Wednesday, July 18, 2007

Chemo 1/8

Terrified, I sat in the oncology center waiting room, reading the Big Pink Breast Book given to me by the surgeon. Tears started welling out of my eyes and down my cheeks. It seems like I can always locate something in that book that causes me to cry right before meeting with the oncology staff.

This time, it was the illustration of a chemotherapy port. A chemo port turns you into a human juice box for duration of your treatment. Instead of finding a suitable vein on your arm, the technician can just pop off your cap, and voila!, you're ready for infusion with the toxic chemical du jour. Throughout my testing and diagnosis, more than one medical staff person mentioned the port, insisting that I could "shower and swim, and if I wore high-cut tops, nobody will even know it's there." That seemed beside the point, considering the fact that if I got a port, it would require me to ignore a tube that appears, from the illustration, to be going pretty deep into one of my chest veins. It made my flesh crawl. If they tried to push this port thing on me again, I was going to fight it.

Imagine my joy when Nurse L, examining my arm, cried "Oh, you have BEAUTIFUL veins! I can't imagine why anyone would suggest a port for you." I will still enjoy hearing "you have pretty eyes," but no complement on my appearance can ever recreate the elation of that moment.

Nurse L, who was patient and genuinely caring, was an enormous help. She at first sat down with us and explained both the therapy and the many, many bottles of antinausea medicine I was to take home. Nurse L. also minimized, in my case, the possible side-effects of chemotherapy, explaining that many people, especially those previously healthy as myself, have relatively little nausea or weakness. Still, I had to inject myself with Neulasta, a bone-marrow stimulant, within 24 hours. After a brief demonstration, I was sure I could do it.

The little private chemo room was a comfortable as is possible with such a procedure. I sat on a hospital bed, headboard up, so I could read, and my husband sat in comfortable upholstered rocker with a footrest. We also had a tv with dvd recorder; maybe a good way to knock off those Sopranos we missed. Nurse L. inserted the I.V. needle into a vein on my right hand, and secured it with a butterfly clip and tape.

I started with a saline drip, then a liquid form of anti-nausea medicine, Ativan. Ativan is also an anti-anxiety drug and sedative, two effects which were spot-on considering the circumstances. Then, the cancer-killing stuff: Adriamycin and Cyclophosphamide. The medicine was a dark rose color, and I was warned that I would urinate a lighter shade of this for a while.

While I infused, I played the Snake game on my cell, having discovered that reading was nearly impossible. My husband compensated for my anti-intellectualism by digging into the latest issue of New York Review of Books. Suddenly, the woman receiving chemo across the hall leaped up, and grabbed her I.V. stand, and hustled to the bathroom. I haven't heard retching like that since my husband got food poisoning at a cook-out in Minneapolis. It was horrible-sounding, since it was clear she had nothing in her stomach left to expel. Nurse L. ran back to our room, ostensibly to adjust something on my I.V. "I don't believe her vomiting has to do with the medications." she said, mysteriously. Wow. If it had nothing to do with the chemo drugs, then what were the alternatives: the flu? morning sickness? watching The View?

The entire procedure took about two hours, including the question and answer session at the beginning. Nurse L. warned me that the second cycle (probably starting with Chemo 5/8), will take about four hours. She also started the process of setting up regular appointments, although she has to coordinate first with the oncologist. We are shooting for Monday mornings at 7:30, since in medical care, the early bird gets the worms, or waits as little as possible, that is.

I felt great at this point. Ativan, I heart you. I meandered into the parking garage, more than willing to climb into any open car door. Everyone seemed so nice. Fortunately husband poured me into the Escort, and we were off to pick up two equally drugged cats, both of which had suffered tooth extractions earlier in the day. When we arrived, we were surprised to find out that Alma had a little impromptu mastectomy as well. The vet had tried to contact us, but our cells didn't work deep inside the walls of BCH. They found lumps near two of her mammaries, and decided to remove the entire side as a preventative measure. So much for the theory that breast-feeding lowers the risk of cancer. During an eight-month period, she had twelve different kittens latched on to her. Her boobs became so pendulous, the vet who spayed her just worked around them as best he could. After she came home, all shaved and (finally) sterile, she reminded me of the she-wolf who nursed Romulus and Remus.

The nausea hasn't been unbearable, it's more like that inkling that you may be coming down with something. The fatigue is a bigger issue, and they warned me that my white blood cell count would probably bottom out next week. At times, red blood cell counts drop as well, and patients become anemic. The Neulasta, which I self-injected this morning, will cause bone aches as my marrow goes into overdrive to produce more white blood cells.

Discussing medical conditions is one of the more deadly forms of discourse, IMO. If given the choice between hearing someone's dream or hearing about their gall bladder surgery, it's always a toss up. I promise more Not Cancer! stories, including those involving the CTA in the near future.

Love to all,
E

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