycles (or sets of cycles, idk). The first four infusions are Adriamycin and Cytoxan. I get one infusion of the two "medicines" every other week for 8 weeks. After that there will be weekly infusions of Taxol for 12 weeks.

It just blows my mind that four infusions, each taking only a few hours, can knock me out for 2 months! I understand the concept, and there's a bit more to it than that, but I found it mind-boggling when I first learned that this terrifying, unpleasant process doesn't consist of being in a hospital for weeks on end or even getting infusions of chemo multiple times a week. I still find it hard to wrap my head around what we're doing and what the impacts are. 

Basically, as I understand it (and I have a stack of partially read books that suggest that I'm only begining to understand it), chemotherapy drugs are designed to kill cells that divide quickly. That's good news for my fast growing cancer. As those cancer cells divide quickly, the idea is to have the chemo drugs knock them out (and take all their little clones with them!). The bad news for me is that I have some other fast dividing cells in my body and I was using them, thank you very much. The chemo drugs also do a number on my red and white blood cells, which is why I am now officially categorized as"immune compromised."

So in the time between my infusions, the chemo drugs are killing stuff (hopefully cancer) and my immune system is taking friendly fire or "acceptable losses" or whatever we want to call them. The other drugs they give me are helping to fight nausea and grow my white blood cells and try to keep the rest of me in better shape than the cancer. 

Cali doesn't find my toxic post-chemo fumes off-putting

My Chemo Experience (so far)

Though I am not spending hours or days in the hospital multiple times each week, I am going to the clinic 3 times a week for the one infusion. Two of the visits are very short; the day before the infusion I have a blood draw, which is to check that my body can handle the upcoming infusion. Then the day after the infusion, I go back for a shot of "growth factor" which is something that stimulates white blood cell growth in my bones. To oversimplify, they check that I can handle the poison, then poison me, then give me a teeny bit of antidote to combat part of the poison. 

Look at me, saying "blood draw" without even a visible wince in the letters. What you can't see is that the thought of a blood draw makes me queasy every time I think about it. Am I queasy from the chemo or queasy from just the thought of needles? Yes. I believe so. Also, I had to stop writing this two days in a row because I thought about "blood draw."

Last weekend I needed to go to Seattle Cancer Care Alliance for an MRI. (The doctors there said that mammograms are less clear for "young" women like me, so they recommend MRIs so they can gauge the extent of my stuff. Luckily, the MRI did not reveal more stuff on the other side and the surgery plan is unchanged at this point). For the MRI, they needed to give me contrast, so they accessed my port (instead of putting in an IV, which I am thankful for). It doesn't really hurt, but the thought of accessing the port makes me queasy. The thought of un-accessing my port also makes me queasy. So this is a fun situation all around. 

This week my port had to be accessed and de-accessed 3x (blood draw, infusion, and MRI) and I am so ready to not even think about that area of my body for a full week at this point. My husband thinks I will become comfortable with needles and all this stuff because of how often I'll need to be involved in the procedure, but he needed to hypnotize me with his eyes while I got the growth factor shot on Thursday, so it's not looking promising so far.

the tape thing on my chest is covering the port, behind me is either drugs, chemo, or saline for my infusion

On the infusion day, the nurses (who are uniformly excellent so far) access my port, then pump me full of medicines to try to limit the side effects of the chemo. They give me some anti-nausea medicine and some steroids. I don't know if they always wait in between the medicine and the chemo, but they did this time.

The Adriamycin comes next. It is a bright red colored poison that is pushed from a syringe into the line for my port. This is the medicine that results in toxic neon red/orange pee. They have very strict rules about flushing twice and washing clothes twice in the first few days to protect my family (and pets) from coming in contact with the poison coming out of my body. This I thought should impress my nephew, I'm like a Marvel villain.

After the red stuff, the Cytoxan is infused via a drip into my port. Then they detach my port and send me home. For me this process took about 3 hours, but for some people getting other chemo or who need the process to go slower, it can take all day, or multiple days. The infusion room has comfy recliner chairs and friendly nurses who are patient with lots of questions (I tested this out) and helpers who bring pillows and snacks. My husband stayed with me for a while, but left because I thought I might read my book for a bit. He thought I'd probably "network" so he was unsurprised when he came back and I had gotten hair loss and nutrition tips from the other patients.

The next day I return for a shot, which apparently has to be administered slowly (ugh!), of the growth factor. Out of curiosity, I looked up the growth factor before my infusion last week. (I wanted to know why "growth factor" wouldn't grow the tumor, too). In the article I read, the first recommendation for its use was to find a different chemotherapy so you didn't have to use it. A ringing endorsement if I ever saw one. I think the issue is that it makes your bones ache, but that isn't supposed to start until a week after it is administered (so, tomorrow, as I write this).

All of this process, like I said, is about poisoning my body so that we can kill the cancer cells and not kill me. The plan is for me to undergo chemo for 20 weeks, with the assumption being that the drugs and poisons will have a cumulative effect on my cancer as well as my immune system.  Right now, then, the effects seem fairly mild, if unpleasant, but I anticipate it will get worse.

Cancer specific presents: a hat for when I lose my hair and some skin/mouth care items. Thanks whoever sent this (apparently I lost track of the email or got confused about who it was from)

Side Effects

I was told that the antinausea medications are pretty good about keeping the nausea at bay, and I'm definitely not in a lot of discomfort or spending a ton of time in the bathroom, but the underlying mild nausea has, so far, been an issue every day. I can't tell if it is all due to the chemo drugs, or if it is also complicated by anxiety, worry, nerves, and fears. The bone aches from the growth factor haven't started yet and neither has the hair loss. 

They also have advised me to drink 3 liters of water a day, which is a lot if you aren't working out intensely. I've been pretty close every day, but it was tough in the few days after the chemo. Its hard to know if the chemo or the anxiety was making me queasy, but it seems plausible that I was also full of water. I had difficulty wanting to eat in the first few days, too. I know fellow chemo patience have told me about this, but I kinda didn't get it until I experienced it. I figured I could just make myself eat, but when it came to it, it was harder than I anticipated.

The most concerning side effect, the destruction of my immune system, is invisible (and will hopefully stay that way), but I did think about it when I went to Rite Aid to pick up a prescription the other day. In the minutes I was in the store, I noticed 2 people without masks, and one man coughing into the mask he was wearing under his nose. My reaction was to high-tail it out of there and someone else pick up the prescription later. I don't know if I'm immuno-compromised enough to warrant being afraid of anti-maskers and public coughers, but with the Omicron variant, holiday shopping crowds, and antivaxxers, I'm not willing to find out.

our third cat, making an appearance

Support

I mentioned this last time, but it is just blowing me away how much support we've gotten from friends, family, and colleagues. And when I finally checked my blog comments from my last post, I learned that folks I didn't even know were reading the blog and offering their support too. I'm incredibly lucky to have so many folks who are so supportive and kind. People have been bringing food (and treats) and it has been such a relief, when I'm not sure I even want to think about food, to have something ready so that all I have to do is eat it. 

Thanks so much to everyone who has helped and who is planning to help, and everyone who has offered, too.