Chemo Update
Today is my 7th round of chemo (out of 8). I’m really nervous about it because my last infusion did not go well. (You can read more about my specific treatment plan here)
Rounds 1 - 4: Adriamycin and Cyclophosphamide
These drugs kill cancer cells by:
damaging cancer cell DNA
interfering with cancer cell growth
preventing cancer cells from reproducing
Adriamycin is so caustic that it has to be administered manually by a nurse in a low-key hazmat suit (only a slight exaggeration). If you were to put a drop on your skin you would instantly get a chemical burn.
Rounds 5 - 8: Taxol
This drug can block cancer cells from repairing themselves and making new cells
Before I started Taxol my Medical Oncologist reviewed potential side effects with me. The most common are bone pain and damaged nails. And we aren’t talking hangnails -- your nails can lift and fall off. To prevent that you have to sit with your hands and feet on ice. For the entire infusion. Which lasts 3 hours. (The ice pulls the blood circulation away from the nail bed and into pads of the fingers and toes)
One final caution was that some people have hypersensitivity reactions to Taxol. Reactions can range from hives to anaphylaxis. To prevent these reactions you receive Benadryl via IV as a ‘pre-med.’ Now, there’s an alternative drug that’s just as effective and causes no reactions at all. But you can’t skip Taxol start with that drug, because insurance companies won’t pay for it until you have a reaction. It’s readily available, it just happens to be very expensive.
Ice, Ice, Baby
All things considered my first Taxol infusion went well. I didn’t have any reactions beyond feeling a little drowsy from the Benadryl and cold af from the ice. I started to experience bone pain 3 days later. It was manageable the first day, but constant. Throbbing pain shifted from my hip to my knee to my back and then to my hip again. The pain intensified over the next few days but ultimately subsided.
My second round of Taxol was kind of a dumpster fire.
Before each infusion I have blood drawn (typically a CBC and blood chemistry panel, plus extra draws at various intervals for a research study I volunteered for). My doctor and the nurses at the infusion center review my levels to make sure that they’re within a range where it’s safe for me to receive chemo. During my last blood draw things went downhill fast.
The first vial was no biggie. But the second was problematic. The nurse couldn’t get the blood she needed and she described how poorly it was going in great detail. I am fine around needles but when things don’t go smoothly and I hear about it I don’t do well. I get lightheaded. Fuzzy. Hot. And then I feel like I might pass out. The nurse called in a colleague to help but then there were 2 people wondering aloud about my blood and veins. I asked to take my mask down for a moment to take some deep breaths (please, just get the blood you need and stop talking!). Then I mustered enough energy to tell them I was starting to feel dizzy (I was trying to will them to get the blood they needed). Finally I told them I thought I was going to pass out.
In a matter of moments there were 4 more nurses in the 4x4 room. I could hear a soft alarm somewhere in the background and knew it was for me. Security showed up. A stretcher appeared at the door. They took my blood pressure (it was 99/59) and a nurse who had just run in must have been feeling for my pulse because she ran back to the door and yelled into the hallway, “PULSE IS IMPALPABLE! PULSE IS IMPALPABLE!” Another nurse told me she was starting an IV to give me fluids (there wasn’t enough space in the tiny room for an IV stand so she held the bag above her head in order for it to drip properly) while another gave me ice packs for my neck and head. Someone held smelling salts to my nose. The MOD (Medical Officer of the Day, an oncologist) came in.
This was the moment when I finally got scared. I was so afraid that if I did pass out, if I closed my eyes, that I might not open them again. Was my heart giving out? Would I see my kids again? I fought it so hard. Eventually things came back into focus. I stopped sweating and started responding to the questions that were being asked of me. I bounced back enough to avoid the stretcher but not enough to walk out of the room. I was put in a wheelchair and pushed down a few hallways to an on site Symptomatic Care Clinic. I had an EKG, did some neurological tests, and finished my IV. Physically I was fine but emotionally I was spent. I just wanted to get through the infusion and get home. But the fun was just getting started.
Several hours later I was cleared to receive my infusion. Nine-minutes in my chest felt like it was on fire and being pushed from the inside out. I started to cough uncontrollably. The nurse stopped the infusion. Cue the MOD and more nurses hovering at the door. The pain and coughing stopped. It wasn’t up to me but I told my nurse I wanted to keep going. I couldn’t stand the idea of prolonging my treatment a single day more.
The doctor cleared me to continue, which meant I had to start the infusion over including the premeds. I essentially got a double dose of IV Benadryl and felt so wonky. The nurse did some calculations and started the Taxol drip at 25% of the original rate. Each 15 minutes the drip rate increased by 25%. I finished the infusion.
But this time around the ensuing bone pain was exponentially worse. I recorded a memo on my phone in the middle of the night on the first day I felt pain:
“My hips are in a vise. There’s an ice pick in my right femur. Someone has a wedged screwdriver under my kneecap. Lightning is stuck in my tibias. My ribs are being whittled away. ”
I couldn’t sleep. My legs felt like they might give out underneath me when I walked. And to add insult to injury I developed neuropathy in my ring and pinky fingers on both hands. They felt numb; like they had fallen asleep. And they itched so much.
The silver lining (?) is that eventually the pain abated. And my doctor called to tell me that:
I would only have a finger prick (for a CBC) at my last 2 infusions
I was going to switch to the chemo drug with no risk of hypersensitivity reactions!
Little victories.
Wish me luck today! (I hope I don’t need it)
*Every person I came in contact with did absolutely everything they should and could have to make sure I was okay. They were remarkably professional and compassionate.*
