Wednesday, September 25, 2019

A Day at Chemo: A Diary


Since I navigate my weekly chemo treatments mostly alone, I thought I’d give you a little play-by-play of what the experience is like. This happened to be a relatively tame week, but there are still so many things that go into having a successful chemo day.

Without further ado, here we go!

12:30pm - What to wear, what to wear? I try to wear clothes to chemo that service three purposes: comfort, fun, and accessibility for the port. What is a port, you ask? A port is the catheter that is implanted in my chest, and that’s what they take blood from and deliver chemo through. Today I chose to wear a full sequin tank top and cozy sweater, and a pair of kitty cat socks that I received from a friend.


Sparkly shirt!

Cute socks! Look at those little ears! (lower right in pic)

12:45pm - One hour before treatment, I put lidocaine on my port so that when they insert the needle later it won’t hurt as much. Because, folks, that sucker is FAT. Photo to come.

12:50pm - I leave my apartment, preparing to stop for food along the way and get to my appointment on time at 1:45pm. Today I will attempt to walk to chemo, which I have not done since being diagnosed - I have always taken a car. But I have been feeling well enough and I decided to test my body and its endurance. Plus, I’m stubborn & frugal and don’t want to pay for a car anymore!

1pm - I walk past a Dunkin Donuts and realize that I want to bring some treats to the nurses at my chemo center. Munchkins would be the perfect gift. But they don’t have enough left at this Dunkin. Decisions decisions. I somehow convince them to make a batch just for me, but I would have to wait for 10 minutes for them to be done. I look at the time - if I choose to eat my meal here instead of elsewhere, I’ll have time to wait. I say yes. 25 minutes later I have them. (25 minutes?!) I rush out the door.

1:50 pm- Alas, I’m late to my chemo appointment because of those darned Munchkins! But they nurses are not mad, they’re excited to get some tasty bite-size donuts to munch on all afternoon.

2:02pm - I get called in for my labs. Labs are the blood draws that they pull so that my blood counts can be assessed and my doctor can determine if I’m healthy enough for chemo. My nurse, also named Erin, comes in and asks me if I mind getting my port accessed (needled!) in the more public lab instead of a private room, because they’re so busy that a room is not available. Ever the agreeable patient I put my modesty aside and say, “Sure!” She then asks me if I’m excited about chemo being done after today. I confusedly tell her that I’m not done, that as Stage IV I’ll never be done, and she says, “Why did you bring the treats, then? People thought it was a last day gift.” And I said, “No, it’s just because I love you all.” Tears all around. I get asked if I want to wear a mask or if I want to just turn my head away from my port (they take germs seriously!) I tell them I’ll just run my head and my nurse makes me promise I won’t breathe on myself. I tell her I’m nothing if not compliant. She asks the lab tech if she agrees, and the lab tech says, “She’s awesome. 100%.” Awww...

My nurse then asks me my name and date of birth. They do this MANY times throughout the day as a safety check to make sure I’m getting the right drugs and the lab are labeled with the right patient’s info. She cleans my port for one minute (!) and prepares to stick the FAT needle in it.

The FAT needle! Zoom in!

I feel no pain - the lidocaine from earlier is very helpful. For some reason, as she attempts to take my labs the blood doesn’t want to come out of the port quickly like normal. But a combination of breathing deeply and holding my breathe does the trick. We laugh and she says that I’m a pro at breathing. I tell her it’s because I’m a singer.

This is what I look like after accessing.
I also get my vital signs done. My blood pressure is high for me - 109/68. My heart rate is high as well - 101 beats per minute. I tell them that this is because I just walked to chemo from home, so I’m a little revved up. But I’m likely dehydrated, too.

2:16pm - I’m done getting my labs drawn and I’m sent back into the lobby of the chemo center to wait for the results. Most often I’m healthy enough to have chemo, although two weeks ago my counts were way too low (low platelets, low white blood cells, low hemoglobin) so they gave me a week off. Today I’ll be in the lobby for about an hour while they wait for my blood count report to come back, for them to find a room for me to be treated in, and for them to get my chemo medicine from the pharmacy. I get myself a cup of coffee (free coffee!) and then settle down to check out social media.

2:20pm - I can’t get WIFI to work on my computer. Drats. Now I have to use my phone and drain the battery. Booooooo...

2:38pm: I get a text from a friend who I try to convince that I’m a Rambo at chemo - crushing it. I think he believed me. :)

2:50pm - There’s a woman in the lobby eating chips very loudly - the crunch of the bag and of the chips in her mouth is enough to make a woman crazy. But then I’m remind myself that I’m Rambo and can take anything. She’s very lucky.

3:22pm - Success! Labs are positive so I get to have chemo today. I get called into Room 5 to start getting set up for treatment. They start my “pre-meds” by hooking me up to a big bag of saline (which I need because my heart rate is too high.) They give me two Decadron pills, which are steroids that will help me avoid nausea, vomiting, and other allergic reactions to the chemo that’s coming. They also give me a drug called Aloxi, which also helps combat nausea and vomiting. They dim the lights in my room and hand me a blanket, a pillow, and a TV remote. I kick up the feet of the recliner and prepare to watch dramatic daytime TV like the Real Housewives of Orange County and The First 48.

Here’s a photo from a recent chemo, showing my typical weekly view.

3:39pm - Now that the pre-meds have settled in they hang up a bag of Gemzar chemo which will drip along with the saline from 30 minutes. They confirm my name and date of birth. Gemzar’s major side effects are nausea/vomiting, low blood cell counts, trouble breathing, swelling in the hands and feet, or a rash. It can also cause red or pink urine, but I have never seen that. (Yikes!)

4:01pm - The nurses gather with another patient outside of my room in a bubble of excitement. It is the patient’s last day of chemo, and she is getting to ring the bell that signifies that she has finished an enormous battle. I’m very happy for her but a little sad for myself. Because I’m Stage IV I’ll never be done with treatment, so I will not be ringing any kind of bell under these circumstances. Well then - I’ll just have to find a reason to ring a bell in other circumstances... :)

4:17pm - They chemo pump beeps loudly, letting my nurse know that this first chemo is almost done. She adds a “flush” - which is more saline “flushing” through the line to make sure I get all of the chemo out of the tubing. 

Here's what the chemo bags and saline look like.

4:24pm - With the flush done, my second chemo arrives ready to be started. This one gets dripped over an hour. They confirm my name and date of birth...again. (You’d think I’d have to be REAL comfortable blabbing my age by now, but it never feels good.) This chemo is called Carboplatin. The main side effects for Carbo are nausea/vomiting, numbness/tingling in extremities, body pain, weakness, rash, and hair loss.

4:29pm - My chemo pump beeps again, this time to let them know that I’ve had plenty of saline solution and the machine thinks I should be done. My nurse asks me if I want extra hydration. I tell her yes, that I love peeing (ha!) She agrees to give me extra for the day. Saves me from having to drink another liter of water at home. Drinking water is very important after chemo, to make sure that I flush out all of the toxins. Grateful to have it here in my veins.

4:49pm - The music from the TV show “The First 48” is so dramatic that my nurse comes in and stares at the TV. Then a commercial for an online car buying company comes on, and we both agree that we would never buy a car online, especially without driving it first. That’s crazy talk.

5:24pm - The chemo pump beeps, letting them know that my second chemo is done and needs a flush. After that, I’m done for the day! But not quite, because they need to take my vital signs (to make sure I’m not dead?) This time I’m 95/58 (normal blood pressure for me), and 88 heart rate (which is normal for me after chemo). They’re happy, I’m happy, so we start the process of checking me out.

5:31pm - The main check out maneuver is to de-access the port (have them take the needle out.) They give me an injection of Heparin, which helps to keep blood clots from forming around the port when it doesn’t have a needle in it. Once that’s done they flush my port with more saline to make sure the chemo and heparin have gone all the way into my arteries. For their final feat of the day, they rip off the bandages that have been protecting the port (and I say rip because the adhesive and my skin just don’t mix. Ouch!) Once the bandages are off, they say, “One, two three” and then pull out the needle, which always hurts more than when they put it in. They press down hard on the port opening and put on a bandage, so that I don’t bleed profusely. (I am on blood thinners due to blood clots being prevalent with chemo - I’ve already had two blood clots in my arms which was NOT fun - I had severe swelling for a month AND they could have travel to my brain or heart!) Once they’re satisfied that I won’t bleed to death, they flip on the lights and send me on my way.

5:45pm - After all of the rigamorole I turn off the TV, take off my blanket, put my shoes back on, and get ready to enjoy my evening recuperating. But first... FOOD (and drink?)

A margarita after a successful day of chemo!

Erin Cronican is a Stage IV breast cancer patient whose career as a professional actor and career coach has spanned the last 25 years in New York City, Los Angeles and San Diego. She has appeared in major feature films and on television, and has toured nationally with plays and musicals. She has worked in the advertising & marketing departments of major corporations, film production companies, theater magazines, and non-profit acting organizations. For more information, please visit www.erincronican.com.

3 comments:

  1. You are a wondrous and amazing woman

    ReplyDelete
  2. Rambo? You make Rambo look all wimpy. So positive and upbeat. Erin all the way.

    ReplyDelete

Thanks for commenting- YOU ROCK!


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