Chemo According to Kari

Chemo #1

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This post is a little different. I want to explain my thoughts on the ins and outs of chemotherapy so far, especially for people who haven’t had much experience with cancer treatment before.

As a disclaimer: I AM NOT AN EXPERT. I am 100% sure this is not everyone’s experience, and all cancers are different!

***I repeat, I by no means consider myself an expert on the subject, this is just how my treatment have gone so far.***

Sunday, April 15th, we had Robbyn and Monday April 23rd I had my first chemo. It was the first out of 8 treatments. I go every other Monday; so it’s a total of 16 weeks for chemotherapy to be completed. I call them my chemo “on week” and “off week.” Basically, I get a dose of chemo on Monday and spend the next two weeks recovering until my next dose. The first four treatments that I received we’re Adriamycin (AKA the “Red Devil” because it is literally bright red and TOXIC, it even turns your urine bright red) and Cytoxin. The second half of my chemotherapy treatment will be a drug called Taxol; which I will start next week.

(That’s right! I’m halfway through chemo as of now!)

Below is a text from my brother’s good friend and coworker. As a cancer survivor himself, he has been a wealth of knowledge and support for us during this process. He sent this text through my brother for my first day of chemo.

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My knowledge of oncology was very limited before I started this journey. Nursing school really only touched on it here and there. It’s astonishing how much I have learned over the last month and a half. In my limited knowledge of cancer treatment, I assumed I would have to sit there all day receiving my infusion when in reality that is not the case. It’s mostly a lot of prep work!

When I go in for treatment they immediately get my weight and labs to make sure I am healthy enough to get the chemotherapy that day. They check to make sure my white blood cell count is high enough along with a plethora of other labs.

After the labs come back, the oncologist looks them over and comes to examine me. She sees me before every chemotherapy treatment; listens to my heart and lungs, completes a breast exam, and asks how I am doing overall. (She is absolutely fantastic in case you were wondering!)

Once she examines me, she verifies that it is ok for the pharmacist to mix my infusion. The infusion is weight-based and made for me specifically, so it can’t be mixed until they know for sure I will be receiving it that day. Once pharmacy starts preparing the infusion, my nurse gives my “premeds,” which is a cocktail of long and short-acting drugs to combat the nausea that is caused by the Red Devil. Those premeds run over 30 minutes.

Next up!

The main event: my chemo!

The Adriamycin is pushed in 3 separate syringes over 15 minutes by my nurse. The cytoxin is next and it runs on an IV pump over 30 minutes. So its a ton of set up time for a short infusion! I usually get to the cancer center at 11:00 and leave by 2:30.

All of these medications go into my port which I had surgically placed the day of my second chemotherapy treatment. They can also draw my labs out of my port so I only have to be stuck one time. They kindly gave me numbing cream to put on it before I arrive, so it doesn’t hurt.

The port is quite possibly the greatest medical innovation in my opinion!

This is my port when it is “accessed” or being used.

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One of the side effects of Adriamycin is mouth sores, so to combat that, the logic is to fill your mouth with ice chips to vasoconstrict (shrink the blood vessels) in your mouth to keep the medicine from causing sores.

So, I can’t talk very well while the medication is going in. Not to mention, I look completely ridiculous.

I’m not sure if it actually works or if the staff thinks it funny to watch me try to talk with a mouthful of ice.

Also, after the completing four treatments of this, I will never be able to eat ice chips again. I associate the taste with the horrible taste of adriamycin in my mouth. For the past week, it has tasted like I have a wet dollar bill in my mouth… mmm.

Another huge side effect of Adriamycin is a drop in your white blood cell count putting the body at increased risk for infection. I get a pump that looks like an insulin pump placed on the back of my arm. It has a medication called Neulasta, that automatically injects my arm 24 hours after chemo with a drug that kicks my bone marrow into overdrive to make more white blood cells.

I have to call if my temperature is above 100.9 because it is considered a medical emergency. My oncologist said she didn’t care if it was 3 am I needed to call her immediately. If you know me, I usually have to be on my deathbed to call for a doctor’s appointment, so this would take some adjusting to.

One more significant side effect of Adriamycin and Cytoxin is hair loss, but you will have to wait for another post to hear all about that!

As you can see from the top picture, the nurse is all garbed up head to toe with protective equipment. A gown, special chemo gloves, goggles, mask, and a special bag to dispose of it in.

It’s very comforting to know that the medication going into my body is that toxic!!

In reality, I don’t care what they are putting into my body as long as it kills the cancerous tissue.

I am also supposed to drink a TON of water. The goal is to keep hydrated and flush all of the byproducts of the chemo out of your system to make you feel better.

This is easier said than done when you are already queasy!

Just a word of warning: drinking that much water especially if you have just delivered a baby a week earlier, make sure you are close to a bathroom because your bladder has NOT recovered from childbirth.

I go back to the cancer center every Friday of my chemo “on week” to get a liter of normal saline to rehydrate my body. I don’t really notice how dry I really was until Saturday morning when I feel like a new person from the extra fluid.

I start Taxol on my next visit, and this regimen will be different. The Taxol is a 3 hour infusion. So, the prep work (labs, pharmacy, and exam) will be the same but with a longer infusion time. So, I am told I should plan on being there 5 hours. I haven’t quite figured out how I am going to sit still that long. All I can say is thank goodness for Netflix and my Kindle.

I cannot complain because God has been so good through all of this and my side effects have been so minimal compared to what many others go through. One nurse even asked if she could clone me! My nausea has been manageable and my white blood cell count has remained within normal range for the first half of treatment. I think most of my fatigue is due to the newborn and 2 toddlers at home!

Chemo #2

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Chemo #3

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Chemo #4 HALFWAY!

(Another chemo side effect: hyperpigmentation or darkening of my skin. Notice my knuckles)

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I have been a nurse for 6 years and a student nurse before that for 3 years. Having no significant health issues my entire life, I have realized that I’ve never fully understood the impact good nursing care can have.

I have taken care of many patients and many of those were cancer patients, but being on the other side of the healthcare system now has turned my world upside down. I am seeing things from the patient perspective that I have never considered before.

Until recently, I had never been in the fragile position of awaiting critical test results, being unsure of my treatment options, or have very little understanding of the treatment I would be receiving. The teaching my oncology nurse has given me has been vital and could save my life.

Feeling the nurses’ genuine compassion and having them taking the time to ask how I am really doing, has made all of the difference. Seeing these nurses care for me makes me proud to be a part of the profession, and makes me want to work harder to be a better nurse and patient advocate in the future.

”Therefore as God’s chosen people, holy and dearly loved clothe yourselves with compassion, kindness, humility, and patience.” Colossians 3:12