Chemo Day.
Sigh. I have been avoiding this post as much as I have been avoiding that 21 days have somehow already passed and chemo #2 is tomorrow morning.
So, here is my next "process" post. A lot of people have been curious about what actually happens during chemo, and honestly I could have benefited from a blog post beforehand, so maybe I wouldn't have lost sleep wondering what it feels like to have poison run through your veins (so morbid, I know).
So here we go. The antibody portion of my chemotherapy was front loaded, so infusion day 1 was even longer than others. We had to arrive before 8am to get started, which meant we had to leave the house by 6:45am. I also front loaded coffee.
First, we met with my oncologist to talk about what had been going on, what my concerns were, lingering questions after that, etc. Then we went upstairs to the infusion center. Because I'm cold capping, we get a little private room off the side of the main infusion area, where seats are separated by curtains. Bonus!
Rather than the typical IV in the arm, the catheter goes into the port on my chest. The needle is hooked to a round anchor, and it is literally pushed through the center of my port, through the skin. Believe it or not, it hurts less than the arm-access IV, because the needle is smaller and you only feel the skin poke. It also preserves the veins, because the veins in the arm cannot typically support the strength of the chemo drugs long term.
The nurse takes blood to check my levels and ensure everything looks good to proceed with the infusion. They checked, and will check at each infusion, white and red blood cell counts, platelets, neutrophils, hemoglobin and other anemia markers, etc. I had straight saline infusion during the entire time.
My levels were all great, thankfully, so it was time to get started. "Pre-meds" go first: Benadryl, two long-acting nausea meds, and steroids to counteract effects or reactions to the chemo drugs. Typically, Ativan, the anxiety drug, would be given at the same time, however we discussed that we would hold off on that one until it was cold capping time. From my end, this was partially to help ease into scalp freezing, but largely because my body was frankly assaulted from this drug cocktail! I had gone in planning to do some reading, working, and adult-coloring book coloring, and all I wanted to do was sleep to avoid that dizzy, foggy-headed feeling. I could not handle the idea of Benadryl and Ativan at the same time. On a daily basis, I take a multivitamin, probiotic, and Zyrtec. I take Zantac and ibuprofen as needed. I really can't do anything stronger than that.
About 30 minutes later, after my blood work came back, it was time to start the antibody portion of the infusions: Herceptin (trastuzumab) and Perjeta. This part of the treatment aggressively targets the HER2 protein that I mentioned in another post. This is a factor that, according to my oncologist, is present in approximately 15% of breast cancer patients and makes the cancer aggressive and more likely to return. For this reason, I will have an entire year of Herceptin infusions, once every three weeks. The antibody portion side effects are more tolerable than the chemotherapy drugs, though come with their own special treats.
I am pleased to report that, despite my morbid curiosities, each of the drugs felt exactly like the saline going through my veins. Whoop whoop! Some people DO have reactions, and they are addressed immediately. Allergic reactions to these drugs happen and is the reason Benadryl is automatically given.
The Perjeta ran for an hour and a half, and then the Herceptin ran for an hour. Half way through the Herceptin, we added the Ativan and then stepped into the bathroom - with my rack of hanging meds and fluids - to soak my hair and get the cold cap on. Still, at this point, I just wanted to go back to sleep. Benadryl is no joke!
After that, it was Carboplatin for an hour, and then Taxotere for an hour. These are straight up chemotherapy drugs, and the side effects are exactly what you would expect from something that quite literally blasts your cells from within.
It bears mention that not every breast cancer patient gets the same menu of medications. There are varying factors in determining the protocol, including whether it goes before or after surgery. I did find, however, that people with similar staging that were also triple positive tend to have the same line up (which is comforting to know).
After all of this, I still had to wait two hours to finish out the cold capping process. At this point, you would think one would have reached her limit. But oh no! There's more. Because chemo tanks the white blood cell counts and our bodies are immunocompromised, we get a Neulasta shot the next day, to recharge the bone marrow. You can either wear an on-body injector, or come back to the hospital the following day for the shot. I opted for the former. It attaches to my belly, and the device feels like a rubber band snapping when the needle injects. Then it just stays put for 27 hours, until it beeps to let you know the injection is starting and 45 minutes later, it is done and you can remove it. There are side effects to the Neulasta as well. Don't google, lest you read the reports of people crippled from the bone pain. Eek. I came equipped, however, thanks to research in the community AND suggestion from my chemo nurse. CLARITIN, of all things, helps counteract the bone pains from the Neulasta. And epsom salt baths, to my daughter's delight.
Infusion day lasted until 5:45pm or so...and I hung up from a conference call at 5:30. I ordinarily do not endorse conference calls while Benadryl is running through my body, but needs must. Probably the worst of infusion day was the headache from the pressure of the cold capping helmet, and the dizziness and heaviness from the Benadryl (presumably). I felt like I had several hundred pounds of weights strapped to my body when I stood up, which continued into the next day.
As for side effects...I had just about all of them. It was manageable, but just...not fun. And by day 7 I was really over it and wanting to feel normal again. Nausea was predictable. I stayed on top of my nausea meds, begrudgingly, but it wasn't enough. By the weekend, I felt so extremely dehydrated (mainly from inability to drink much) that I was literally dreaming about going to urgent care for fluids. The worst parts were the unexpected parts. My tongue felt like I had scalded it on hot tea...for 10 days. Like someone had taken sandpaper to it. It didn't have sores, but felt burned and raw and my taste was affected. Things tasted metallic or just off. I learned a trick that if I lick a lemon slice before eating or drinking, I could get some of the flavor back and it worked. I also learned not to eat on metal silverware and to opt for plastic. Aside from that, I dealt with GI issues that required heavy diet modifications and dealt with (am still dealing with) horrendous reflux and heart burn, and - the best part - UTI symptoms that were thankfully clear when tested. Everything basically felt like it had been burned on my insides!
I don't share this to garner pity, because I don't want that. I share because I know you, too, are curious, because many people have asked and been genuinely curious, and because knowledge is power.
I'm not particularly excited to do it all over again tomorrow, BUT! there are bonuses. Tomorrow's infusion day will be a little shorter and a little less extreme. After tomorrow, I will be 1/3 of the way done with chemo treatments. And perhaps the most useful part, I know what to expect and that I can handle it. I know that after 10 days, things will start to feel normal again (other than GI issues, which linger), and that after 14 days I will get energy back and be able to eat and drink almost normally, all things that allow me to be optimistic going into the next round. I am strong. I can tolerate this. I can beat this. #warriorchick #fightlikeagirl
p.s. I don't have to beat it alone though, and this round, I am going for acupuncture on Thursday, and for fluids on Friday, so that I will be better equipped going into the weekend.
So, here is my next "process" post. A lot of people have been curious about what actually happens during chemo, and honestly I could have benefited from a blog post beforehand, so maybe I wouldn't have lost sleep wondering what it feels like to have poison run through your veins (so morbid, I know).
So here we go. The antibody portion of my chemotherapy was front loaded, so infusion day 1 was even longer than others. We had to arrive before 8am to get started, which meant we had to leave the house by 6:45am. I also front loaded coffee.First, we met with my oncologist to talk about what had been going on, what my concerns were, lingering questions after that, etc. Then we went upstairs to the infusion center. Because I'm cold capping, we get a little private room off the side of the main infusion area, where seats are separated by curtains. Bonus!
Rather than the typical IV in the arm, the catheter goes into the port on my chest. The needle is hooked to a round anchor, and it is literally pushed through the center of my port, through the skin. Believe it or not, it hurts less than the arm-access IV, because the needle is smaller and you only feel the skin poke. It also preserves the veins, because the veins in the arm cannot typically support the strength of the chemo drugs long term.
The nurse takes blood to check my levels and ensure everything looks good to proceed with the infusion. They checked, and will check at each infusion, white and red blood cell counts, platelets, neutrophils, hemoglobin and other anemia markers, etc. I had straight saline infusion during the entire time.
My levels were all great, thankfully, so it was time to get started. "Pre-meds" go first: Benadryl, two long-acting nausea meds, and steroids to counteract effects or reactions to the chemo drugs. Typically, Ativan, the anxiety drug, would be given at the same time, however we discussed that we would hold off on that one until it was cold capping time. From my end, this was partially to help ease into scalp freezing, but largely because my body was frankly assaulted from this drug cocktail! I had gone in planning to do some reading, working, and adult-coloring book coloring, and all I wanted to do was sleep to avoid that dizzy, foggy-headed feeling. I could not handle the idea of Benadryl and Ativan at the same time. On a daily basis, I take a multivitamin, probiotic, and Zyrtec. I take Zantac and ibuprofen as needed. I really can't do anything stronger than that.
About 30 minutes later, after my blood work came back, it was time to start the antibody portion of the infusions: Herceptin (trastuzumab) and Perjeta. This part of the treatment aggressively targets the HER2 protein that I mentioned in another post. This is a factor that, according to my oncologist, is present in approximately 15% of breast cancer patients and makes the cancer aggressive and more likely to return. For this reason, I will have an entire year of Herceptin infusions, once every three weeks. The antibody portion side effects are more tolerable than the chemotherapy drugs, though come with their own special treats.
 |
| Perjeta side effects |
 |
| Herceptin (trastuzumab) side effects |
I am pleased to report that, despite my morbid curiosities, each of the drugs felt exactly like the saline going through my veins. Whoop whoop! Some people DO have reactions, and they are addressed immediately. Allergic reactions to these drugs happen and is the reason Benadryl is automatically given.
The Perjeta ran for an hour and a half, and then the Herceptin ran for an hour. Half way through the Herceptin, we added the Ativan and then stepped into the bathroom - with my rack of hanging meds and fluids - to soak my hair and get the cold cap on. Still, at this point, I just wanted to go back to sleep. Benadryl is no joke!
After that, it was Carboplatin for an hour, and then Taxotere for an hour. These are straight up chemotherapy drugs, and the side effects are exactly what you would expect from something that quite literally blasts your cells from within.
 |
| Taxotere side effects |
 |
| Carboplatin side effects |
After all of this, I still had to wait two hours to finish out the cold capping process. At this point, you would think one would have reached her limit. But oh no! There's more. Because chemo tanks the white blood cell counts and our bodies are immunocompromised, we get a Neulasta shot the next day, to recharge the bone marrow. You can either wear an on-body injector, or come back to the hospital the following day for the shot. I opted for the former. It attaches to my belly, and the device feels like a rubber band snapping when the needle injects. Then it just stays put for 27 hours, until it beeps to let you know the injection is starting and 45 minutes later, it is done and you can remove it. There are side effects to the Neulasta as well. Don't google, lest you read the reports of people crippled from the bone pain. Eek. I came equipped, however, thanks to research in the community AND suggestion from my chemo nurse. CLARITIN, of all things, helps counteract the bone pains from the Neulasta. And epsom salt baths, to my daughter's delight.
Infusion day lasted until 5:45pm or so...and I hung up from a conference call at 5:30. I ordinarily do not endorse conference calls while Benadryl is running through my body, but needs must. Probably the worst of infusion day was the headache from the pressure of the cold capping helmet, and the dizziness and heaviness from the Benadryl (presumably). I felt like I had several hundred pounds of weights strapped to my body when I stood up, which continued into the next day.
As for side effects...I had just about all of them. It was manageable, but just...not fun. And by day 7 I was really over it and wanting to feel normal again. Nausea was predictable. I stayed on top of my nausea meds, begrudgingly, but it wasn't enough. By the weekend, I felt so extremely dehydrated (mainly from inability to drink much) that I was literally dreaming about going to urgent care for fluids. The worst parts were the unexpected parts. My tongue felt like I had scalded it on hot tea...for 10 days. Like someone had taken sandpaper to it. It didn't have sores, but felt burned and raw and my taste was affected. Things tasted metallic or just off. I learned a trick that if I lick a lemon slice before eating or drinking, I could get some of the flavor back and it worked. I also learned not to eat on metal silverware and to opt for plastic. Aside from that, I dealt with GI issues that required heavy diet modifications and dealt with (am still dealing with) horrendous reflux and heart burn, and - the best part - UTI symptoms that were thankfully clear when tested. Everything basically felt like it had been burned on my insides!
I don't share this to garner pity, because I don't want that. I share because I know you, too, are curious, because many people have asked and been genuinely curious, and because knowledge is power.
I'm not particularly excited to do it all over again tomorrow, BUT! there are bonuses. Tomorrow's infusion day will be a little shorter and a little less extreme. After tomorrow, I will be 1/3 of the way done with chemo treatments. And perhaps the most useful part, I know what to expect and that I can handle it. I know that after 10 days, things will start to feel normal again (other than GI issues, which linger), and that after 14 days I will get energy back and be able to eat and drink almost normally, all things that allow me to be optimistic going into the next round. I am strong. I can tolerate this. I can beat this. #warriorchick #fightlikeagirl
p.s. I don't have to beat it alone though, and this round, I am going for acupuncture on Thursday, and for fluids on Friday, so that I will be better equipped going into the weekend.
.jpg)
This reminds me of my infusions for RA. Kills the immune system and you feel crazy for a few days. Those pre-meds...yeah, I tried conference calls and when I woke up, no one was on the line because the Benadryl took me out. So, it’s ok to Give that up. Use the time to rest as much as you can. As infuse in a center with chemo patients I try my best not to complain. Hugs from Atlanta.
ReplyDeleteI am following your posts faithfully and thinking/praying for you often. Even in the midst of all of this, you find a way to see the light; the humor. That's what I love about you and why I know you'll kick cancer's ass. It messed with the wrong girl. Sending big hugs from the mitten ;)
ReplyDelete