Chemotherapy

So what's chemo really like, you ask? Well, dearly beloved, let me tell you at least of my own experience.

Kevin and I usually arrive around 9:30 am, although this is going to change. What I'm describing is a fairly typical regimen for breast cancer, although there are LOTS of different protocols, and other types of cancer have their own.

The first bit, which yesterday didn't go as smoothly as I'd hoped, is to access a vein. I had a port-a-cath installed a week ago, which is a little subdermal gizmo with a rubber top, that's attached to a tube running into my vena cava. That means generally they can get a blood sample for labs, and give me chemo and the associated drugs, through the port, rather than using a needle in my arm. I dislike getting poked with needles in the arm every single week, and I generally find an IV uncomfortable even though they are supposed to be painless, so I like having a port.

Alas, this week it was not to be. They tried to access the port, but since the surgery is only a week old, there's still some swelling, so they couldn't hit it. Three tries, and the nurses gave up. They don't like poking around any more than necessary. So the old IV it was. Always in my left arm, and I tell you, I'm running out of veins.

Then they give a passle of pre-meds, which decrease the risk and the discomfort of chemo. Notice I said decrease, not eliminiate.

Mine looks like this - tagamet, to decrease stomach acid. I sometimes ask for that first, since it's common to arrive with an upset stomach. Benadryl, to prevent a major allergic reaction - anaphalaxia - to the chemo drug or drugs. Dexamethazone, a steroid, also to prevent an allergic reaction, and to make the chemo more effective. Ativan, an anti-anxiety drug, both to offset a manic reaction to the dexametnazone, and also anti-nausera - most tranquilizers are also secondarily anto-nausea drugs.

These take about two hours - I try to eat lunch before the atavan and benadryl hit - in other words, when the room starts spinning. Yesterday it was a shrimp burrito, and it was heaven.

Then they start the taxol. First off, many chemo drugs are caustic, so the nurses don extra-heavy duty protective clothing. Imagine a hazmat outfit, but printed in happy happy pinks and blues, face mask with an eye shield, and heavy duty, elbow length rubber gloves. I want to steal one of these for next years' halloween costume.

The taxol takes 90 minutes, and generally I sleep through most of it. One of the nastier side effects of taxol is that it seems to have weird emotional side effects - I almost always cry about 30 minutes into it, and I'm typically weepy for about two to three days after, until it's back out of my bloodstream. Hard on my soul, and hard on the people taking care of me.

On this regimen, the next thing is Avastin. This is not a traditional chemo drug (poison - kills all fast dividing cells), but an antiangiogenic. Cancer cells, in order to become tumors, have to fool your body into believing that they are normal cells, and to grow a new blood supply. Avastin prevents new capillaries from forming, so new tumors get starved. Very nifty trick, that.

First time I had it, it took 90 minutes. This time they went to 60 minutes, next time I can go to 30, if i don't have a bad reaction. Again, generally sleep through it, but I have movies and books on CD just in case.

All told, takes around six hours. Then they unplug me, and I stagger home in a fog of drugs. One of these tends to wire me up, so I don't always sleep well the night after the chemo. Also makes me feel really hot and flushed - I look very pink and healthy, ironically.

It seems to take about three days to wash back out of my system. The second day after is usually the worst - energy level is lowest, nausea is highest. I've never ACTUALLY hurled from chemo, I take a VERY expensive anti-nausea drug called Zofran, but in some ways feeling like you are going to hul but never actually doing it is almost worse. At least when you have flu, and you DO hurl, you feel better for a little while after. This just goes on continuously. Bleagh.

Day four, Tuesday, so far I have felt miraculously better. Not 100%, but far better than the day before. I get two more good days, then back to the grind.