Saturday, November 20, 2010

Club Chemo

“It’s different for everyone,” is the big chemo tagline. That means no matter how many cancer patient stories you hear, you can’t know what your chemo experience will be like – a frustrating concept for someone who likes to prepare.

I try to think of chemo as a positive, life-saving measure. But it’s hard when you read the warning labels: May cause hair loss, nausea, vomiting, diarrhea, stomach aches, constipation, heart arrhythmias, fatal heart damage, extreme fatigue, mouth sores, joint pain, easy bruising/bleeding, slower healing of existing wounds, and a temporary white blood cell loss that can make common viruses and bacteria life-threatening.

Those are the warnings for the drugs I’ll be taking for the next three months. The drug I’ll get for three months after the baby is born has these warnings: May cause nausea, vomiting, loss of appetite, change in taste, thinned or brittle hair, joint pain, unusual bruising/bleeding, permanent numbness and tingling in your fingertips, fever, chills, cough, sore throat, difficulty swallowing, dizziness, shortness of breath, severe exhaustion, skin rash, change in bowel habits, and infertility.

Fun stuff.

Yesterday was my day to join club chemo for the first time. I know I need to do it. But I don’t want to. Part of me hoped my membership papers might get lost in the mail, despite all the perks, like free snacks and drinks at the chemo lounge. Six months of club chemo feels like an eternity to me right now.

We walk through this door at the back of my oncologist’s office. There is a white sign with the word “Stop” in red letters. In smaller print it says to double check you have your bracelet, among other administrative things. Oh, how I just want to stop. Of course, I don’t.

Behind the door, the mundane doctor office transforms into a hospital setting - Club Chemo. A wide nurse’s desk greets you with a second check-in sheet. Behind the desk are rows of reclining hospital chairs, separated by curtains and adorned with IV poles. Party-time.

When I came in to this place for blood work two days ago and saw people receiving chemo for the first time, my waiting chair faced two bald, elderly women who looked like they would pass away if you blew on them wrong. Their bodies seemed to give them more pain than capabilities. I felt really sorry for them. It didn’t help my imagination problems in positive ways. Chemo is what I dreaded the most about my treatment. The older women were like living, moving posters of my worst flashes of imagination.

Today the patients near me seem to be able to walk. They don’t look overly sick. They have hair. I learned this morning that I’ve got about 14 more days of hair before it starts falling out. How can they all be in here for their first chemo session? Then I get another glance at a woman with long auburn hair in her 50s. She’s laying in bed with her eyes closed. I notice her hairline is slightly crooked, like she turned in bed and the movement pulled her whole head of hair down diagonally just a millimeter.

My nurse comes in to start my IV. Her name is Kelly - she'll be serving me my cocktail of drugs today. I like her immediately. Her scrubs have pink breast cancer ribbon print all over them. I’m back in my upbeat, nervous tone after a few teary moments in the bathroom. I ask her if she’s bringing my poison. She makes a gentle complaining face. She hates when patients call it that. It makes her feel guilty about her job. But she adds that no one should have to go through it. I apologize. I explain that I know I’m supposed to be visualizing more positive things: like the drugs killing the cancer, peaceful beach settings or the image of a tiny Chemo Shark being unleashed to chomp away at cancer (while accidentally eating other cells too). But my imagination isn’t working well today. I tell her I’ve brought distraction instead – in the form of reruns from Season 3 of 30 Rock.

She starts me on the easy stuff: the steroids, the saline, the anti-nausea drugs. Steve starts up the 30 Rock Reruns on his i-Phone (I wish I could get advertising fees for that product placement). We start giggling aloud. The distraction is working. I feel this intense appreciation for the actors on the show – that I could be laughing out loud as my chemo drugs get wheeled down the hall toward their target.

The nurse comes back with the Adriamycin. There are three long, one-inch thick syringes filled with the drug that looks like red Kool-Aid. They are the biggest syringes I’d ever seen. I did some research on the drug on Wikipedia. Scientists first discovered the substance in soil bacteria found at an Italian Castle. It almost sounds romantic. But its nicknames give its true effects away. “Red death.” It also is known as the “red devil.” It can damage your heart though the damage is unlikely at lower doses.

I try not think about it and look back at the screen. 30 Rock takes place at a tv studio for a comedy show. One of the actors has been fined by the FCC for swearing on live television. Instead of feeling shame at the punishment, he gets excited because he realizes he can afford the fine, which means he no longer has to worry about what he says on tv. He can just pay the fine each time. Of course the show’s producer is pulling her hair out.

I start laughing again as the nurse starts to push the first syringe into my IV. Every time she pushes, I feel something heavy flooding into my chest. I start taking deep breaths because this weighty fluid makes it harder to breath. She measures my oxygen levels. They check out. But she starts watching me like a hawk. One of the warning signs of an adverse reaction to the drug is shortness of breath.

I return to laughing. She continues pushing. Each time the weight feels heavier and heavier. I’m starting to feel really uncomfortable. I’m about to ask her to slow down when she pushes the syringe again. My laughter turns to tears, and all these images flood into my head of me gasping for breath while they run for some kind of antidote. I know part of the discomfort is emotional panic. But that knowledge doesn’t stop the tears for a few minutes.

We take a break. When the nurse continues, she does it much slower. The pressing feeling becomes more bearable. Next she brings the Cytoxan. It looks less scary. Just a clear IV bag. But my research reminds me that this drug is related to mustard gas. Awesome. This one just slowly drips into my IV. The nurse slows the dripping more after my reaction to the last drug. I only have to take really deep breaths a few times.

We finally pull out at close to 3pm. We’ve been there for nearly 6 hours. I’m feeling real tired, even though the IV was pumped with steroids. I stay awake only by working on this blog. That is about all the energy I can muster.

Today, Saturday, I’m feeling better. I’m waiting for the fatigue side effects to start kicking in. Will it be today, tomorrow, Monday, Tuesday? Will I be one of the lucky ones who don’t get it so bad? I don’t know. But I can feel our baby boy kicking. The doctors assure us the baby will survive the chemo fine too. But feeling him move is a relief.

Thank you to all who helped us with dinner, meals, cleaning and support after the surgery. Your kind acts have meant a lot to us.