Very few people have asked me what the process of Chemotherapy is like. I found this surprising as I thought a few people might be curious. But in retrospect, I never asked that question to any cancer patient previously. When I went for my first Chemo treatment, which was the most frightening day of my life, I had absolutely no idea what to expect because I had never asked the question.
Recently, my Chemo Nurse explained that she has been an Oncology Nurse for 35 years! She has seen many changes in that time period. Nurse Deb was telling me how Chemotherapy used to require a 3 day hospital stay. Admission the day before, Chemotherapy on Day 2, and rest and releasing on Day 3. She felt that when Outpatient Chemotherapy Centers were established it was a very positive change because patients do better at home and away from hospital germs.
On my first day of Chemo, I was under the wrong impression that they would hook me up to an IV of one sack of drugs and sit me out in a hallway and in about an hour I would be done. Truly I was amazed when I discovered that the University of Michigan had at least 6 infusion areas just for adults, all staffed with Nurses and Aides and the ability to handle over 60 people at any given time.
When I was taken back to a private area set up like a hospital Emergency Room I was shocked! It had a large team of nurses in a semi-circle with a comfortable hospital version of a La-Z-Boy type chair, a television, a chair for your companion, and room for the Chemo Nurse to maneuver. Also, there are separate rooms equipped with beds. On three occasions, I have been lucky enough to have those, but they try to keep those areas for the very ill patients who are bedridden.
Every time a medical team member immediately offers you and your companion warm blankets, drinks, and bagels. I immediately felt the love. Warm blankets and bagels will do it every time!
Almost immediately, your specifically appointed Chemo Nurse comes to introduce themselves to you. They are specially trained Registered Nurses. These men and women are extremely impressive. I am thankful for their compassion, their knowledge, and their willingness to answer questions and teach you about your particular drugs. They really do put you at ease. Immediately I feel like they know what they are doing, and I can relax and be the patient. On my first visit, I was given almost undivided attention which really helped the anxiety.
Only when you arrive at the Chemotherapy area are the drugs ordered for you from Pharmacy. That is because the drugs that are administered are so expensive (mine have been over $9,000 each visit) and each “chemo cocktail” is made individually for you based on your drug, your weight, and body mass. Thus, there is always a wait once you arrive of approximately one-half hour.
The other thing that amazed me was how many other pre-Chemo drugs are given. For example, in my case I am given Ativan for nausea and nerves, steroids, anti-allergic medications, Pepcid, other anti-nausea drugs, all to prepare you for your “Chemo Cocktail.” These are all given intravenously through the port that was surgically implanted.
Speaking of ports, this is always an adventure. Sometimes they work perfectly, and other times they don’t! I have had to literally almost stand on my head forward and backward to get mine to work. It is comical as one time my wig fell off as I was leaning forward toward my feet with my arms reaching downward! Thankfully, nobody cares and everyone understands as we are all in the same situation. My positions have been hands over head, cough, hold your breath, bend over your back, lean to your left, lean to your right, and lean forward and reach. As it has been explained to me, the ports just clog up as after all they are implanted into your body. If they don’t work after all of the acrobatics and aerobics, an injection is given to loosen any matter that has clogged the port.
Another surprise was how long the entire process takes. From start to finish for my “Chemo Cocktail” and other drug I receive which is “Herceptin” it can take anywhere from 3 to 5 hours for the other drugs and infusion. Plus, before you begin your bloodwork which has been done an hour before Chemo, is checked to make sure Chemotherapy can proceed. Always, I ask to be given a copy of my blood test results as I believe it is important to know where my blood counts are.
When your specially formulated bags of drugs arrive from the Pharmacy, another nurse accompanies the Chemo Nurse into your room. You are instructed to read your arm band, state your name and date of birth. This checking your armband happens over and over again as so many precautions are taken so the wrong drugs are not administered. The additional nurse checks the statistics including your weight, height and then calculates that you have received the correct dosage. This is also confirmed by your Chemo Nurse. Then as an additional precaution, I always ask to see the name on the bag of the drug. No one minds and in fact, my Chemo Nurses have always been glad that I take an interest in what I am receiving.
When I first had the drug Taxol administered to me, extra precautions were taken as it often can cause an allergic reaction. My Chemo Nurse said that if I would begin to have a reaction, a team of medical professionals would descend on me in Code Blue fashion. But she said, “don’t worry” and I laughed! She went on to say that they had never lost a patient yet, but they are very careful about allergic reactions. This was reassuring, but of course I was grateful when I had no reaction.
While the infusions occur, you can read, sleep, work on your computer, or just look around. I prefer just look around. There is so much going on in the Chemo areas that I find it fascinating. Also, I really enjoy talking to other patients receiving Chemo. They are so inspirational, and I have learned so much from them. One thing I learned is that Taxol can cause you to lose your fingernails and toenails. A Stage IV Breast Cancer patient told me to soak my hands and feet in ice as this would prevent that occurrence as the ice would prevent the Taxol from going to your finger tips and toe tips. So everytime I go, I take my plastic containers with me that look like dishpans and the medical personnel fill them with ice. If I am having any tiredness from the drugs, the minute you put your hands and feet in the ice, you instantly wake up! So far so good. No adverse reactions and my nails are perfect!
Many times the drugs cannot be given simultaneously, which is true with the drugs I receive. This, of course, takes more time. But you just adjust. I am always in shock and awe when I see some cancer patients receiving over 12 bags of drugs! They are at the Infusion Center for hours on end! The amazing part of the whole process is I have never seen one impatient Chemo patient. They are always the role models for patience.
Once your infusions are getting close to being over, relief sets in. But then a little fear sets in as well because you wonder how you will be feeling. Once your Chemo Nurse releases you, the feeling of freedom sets in and gratitude that you have another Chemo session completed. Thankfully, I have always felt good immediately after infusion because the steroids and other meds they give you perk you up! The fatigue and side effects don’t usually set in for a couple of days. You become familiar with the pattern of your particular drugs.
Hopefully, if you are awaiting Chemotherapy, this information will help inform you and remove some of the fear. If you have a friend or family member going through Chemotherapy, please ask them questions about their Chemotherapy Infusion. They would be very grateful to have you listen to their story.