Wednesday, February 17, 2010

Chemo details...

It occurred to me that most of you would likely have no idea what is involved with the process of receiving chemo - so I'm going to tell you!

First of all, I'm no expert on this, but have learned that every type of cancer has different types of drugs to do specifically different things - and even within a type of cancer, the drugs are not all the same as they are applied based on the aggressiveness of the cancer and probably other factors too. So that's why the side effects are not the same for everyone - could be different drugs in different doses given for different reasons. Some chemotherapy drugs do not cause hair loss. The breast cancer chemos DO generally cause hair loss (but not always 100%).

I mention the above because this day-in-the-life of chemo is for MY particular treatment and wouldn't necessarily be the same for other cancer patients.

So going way back to the generalities, I was slated for 8 sessions of chemotherapy to be done every 3 weeks. Every session, I meet with my oncologist to update him on what has been happening with me and it is usually a very short visit which often feels very pointless. How are you feeling? 'fine, considering' Any unusual side effects or anything that you can't handle? 'no'. And basically that's it. Of course I realize they are doing due diligence to carefully monitor - probably be cause THEY know how dangerous the chemicals are that I'm getting, but I don't really know it. So when my feet are going slightly numb, I think 'no big deal' - but they are asking me if I can feel the ground and if I have trouble walking and is it a burning, aching or sharp pain. Which makes me wonder what's coming.... HMMMMMMMM

So the next step is bloodwork. I have to get my blood tested the day before chemo every time I go. I think they typically like to schedule the blood test and the oncologist visit on the same day but it doesn't always work out that way. Sometimes I see the oncologist the week before chemo and then get my bloodwork done the day before. When the appt is the SAME day, I am scheduled for bloodwork at the hospital lab. But if the appt is a different day, I get my bloodwork done at an outside lab near my house and have to go early in the morning so the results will go out in the morning run.

When I went to the hospital for my bloodwork at 1pm, my results were already with my oncologist by my 2pm appt - so I found out early that my bloodwork was GOOD and my nutrophils were at 1.6. Yay!

In the cancer clinic, there is a reception desk and a chemotherapy desk. Typically, I would check in at the chemo desk but when it's not open, I check in at reception. I always carry a little white appt card that has all my statistics on it and they handwrite out what all my upcoming appts are. When you visit the onc, you have to put the card in a tray and they pull your file from this instead of having to stand at the desk. This is very efficient, except I often forget to retrieve the card afterward. Sometimes it gets chucked out, and sometimes they send it along to the chemo room for me to pick up on chemo day.

So you basically let the hospital know you're there, and then they will ask the pharmacy to make up your chemo drugs. They do not do this in advance as far as I can tell. Apparently chemo drugs are expensive and don't 'keep' - so to mix some up and have someone not show up is no good. Some days it's faster than others.

So I checked in at 8:30, waited for about 10 minutes and then was brought into the chemo room. The Surrey chemo room has sections called 'pods'. Each pod has a few chairs and there is a nurse assigned to each pod. There are also 'floating nurses' - who are extra help but not assigned to one pod. Probably they float between 2 or 3 pods. There are 5 pods in Surrey.

The chairs in the pods are comfortable and recline all the way back. When I get to my chair, I arrange all the stuff I've brought ie, hang my coat & purse, put my 'entertainment bag' within easy reach (DVD player, DS, book, knitting) and my snack bag for the long last 4 treatments. (I didn't need snack bag for the 1st 4 treatments as they were only 2 hours). My treatment this week was SEVEN HOURS! Got there at 8:30, got home at 3:30. Several people came and went while I was there - everyone else's was much shorter than mine. One guy was there for only a half hour! And I overheard the nurse talking to one of them to tell her that her next treatment was in May. A 3-month interval!! That's when I knew that I really don't know much about cancer despite my situation.

Then the nurse grabs his/her (there are a couple of guy nurses in Surrey) 'puncture kit' and since I have a Port-o-Cath, they swab it down on my chest and then poke the god-awful needle through my chest. It hurts quite a bit as far as needle pain goes - except ONE time one of the guys did it for me pain-free so I keep hoping to get that again but so far, no luck. The needle part has a tube attached which is where they hook up all the drugs.

First of all, they hang a bag of saline to get me hydrated. Then once the drugs arrive, I get quizzed on how to spell my name, what my birthday is etc. They do this before every drug so I get asked this a LOT. The lady next to me asked what would happen if she gave the wrong answer. Phil said he would double check and make REALLY sure - probably ask for ID because he has had patients with the same name and same birthday before. So he also checks the BCCA ID number too. He's very thorough. And I also found out he plays ball in the same league Cam and I do but that he will never acknowledge me first because it raises questions about how you know someone. So I assured him I wouldn't be offended and would be sure to acknowledge him because I don't care if he tells people that he looked after me during chemo. But I thought it was pretty cool for him to explain it to me.

I kind of know what he means because I used to tell that to my Fantasia customers too. Ie, walking down the mall and shouting out 'HEY - how's that mechanical boyfriend working out for ya???' probably wouldn't be good for repeat business or word-of-mouth referrals......

Anyway, once I'm hooked up, I'm on my own. Each Pod has a computer station so mostly the nurse is at the computer working on whatever it is they need to do. They are always nearby.

There are lots of volunteers at the hospital and I constantly get asked if I want a beverage. It's FREE!!! Gingerale, Cranberry Juice, Water, Milk, Coffee or Tea. They want people staying hydrated during chemo. Plus they are pumping you with all kinds of fluids so I have to make a LOT of bathroom trips during my visit. (Guests get these free beverages too - you're allowed one person in there with you but I think they are lenient because I have seen 2 guests in there before).

Back to the bathroom trips - they are not a problem - each of the IV poles has a battery pack in it, so I just unplug it from the wall and the battery takes over and I wheel my contraption into the washroom with me. The biggest problem of all is the embarrassment factor. I don't see other people making 20 million bathroom trips.... everyone must think my bladder is tiny.

When there are no volunteers, the nurse will offer you the beverage - and also will always offer a pillow and warm blanket. And I always take it because it gets really cold in there. Today I also requested a foot massage since Phil seemed so accommodating - but he just laughed at me and told me his wife was lucky to get one of those.... (no - he ISN'T gay! I don't think the other male nurse there is either)

Once the drugs are done, they run another bag of saline and then they push a syringe of Heperin through the line. That cleans out the Port and stops it from getting clogged up. Then, I have to gather up all my crap and get the heck out of there!

After the first 4 treatments I was able to drive with no problem as the drugs did not affect my reactions but the final 4 treatments involve getting Benadryl before my Taxol drug and it knocks me out, so I won't drive after these treatments.

And these final 4 have less nausea attached to them, but now I just wait dreading that horrible muscle and joint pain that I know is coming - and probably worse than before since I got my full dose this time. Ack!

At any rate, only 2 more to go!

Wednesday, February 10, 2010

To Radiate, or not to Radiate - that is the question....

First of all - Happy Birthday to my mom!

Second of all - I had my radiation oncology appt today and was told again what we kind of already knew from before - my situation is in a 'grey area' as far as radiation goes and I am expected to decide if I want it or not.

That is kind of the way docs work these days - no one wants to take responsibility for giving the wrong answer so they leave it in the hands of the patients - who, after all, have all the training & knowledge to make such a decision, right?? (yes - heavy sarcasm).

The good news is that the oncologist DID answer the question as to whether or not she would vote 'yes' for me to do it, and that if she were in my shoes, she would do it. But the main argument for me to do it is basically that there isn't a specific reason for me NOT to do it... HuH?

OK - I get it - it means I am healthy enough otherwise that there is nothing stopping me from having radiation. So then I have to weigh risks against benefits. So they tell me the risks are minimal. And they also tell me the benefits - for me - are minimal. But on the other hand, if I want to do EVERY thing I possibly can to fight cancer, then I should do it.... SHEESH.

5.5 weeks of week-daily (ie, Mon-Fri) treatments. I count that out to around 28 treatments.... plus I have to squeeze in the tissue expander fillers before radiation starts as it tends to thicken the skin and it won't stretch well after radiation.

I'm thinking I should do it - but I haven't done ALL my research yet. If any of you have any comments or opinions to weigh in on this, feel free to email me.

Monday, February 1, 2010

New Side Effects...

My 2nd set of drugs started last week and I was told about side effects including muscle and joint pain, plus tingling in the hands & feet.

Boy oh boy - they weren't kidding. I have just spent an extremely uncomfortable weekend chasing the pains around my body with hot water bottles and ice packs. I haven't decided yet which one helps more - but perhaps the alternation is distracting.

Thankfully, the literature says it should last just a few days and today was much better than Saturday and Sunday were. I even took a T3 at bedtime last night. I haven't had one of those since a week or so after surgery. It not excruciating - it's a mild pain, or serious discomfort.

On a lighter note, when Cam was away this weekend, I got bored kicking around by myself and so I found a good way use the hair mousse that I got for Christmas... (some people are really frickin' HILARIOUS)... Yup - there's me - home alone and bored... and pulling out a can of mousse and spraying my head and photographing myself. I actually did it twice because the first time I went to take the pic and the battery was dead so by the time I got the camera plugged in for a second try, the mousse had melted off my head. I was REALLY bored....

But hey, this has got to be an improvement over the time I put a bra on my bum and took a close-up picture like it was cleavage, right? (NO - I WON'T be posting that picture - it was over 20 years ago).

WELCOME TO MY TWISTED WORLD HA HAHAHAH HAHAHA HAH HA HA HAHAHHa (my typed version of maniacal laughter).

PS - when I originally added the picture to the post, it was at the top left - and with my subject line saying 'New Side Effects', it looked like the mousse was a new side effect of chemo... funny - but confusing - so I moved the pic to a more appropriate location.