It's Chemo Day and You're Invited! (Post #28)

 

Just a few of the things I got done while on my steroid high. 😊

So "chemo day" begins the day before, which doesn't really make sense, but stay with me here, it's all about the drugs. In preparation for the chemo infusion, I start to take steroids (Decadron or dexamethasone) the day before. They are taken twice, in the morning with breakfast and at 2:00 pm with a snack. They must be taken before 5:00 pm and 2:00 pm is as early as they allow; they definitely interfere with sleep. I take them again on chemo day and the day after, using the same dosing. This is intended to reduce any adverse reactions to the actual infusion. They also help ease you into the side effects, as they help combat those as well. But, they also give me a burst of energy and I turn into the Energizer Bunny! I take full advantage of this effect and plan accordingly. The house is never so clean, nor the baked goods so prolific as the weekend before a chemo infusion. 😁 

MAR and meds are ready to go in the morning!

I like to have everything ready to go the night before as I often have a bit of a last-minute to-do list with items still outstanding. Here is a photo of my meds for the morning: Decadron, Ondansetron (to combat nausea and vomiting), Restoralax (Google it 😑), and Claritin (to combat any potential allergic reaction). I finally created a MAR (Medication Administration Record) that I think will work well. Along the left column are all the meds I take, along with the recommended dosage and matching squares. For example, Tylenol is taken 4 times a day, so there are 4 squares to write in the times I took it. Across the top is the date. Each day upon waking, I pencil in the anticipated timing for each medication. After taking the first dose, I then set a reminder on my watch so I don't miss one...yes, this is necessary. Unfortunately. Chemo brain is real! 😖 

Decisions, decisions!

There are other preparations to be made prior to chemo day, such as which knitting project to take, what our route will be, as we inevitably have other errands to run, earbuds, and my laptop to charge...you get the picture. It's actually not unlike preparing for a trip! I like to pack an assortment of drinks and a snack in case I get hungry. 

There are preparations to be made in the home as well.  Any clothing or linens I touch this week have to be watched twice, separately, in hot water. So the hampers have to be empty. The smaller bin is my own personal garbage, as I'm toxic for the first week and tests demonstrate that it's possible for members of the same household to have measurable amounts of chemo drugs in their blood, despite not having any administered. To say I'm slightly neurotic about this would be a massive understatement. One Makus on chemo is enough. (I've also added special probiotics to our septic system to combat "Death by Chemo" as it has the capability to kill the good bacteria. It's kinda' like giving your sewer probiotic yogurt. 🤷🏻‍♀️)

I also need to ensure that my paper towel dispenser is ready to go, as sharing towels is a no-no, and frankly, it's just easier. And yes, extra TP must also be close at hand. Doesn't chemo sound fun? 🤪 (Yes, Liz, I did remove the extra junk off the half-wall before taking the photo. I didn't think anyone wanted to see my bottle of Poopouri, my "'Log' Log" and pen, etc, etc...😄)

Can I just take this opportunity to share how much all this garbage-making pains me? A dear colleague (Not a former colleague, I'm coming back, Brandy!) made me aware of just how much garbage one individual can generate. So I've made it my personal crusade to cut back wherever possible. No, I won't be using cloths in place of TP any time in this lifetime, but I've cut back on using disposable products wherever possible. (Like using microfiber cloths instead of paper towels, using brushes and washable makeup rounds instead of disposable applicators, etc.) Now I'm forced to use all these disposable products due to fear of either toxicity or infection. (No double-dipping into any creams or make-up compacts. You have to take a new applicator.) Now, I'm not about to chain myself to a tree, but I think taking care of God's beautiful creation just makes sense. I have three kids and hope one day to have grandkids; I like the proverb that says "We do not inherit the earth from our ancestors; we borrow it from our children." Okay, rant over...😬

I keep my Bible, my journal, and my pencil case on a table right beside my bed. Beginning the day with Bible reading, journaling and prayer ensures a better start, especially when I'm feeling well and have a tendency to rush into the day on my own strength...only to quickly tank. 🙄   (Don't even bother trying to read my journal; I have a mild form of dysgraphia, remember? Besides, it's boring. I spill my guts more on this blog! 😊) 

In a small house, you have to get creative. In order to accommodate our new King size bed, my makeup table had to go. This pull-down cabinet works like a dream! Note the pile of disposable tools on the left. (Insert cringe here. 😖) Have I mentioned how much my skin has changed since beginning chemo? No? Well then. 😬 My entire life, I've had oily/combination skin, depending on the season. Ever since I was diagnosed with melanoma in 2020, I have been pedantic in my use of SPF. However, now I've had to add various serums and moisturizers to combat the drying effects of chemo, and keep my face from imitating one of last year's seed potatoes. Oh, and I suddenly have freckles. It's grand. My kids were supposed to have freckles, not me! There are 3 larger spots on my nose, which, of course, are freaking me out, as I worry about melanoma! Don't ask for a look at my photo gallery on my phone...😬)

After a frantic morning trying to finish up my unrealistic pre-chemo to-do list, we're packing to go. I use my airplane carry-on suitcase, as you're not supposed to lift anything after chemo, and besides, I don't know how to pack lightly. 😊 

Oh, I almost forgot! I keep mentioning fluids/drinks but you might be wondering what that means. Basically, it's recommended that you double hydrate. Most people are told to drink 8 cups of water each day. So on the day before, the day of, and the day following chemo, I consume a minimum of 16 cups of fluid. This applies to non-caffeinated drinks only, so sorry MaryAnn (My amazing SIL!) your pot of coffee wouldn't count! 😁 Water tastes gross right now, so I add Buble drops, or mix juice and sparkling water. And no, I'm not driving. I've kinda' given that up. Apparently, my skill level has dropped. 🤷🏻‍♀️ (And yes, I know that Labour Day was a long time ago and yes, I'm acquainted with the "no white past Labour Day," but I haven't been getting out much and besides, it was 22C! 😊)

We arrived! Here we're waiting in line at the main reception desk. You're given a Cross Cancer Institute ID card upon registering as a patient but  mine was lost in the ICU kerfuffle after my surgery, so I got a new one on the day of my first infusion. Well, I forgot it at home today, so now I have two!  Apparently, this was a common issue today. The receptionist started laughing when I showed her my driver's license instead. 😊 Chemo brain is a rather unpleasant reality and one that no amount of rest or medication can relieve. You can get mad, or just laugh and add the latest ridiculous escapade to the "Chemo Made Me Do It" list. Like when I was baking and cracked an egg into the garbage and threw the shell into the mixing bowl. 😂 (Aren't you glad I'm not driving?)

Here we're waiting to be called into Systemic Therapy B. You see me here with my carry-on and trusty cooler, which holds my frozen mitties and booties. While waiting around the Cross, something one must do a lot of as the pre-chemo appointments are one hour apart with blood tests at the lab followed by an appointment with your oncologist, it quickly becomes apparent that cancer is no respecter of persons. There are patients who are much too young and otherwise healthy, walking around with their green sheets in their hands. (You get a green sheet telling you where to go upon registering.) There are patients from every culture in Canada, from every age demographic, every income bracket, and dare I say, every level of vanity? I participated in the Look Good Feel Better virtual seminar and strongly believe that I, personally, cannot expect to feel well if I look like a schlup. I had no idea I was so shallow! 🤷🏻‍♀️

I have a bevy of chemo-related t-shirts. Last week's said "Straight Outta' Chemo!" and today's says "I have Chemo Brain - what is your excuse?"

And we're in business! I got a reclining chair today, instead of the hospital bed I had the first two times. The poke to insert the IV is always a bit nerve-wracking. As someone with not only a bleeding disorder but also rubber veins that like to roll, I don't take a "hole in one" for granted. (Oh, that's a good pun! Sorry, not sorry. I'll take my entertainment wherever I can find it! 😁) Upon arrival, you are given a warm blanket to wrap around your arm. This helps make your veins more visible or  "pop," to use the medical term favored by most nurses. My veins were exceptionally bold today, which made the nurse's job much simpler. Here you see the cannula which was inserted using a needle, (which is then removed) the extender set, and two ports, one for normal saline and one for the chemo drugs. (I do not have an implanted port on my chest wall, thank goodness; they sound painful!) Not that IVs are fun...😕 

We always begin with Trastuzumab, better known as Herceptin. This drug was given over 90 minutes, followed by a half-hour observation period at my first infusion. This was sped up to a 45-minute infusion and a 15-minute observation for my second round, and today it only took 30 minutes and did not have an observation period. This is, unfortunately, as fast as it goes. 🏎 The rate of infusion is the yellowish green digital number on the right-hand side of the machine. I have no idea what the numbers all mean, but the higher this number, the faster the infusion. (Ask Marigan if you want details. 😊 Apparently, it involves math.) 

Welcome to the frozen world of neuropathy prevention. I wear mittens and socks/booties purchased on Amazon that have been frozen solid, in an effort to constrict the blood vessels in my hands and feet. By constricting the blood vessels, the hope is that the chemo will not invade these areas as much, and thereby avoid neuropathy. Neuropathy is defined as: "Damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness and pain in the affected area." It is the direct result of Taxotere, also known as Docetaxel. It may or may not resolve after chemo has finished.  Some people do something similar, called cold-capping, to avoid hair loss. However, you are not guaranteed a better result than a 50% chance of losing only 50% of your hair, which isn't exactly wonderful. Not only that, my oncologist discouraged this, as he has seen metastases (spreading of cancer to other body parts) on people's heads who have done this, but has never seen metastases spread to hands or feet. Being married to a neurologist meant that not icing was never really an option. He would never let me live it down if I developed neuropathy after making no attempts to prevent it! 😁 Docetaxel is given slowly for 15 minutes, then sped up for another 45, for a complete time of 60 minutes. There is no observation period required. 

Yes, I'm taking a selfie in the bathroom. (Oh, how the mighty have fallen. 😜) However, I have yet to succumb to the purchase of a selfie stick! 😊 Obviously, being doubly hydrated means that this little room and I are well-acquainted. You simply unplug your IV pump, take your excursion, go back to your cubicle, and plug it back in! 

The last chemo drug is given at top speed. (Check out the 999!) Carboplatin is the drug responsible for nausea and the change in taste buds. I will be very happy to have this one in my review mirror once I've completed three more rounds! When we arrived at my appointment, the nurse asked whether I'd taken my pre-chemo medications. I had remembered my Decadron, but had forgotten to take Ondansetron an hour prior to my appointment. Oops. Thankfully, because I receive the Carboplatin last, I was able to take the Ondansetron and immediately begin my Herceptin. Had circumstances been different, I may have been forced to wait. 😬

We usually park underground, and it's not cheap. I can't imagine what the people who come in multiple times a week do if they're on a fixed income. There is some limited residential parking in the area, but these patients are usually not capable of walking any real distance. I, on the other hand, am being chauffeured by my daughter, who believes it is her moral duty to ensure that I reach my step goal each day. 😑 Pro-tip, dispose of the ticket as soon as you have exited the parkade to ensure that you don't accidentally scan the wrong one and can't figure out why the gate arm isn't lifting. (Chemo brain is contagious? Who knew! 😁) Upon leaving today, there was a major traffic jam as someone was having difficulty at the exiting machine. Then they didn't realize that their vehicle was in reverse and almost creamed the car behind them. Marigan's response: "Well, looks like someone drove themself to chemo..." Sadly, she's probably right! 

Proof that I did NOT drive myself to chemo!  😄

On the days we have medical appointments, we always try to do something fun and "have an adventure." Today we popped into the Italian Center. Oh my, this is definitely on the list of my Happy Places. I get downright giddy in the bakery and the candy aisle can keep me mesmerized for longer than I care to admit! 

So, let's address that hulking elephant in the room, shall we? If I am comfortable spending time in the Italian Center, why am I not attending church or other in-person events? Well, see those white things covering our mouths and noses? Yeah, we mask. Everywhere. It's weird enough doing so among the general population, but being the only people doing so in the group of over 300 is downright unpleasant. I've masked since the beginning of the pandemic, with very few breaks as numbers have dipped. Now, however, I have been told in no uncertain terms that I am "immuno-comprised" and not taking extra precautions is foolhardy. (Please keep your opinion on masking to yourself. I have cancer, remember? You're not allowed to argue with me! 😁) Actually, what he said was, "Well, you don't have cancer; you had cancer, but you don't anymore, but you are immuno-suppressed due to the chemo." I may have sprung a leak. 😥 I don't have cancer anymore?!? Hallelujah! (But I'm still pulling the "cancer card" when it's for my benefit! 👼) Now, of course, that's not a guarantee, and chemo and radiation are just tools to ensure that he was speaking the truth, but "Squirrel!" I think I got a bit distracted...😏 While the Italian Center may have other patrons, at no time was I crowded, nor did I wait in line. It's actually pretty easy to avoid clusters of people...without looking like a crazy person-phobic individual! 😄 Am I scared of people? No, but I really, really want to be done chemo by December 5, currently booked as my last infusion. Even a cold could mean that I would need to delay treatment, provided it messed up my blood counts, so while I don't fear people, I'm not keen to get sick. On one of the Facebook breast cancer support groups I follow, a woman just posted how she had just tested positive for Covid and now her treatment would be delayed for 10 days. I would find that extremely difficult, as it would mean that I would be feeling lousy over Christmas. So this is why, despite feeling a longing to attend that translates to actual physical pain, I am currently not attending a facility where 300+ people raise their voices in song and sit rather close together. I'll be back! Honestly, I can hardly wait. Once I've completed my Docetaxel and Carboplatin infusions, life can return to some state of normalcy since Herceptin alone does not suppress the immune system. (It's not technically chemo, but a targeted hormone therapy.)

Okay, so this photo might be a bit misleading, as I didn't actually stay on the couch. The steroids are running strong and I spent about an hour in the garden, planting bulbs and discount perennials...which was a terrible idea as my arm is rather tender and threatening to turn a beautiful shade of aubergine! I'll just keep the bandage on, so no one notices. 😊 Knowing that my energy stores will deplete rather rapidly over the next 24-48 hours made me keen to complete my to-do list, which I did! And now it's time for bed. 

As always, I appreciate your prayers and support. For some reason, I was a bit apprehensive regarding today's infusion, almost like things have been going too well, and surely they can't continue like this...😏 But God is mighty and today went exceptionally well. I hope you enjoyed coming along with me to chemo! I can take it from here. You really don't wanna' join me over the next week or so. 🤢🤕🤧