Falling Down...Chemo Time Pt 2

Tips for Surviving the Chemo!

So what actually happened on the first day of chemo and how did I get thru it?  Well let me break it down.

So as you know, my regular oncology nurse was not on duty the day I started chemo and I ended up with a floater nurse.  Nice girl, but she did not have the experience that my regular assigned chemo nurse had.  I had no idea this would be an issue, but of course, nothing in my life has ever been simple.

After consulting with my oncologist and taking my prior history of childhood cancer, chemo and radiation treatment into account we decided on the treatment regimen Adriamycin & Cyclophosphamide or AC.  It was a twelve week regimen of chemo given every three weeks with a booster shot of Neulasta (a man made form of protein that stimulates the growth of white blood cells in your body, that help fight fight off infection) given a 24 hours after chemo. 

At this point I'd come to the realization that there was no tuning back & chemo was happening.  Weary & emotionally drained I sat back in the large comfy reycliner and submitted.  The moment I had dreaded was upon me & a sense of calm kicked in.  As the nurse called off my name and birthdate again and again to confirm who I was and what was about to go down, I took a deep breath and exhaled softly.  I thought about the last time I had overcome fear and focused on that moment.  I was floating off the Cayman Islands snorkeling above a semi dark reef.  The water was so warm and salty and so crystal clear you really didn't have to push hard to stay afloat.  As I stuck my head in the water a long large eel swiftly poked his head out of the reef.  On a normal day I would have panicked and filled my lungs with water.  But on this day I relaxed, smiled and marveled at the brilliance of the moment, and decided not to fear the unknown.  I swam closer and paused as I watched the eel glide easily thru the water and nonchalantly accept a handout from the guide, all the while the eels green color glistening in the bright sunshine. I channeled that same sense of calm into the room as I eased  back in my chair and did what was necessary to extend my life.

Let's move on, here are my tips for surviving chemotherapy pt 2:

Tip #4 - Ask for the most experience nurse to put your IV in if you don't already  have have a medical port surgicaly implanted to receive your chemotherapy infusion.  I did not want a port.  After going for a consultation, the side effects of having a port inserted into your chest in order to push the chemotherapy drug into my system, just did not sit well with me.  The doctor explained the side effects which included the possibility of infection, clots, collapsed lung, leaks and other horrible scenarios that I was not prepared for.  So I went with a IV, but if I had insisted on a experienced nurse, I believe the IV would have been inserted into my arm properly and I would not have suffered the ugly, chemo burn.  After that initial mishap, I had a port surgically implanted.  Although the port performed ok, my body never adjusted to it and a subsequet opportunistic infection caused a stay at the hospital & some serious life threatening drama. I'll cover that maddening experience in a later post  It's suffice to say, I was not the most well behaved patient.  

Just before the start of chemo I did insist on:

Tip #5 - Ice - It was so important.  I talk to many other cancer survivors who are either going thru chemo or who went thru it, and are suffering with numbness in their fingers and toes.  Ice is the only thing that kept me from getting this dreaded side effect Neuropahy:

Peripheral neuropathy is a set of symptoms caused by damage to the nerves that are away from the brain and spinal cord. These distant nerves are called peripheral nerves. They carry sensations (feelings) to the brain and control the movement.
— American Cancer Society

In order to give myself a chance at not developing this side effect, I insisted that the nurses give me ice and lots of it.  What did I do with the ice?  I put it in small cups and containers and stuffed my fingers into them, essentially freezing them.  I did the same thing with my toes. I had containers or bed pans (which are angled, which is useful) and had them filled with ice.  With my feet I was very careful to only cover my toes and nothing else.  Yes, it was awkward, hurt like hell (especially the first couple of minutes) but it was worth it.  I would sit with warm blankets covering me,  for at least 2 or more hours, carefully making sure my fingers and toes stayed covered with ice.  Once the crazy sensation of a dipping your fingers and toes in ice went away (via numbing from the cold) it was all about determination.  I toughed it thru and the reaped the benefits.  I have full sensation in my fingers and toes!  I type, text, dance and grasp everything without a problem.  This only works if you ask for and set up the ice before the chemo infusion starts.  There's no guarantee that it works all the time, but using this method worked for me, so I'm passing the tip along.

Tip #6 - Visit the Dentist - Visit your dentist before you start chemo.  You see chemo is a very toxic drug that will exploit any weakness your body already has or develops.  So if you want to keep your teeth in your mouth and avoid issues with sores or losing teeth see your dentist.  I am forever grateful to my dentist who took the time to fill cavity and prescribe a special toothpaste (Colgate with 5,000 units of fluoride called PreviDent. Delivers four times the fluoride of regular toothpaste and unsurpassed cavity prevention).  I brushed after every meal and especially before I went to bed and did not have a problem.  In addition my dentist recommended I rinse with the mouthwash Biotene, to keep my mouth from becoming dry and developing sores or ulcers.

I owe my smile to my dentist!  Thank goodness I went for a visit before I started chemo. Purshase a packet of toothbrushes & have a discussion about oral health. Biotene use for me was definitely beneficial. 

Tip #7 Water - Drink lots of water.  I drank 3 liters of water a day.  You need to drink lots of water to flush out the chemo and all of the accompanying drugs that go with it.  Stock up on it.  Ask others to buy it.  Ask the nurse for it.  Drink lots of it!

The body needs lots of water. I co- sign on the large amounts. Drink & then some more!!!

Tip #8 Be Organized - Speaking of accompanying drugs that go with chemo, its hard to keep track of what to take, how to take and when to take your medication when going thru a crisis.  My oncology nurse wrote down day by day on a sheet of paper what I was supposed to take and when.  I followed this schedule.  I made copies and as I went thru each session, mark off what day it was and what drugs had been taken.  It was one less thing for me to do. 

Some of what I took, when I took, how I took!  Ughhh. 

Tip #9 - Dress comfortable and bring a bag with you.  I would bring a change of clothing (for me it was shorts, T shirt, a loose cover up and warm colorful socks) and slip into the outfit before chemo started.  My to go bag included small towels, ginger chews (for nausea), water, snacks, tissue, magazines, pillow, shawl, scarf, electronics, anything I would need to get me thru the session.  Most times I just drank water, focused on my ice melt, snacked and dozed off and on.  Most chemo sessions last a couple of hours depending on the drugs your getting. 

My Miami people sent me these!  Ginger may help with nausea. 

Listen, tissues are a must when on chemo!  Your eyes & nose just leak, at the most awkward times!  Keep em with you. 

Tip #10 - Take your meds when your supposed to.  I learned from the smart and witty facilitator from my support group to never chase pain or nausea.  Take the medication even if your not feeling the symptoms.  Don't chase the pain, because once it starts, then you have to play catch up to get it under control.  Save yourself the agony, take the medication.   

Tip #11 - Talk with your oncologist immediately about the side effects that you may experience going thru chemo.  I made the mistake of talking to my family and suffering thru it.  The Nuelasta shot was nasty and I was as stiff as a board, unable to move, talk, sleep and eat comfortably from the effects of that shot for 5 - 7 days.  My doctor was not happy that I had suffered in silence, and announced in no uncertain terms, that I was not to attempt to do the silent suffering again. My meds were adjusted and I was given a antihistamine to help offset the effects from the shot. My doctor threatened to hospitalize me and dispense my chemo on a daily basis if my body didn't recover quicker and the side effects decrease on my next round of chemo.  Thank goodness the addition of a antihistamine after my Nuelasta shot worked and I felt so much better.  Lastly, in addition to all of the pain, I suffered an allergic reaction to the  chemo.  The skin on my legs, arms and belly broke out in hives, welts and was extremely itchy.  I used an over the counter cream to combat this reaction and recovered after about 2 weeks. 

Tip #12 - Clean your home, stock up on meals, get care for kids& pets . (Stay organized) Your body will be stripped of defenses going thru chemo.  Clean your home, get it organized.  Make it user friendly.  Cook and freeze meals.  Have snacks prepared and in the fridge.  Do your laundry, and put together favorite comfy outfits in easy to reach areas.  Gather your favorite books, chairs, pillows, throw blankets and have them easily at your disposal. Have friends or family make the meals and deliver or keep the menus nearby to order out.  Make sure to get help taking care of your children if needed to get them off to school, prepare meals and do homework.  Don't forget about the pets and have someone feed the fish, pet the cat and walk the dog.  Keep a binder close by of the drugs your on and your doctors contact info so that you or anyone can easily access this information. Arrange transportation to and from the chemo center. Make sure all your prescriptions are filled before you start chemo.

Boy am I battered. Between the dark circles under my eyes, the burned & bruised veins in my arm & my overall blah aura, I'm surprised I took this pic. But it documents exactly what it was, a battle.