A Day At Chemotherapy

"We have two options, medically and emotionally: give in or fight like hell." 

~Lance Armstrong

The prospect of chemotherapy can be daunting. We've seen so many movies of chemo patients who are bald, pasty gray, emaciated and throwing up. Chemo of today does not have to
be that way.  

For me and my Stage II Triple Positive treatment, I had none of these. I cold capped and kept my hair, managed to keep most of my color, didn't lose weight, and never once threw up.

It doesn't have to be frightening.

I had a four different chemotherapies during my day which already made for a long day. Coupled with that was the fact that I cold capped, it made the day about eight hours at the infusion center. 

This is a play by play of how my chemo day went: 

Lidocaine over port

One to two hours before the appointment, I smear lidocaine cream on the port site. I was told to put it on this way: like frosting, not like lotion. It had to be a huge blob of white completely covering my port. I would cut a 4x4ish square of Press and Seal wrap and put it over the blob. I would go about my day, getting dressed, brushing my teeth, etc. I would even put it on at work and teach small group reading.  This way, when they accessed my port, I would feel pressure from them pushing, but never any pain. 

I would dress in leggings and a shirt, often a v-neck.  It had to be something stretchy that I could pull down to see my port because I would have a tube running from the port to the IV and it would be like this for a few hours. Over that, I would wear a button down shirt. I often wore a pair of short boots that easily slipped off. The room (and me) could be cold or warm. It was always a guessing game so I always had options.

For me, I would arrive at the doctors office and be seen there first, prior to the infusion center. I would be given a clipboard that asked any symptoms since I had last been in. I listed EVERYTHING I could think of. If my eyesight was off, I wrote it down. If I was dizzy, I wrote it down. This came in handy when I said my hearing was off and it turned out I had lost it due to one of the chemotherapies, which was then stopped.

I would be called into the exam room and be weighed and my blood pressure would be checked. My port would then be accessed by the nurse. This involved every piece of plastic in the building and wasn't quick. Once it was ready, she would have me turn my head to my side away from the port. This wasn't so I couldn't watch. It was so my chin was out of the way. She would push the inch long needle into my skin over my port. I never felt any sort of poke. Once in, she would flush it out with saline and it always tasted funny. I could have used gum or a mint, but I just commented every. single. time. I would have a tube running from my port, and down four or five inches. The would usually tape this to my shirt and leave it.

Once the port was accessed, the doctor would come in and go over the paper that listed all the symptoms and talk about things that were going well or not so well.

About 30-45 minutes after I'd arrived, I would be given a piece of paper that would end up costing my insurance almost $40,000, and I would go across the hall to the infusion center to actually get the chemo.

My infusion center was a long room with curtain dividers. There was a chair for a support person, a window to look out and a fake leather chair for me. I had access to a television, and I Pads were available. I also had access to electrical outlets if I wanted to bring my own heated blanket or charge any device. There was a snack area full of all sorts of goodies if I got hungry or thirsty. After all, it was an eight hour day. 

I would make myself comfortable in the chair and they would bring me a warm blanket. One of the perks of cancer was those warm blankets. 

Prior to anything happening, I would be asked my birthday. This happened all the time so I was always ready for it.

Another nurse would come in and she would give my my premeds. I know for sure I got Ativan/Lorazepam because that made everyone happy. It would calm me down so I wasn't such a hot mess for the nurses. It also has anti nausea benefits. I would also be given a separate anti nausea medication that was not only good for that day, but the next two. I'm not sure if I was given steroids or Benadryl or anything else at that point.

Finally, after answering the birthdate question again, two nurses would come in and prep one of the targeting chemotherapies. They would ask my name and birthday again (yes, again). One nurse will look at your band while reading numbers. The other nurse will repeat those numbers off the computer. It’s a check and balance thing. They would hook a tube up to the wire hanging off my port and start the machine. We would be finally getting the first of my four chemos. I can't feel anything happening as it goes through the port and into my heart. Nothing hurts, or is cold or anything. I just feel nothing except sleepy for the premeds and the anxiety crash. 

Each bag takes between 30-90 minutes to drain, depending on the particular chemo, and if it's the first chemo or the fourth. The first chemo is almost always longer. I “beep-beep” from the machine on the IV rack when I’m done.  Sometimes I beep-beep through my nap.  Or in the bathroom.  Or at the snack area.  

I am attached to a wheeled IV stand that I know full well how to unplug from the wall and take for a walk.  I go to the bathroom and stop off at the snack bar – a lot. It helps to just keep moving. 

I "beep beep" after my first chemo and nurses come into the room to change it out. A lot of times, I'm actually asleep and they have to wake me up. They do, they check my wrist for my band that has my name and birthday on it and ask me my birthday. The second targeted chemo starts.

At this point the Paxman cool cap is going on.  Some of this I do in the infusion room; later I found to spray the hair in the bathroom and come back for the rest. For Paxman, the hair has to be really wet. Myself, my husband and the nurse put the part with the gel in on and then the three of us would wrestle with the outer layer to make sure it's tight. Then the nurse turns it on.  I can feel the cold going through the channels in the "helmet" and it is cold, but I don’t get the brain freeze or headache.  I don't know if it was my tolerance or the Lorazepam, but it wasn't miserable at all. 

I did find out that I could still put earbuds in and arrange the hose attached to the cooling machine and take a nap.

 A half hour to an hour later, the IV machine "beep beeps" and it's time for the next drug.  

Then the nurse comes in in a plastic gown, mask and gloves (before this she was only wearing gloves to hook up the IV bag).  Now she’s gowned up from head to toe and the cords are a different color. These are the meds that aren't targeting the cancer, they are going everywhere. I found it ironic that they were so protected, yet this stuff was going straight through my heart. 

This was another 30-60 minutes, "beep beep" and it's time for the final drug. Again, they have to wake me up. They repeat the gloved and gowned up routine and the last drug is being administered. 

Because I cold capped, I would have to stay another 30-90 minutes AFTER the last chemo bag was emptied. The would disconnect me from everything, pull the needle out of my port and put a bandaid over it. The I would sit in the chair with the Paxman cap still on, still cooling the scalp. This was just because of how the Paxman machine works. Had I not been doing it, I could have left after the last chemo. 

After the Paxman shut off, we pull the cap off . We did learn to wait five minutes after the Paxman machine stopped to let my hair thaw a bit.  The first time there was ice and it pulled on the scalp.  This wasn't helpful because the goal was to not have my hair fall out.

Finally, we would pack up and leave, anywhere from six to nine hours after we got the cancer center.

I always felt fine when I left, never nauseas or in pain. I was a little woozy from the premeds and just from sitting and napping for so long, but I probably could have driven home had my husband not been with me. 

So that’s Chemo Day in a nutshell. For my first time, it was super stressful because I didn't know what was going to happen, if it would hurt, how I would feel, etc. Hopefully this eases fears a little bit. 

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