Week One of Chemotherapy
Well, week one of chemotherapy is behind me. In fact, I am writing this post on day three of week two, and am happy to report I’m not only still alive, but doing pretty darn well so far. A lot happened between October 21, 2020 (the day before round one of chemo) and today but thankfully all of it was good.
The day before chemotherapy I met with the Medical Oncologist and it was made clear that I would be getting twelve rounds of chemotherapy, once per week, for the next twelve weeks. He answered some more of my questions, and then I was on my way. They also accessed my port to draw blood and left in the needle so I wouldn’t have to get stabbed again the next day for chemo (highly recommend doing this if you’re getting blood drawn on a different day than chemo).
The First Round of Chemotherapy
The morning of chemo I was slightly nervous on the ride down, but more nervous as I got settled in my little nook in the infusion room for a long day of treatment. Round one would be a longer day than normal because they have to give a loading dose of Herceptin which takes three times as long as the usual dosing.
Because of COVID, the infusion room is divided up into spaces with curtains or small rooms where each patient is seated. You have a nurse assigned to you for the day, and it’s a lot like being on an airplane because every time a nurse passes your station, they ask if they can get you anything or checks on how you’re doing. They even come around with a food and drink cart part way through the day.
After getting settled in my nook for the day, the nurse checked my vitals and then sent down the orders to the pharmacy to make up my drugs. They start you off on IV fluids and since my port is already accessed, they simply hooked up the bag of fluids and left me to relax while my meds were made. Probably about twenty minutes later they came back with my pre-meds. Before getting my chemotherapy drugs I would be getting three different drugs to ward off an allergic reaction as well as an anti-nausea drug. First they gave me Benadryl (one pill) and Pepcid (through my IV), and then they gave me Dexamethasone (steroids) through my IV. Fun fact, if they push the steroids too fast, you’ll get a very warm and itchy sensation in your butt, so I got to experience that odd sensation for about a minute while they gave me the steroids.
Getting all of the pre-meds takes probably about ten minutes. Once they’re done giving you all of those, they give you the chemotherapy. Because chemotherapy drugs are dangerous, the nurses have to wear a special gown and gloves while handling the IV bag and they even have to get another nurse to check that they’re administering the right drug to the right person for the right amount of time, every time they administer it. Because this was my first time getting chemotherapy, the nurse had to stay with me for about fifteen minutes after starting the Taxol to make sure I didn’t have an allergic reaction.
I was fine when the nurse was giving me the pre-meds, although I could tell I was getting more nervous, but as she started the Taxol, I got pretty nervous. There was no going back now, and I was scared. What if I had an allergic reaction? What if I got violently ill because of the drug? I asked to recline in my chair, told her I was nervous, and she tried to calm me down by talking a lot, which didn’t really help, but she did her best. I finally got my nerves under control after about five minutes, and after another ten minutes, she said I was fine and that she’d be back to check on me in a bit. I would receive an hour of Taxol and spent most of that time in a fog mentally due to anxiety, and oscillated between watching The Office going to the bathroom to empty my bladder.
After the hour of Taxol, the machine starts beeping to let the nurse know that the meds are done and it’s time to do the next drug. I was a little less nervous for my second drug, Herceptin, because I knew the side effects of this one were minimal compared to Taxol. However, I was still going to be getting a loading dose and there is a risk of an allergic reaction to this drug too, so I was a little nervous when she started the IV. After the first ten minutes, though, she said I was OK, and left me to continue watching The Office for the remaining ninety minutes. Finally, the machine beeped again, and she came back to tell me that now I just had to wait another thirty minutes to make sure I didn’t have any other reactions, and then I could go home. I texted my mom to let her know and eagerly awaited the OK to go home.
I arrived at my appointment at 9:30 AM, and at 2:52 PM I was released from my first round of chemotherapy. I’d done it and I was so glad to be done but also anxious about what the side effects would be like in the upcoming days. After getting home, I decided that I would take a walk, and felt very energetic because of the steroids. I took the anti-nausea medication that they gave me that night before bed, and tossed and turned a lot throughout the night partially due to anxiety and partially due to the steroids that were coursing through my veins.
Day Two
The day after chemotherapy I had a three hour graduate class in the morning, and went for a walk in the afternoon. My face and chest were pretty warm and flushed due to the steroids, and I was taking my anti-nausea meds still to make sure I didn’t have any issues with my stomach. I went to bed still flushed from the steroids and feeling warm all over, but overall day two was fine. I was pretty nervous for day three and had a hard time falling asleep again.
Day Three
I woke up in the morning of day three assuming I would feel different because it was day three and that was when the worst was supposed to hit. Well, I woke up feeling basically the same as the day before except my mind was pretty foggy. I ended up getting up and doing an hour on the treadmill, although forced, and then by the afternoon, I decided to do a very short hike up Mount Uncanoonuc in Goffstown. I felt foggy still for most of the day, but the feeling faded as I got moving.
Day Four
Once again, facing the second of the “bad days” I woke up feeling slightly more tired than the day before, but still not terrible. As the day wore on, I woke up more, and was able to do another hour long workout in the afternoon. I was continuing to take anti-nausea meds twice a day and my stomach felt fine so I was eating normal, although much healthier than my usual diet, with lots and lots of water (3 liters a day at least).
Day Five Through Seven
Monday morning, day five, I woke up still feeling pretty foggy. For the past three days I definitely felt more lethargic in the morning, wanted to lay around in bed, or slept in late, but by day five I knew that the only thing that cleared my mind of the fogginess was activity. I reluctantly got out of bed and all of a sudden around noontime on Monday the fog lifted. I felt like myself again, I felt clear-headed and normal, and it was the best feeling in the world. I continued to feel more and more normal as Tuesday and Wednesday rolled around. You don’t realize how amazing a clear mind is until you don’t have it for a few days.
Final Thoughts on Week One
I went into the first week of chemotherapy having no idea how I would react to the drugs other than what the most common side effects were for other people. I completed week one feeling way better than I expected and although I know every week will be tougher and tougher, I am thankful that I’m done with one whole week of chemotherapy. I did my best to follow the recommendations of the doctors and I believe that’s what helped make the first week go so smoothly. Some advice that I would give to someone undergoing chemotherapy is as follows:
Drink a ton of water. The drugs dehydrate you, and you want to flush out the chemotherapy as well as all of the dead cells. Especially the first four days, drink at least 80 ounces of water per day.
Moisturize your face. My face feels especially dry on the first few days after chemotherapy. Even with a heavy moisturizer I feel like my face is still dry so don’t skimp on the moisturizer.
Eat smaller meals and often throughout the day. I consistently took my anti-nausea meds week one, and now on day three of week two, I haven’t taken any of the anti-nausea meds at all this round and haven’t needed them. But, for the first week, I found that I needed to eat smaller meals because if I ate too much it made my stomach upset.
Force yourself to get up and get moving throughout the day. Whenever I have a cold, I always feel worse when I don’t move around at all and it always takes longer to recover when I’m inactive. So even if you don’t feel like it, get up and take a shower, move around the house a bit, and if you feel up to it, do a short walk, even on the tough days (3 and 4).
Establish a routine once you know how you’re going to feel during chemo. Now that I know days 3 and 4 will be foggy, I will do little things throughout those days, but not expect a ton from myself. I know my mind is clearer the rest of the week so I plan on doing more of my normal activities on the days when I’m clear-headed (homework, hiking, bills, etc).
Ask questions of your doctor. Throughout the week, I came up with various questions that I typed into my phone to ask my PA when I saw them the day before round two of chemotherapy. This helped a lot because I wouldn’t have remembered a lot of them if I didn’t type them up.
Use apps to track how you’re feeling. I’m a data junky and the first thing I did when I started chemo was scour the app store on my phone for some way to track how I was feeling during chemo. I ended up finding an app called “Chemo Wave” that is extremely helpful (although based out of the west coast so the timestamps are off on the home screen). I can track how I’m feeling with lots of different options pre-programmed. Water consumption, medications, pretty much everything you’d want to keep track of to tell your doctor is in this app. I’m also using My Fitness Pal again to track my calories and water consumption as well as my Garmin watch and app to track fitness.
Don’t be afraid of losing your hair. I remember when I met with the Oncologist back in September and he said that I would lose my hair, I was beyond upset. I had spent five years finally growing out my hair, after having a pixie cut for over a decade, and the idea of having to go through the growing-out process again was like a nightmare to me. Now, I am completely OK with having to grow out my hair again. In fact, I completely shaved my head two days ago, and don’t even notice the difference unless I look at myself or feel a cool breeze blow over my freshly-shaved scalp. It’s kind of nice to know that I won’t have to watch my hair become thinner and thinner, and it’s like a fresh start, with zero roots - a new beginning - when my hair finally does grow back. It is, after all, just hair.
I’m so thankful every day that I am handling chemotherapy so well and that I have such an incredible support system at home and through my doctors. I wouldn’t ever wish to go through this again, but it has really opened my eyes to what’s really important, what a blessing the simple things in life are, and I have discovered joy in things that most take for granted (a clear mind, for one). I’m hoping that each week will go as smoothly as the first one and a half have gone, and will continue to write weekly about how things are going throughout chemotherapy.
