Day 40 | Exhausting Day: First AC Chemo Treatment

Well, today was supposed to be hard. It was supposed to be the first day of chemo. It was supposed to start at 8 and end at 12.

But. Seems cancer is a life lesson in anti-planning.

The Biposy

Instead, today started with a 5:45am wake up call. We got to the James at 6:30am to be prepped for a 7:45am procedure - a core biopsy of the one potentially malignant big lymph node under my collar bone. They said they were going to put me under because of the location of the node and the sensitivity of the area. They told me I was NPO 12 hours before the "surgery" - nothing by mouth. 

(More details on the "why" in the last blog - A Lesson in Supraclavicular Lymph Nodes)

I strongly preferenced to NOT be sedated. ....Mo' anesthesia, mo' problems.  They said, "we'll see" until the doctor got there. She said, if you think you can handle being awake, that's fine by me! 

The radiologist was amazing. She specialized in head and neck cancer scans. (Sounds very specialized to me). She talked to me through the whole procedure. 

She told me that she wanted to take three core samples. From three holes this time. She said, if this were definitely NOT cancer, she wouldn't take a sample. If this were definitely cancer, she would only take one sample. This was in the grey area - maybe cancer. Maybe not. 

It wasn't pleasant, but it was pretty fast. She gave me a big band aid and sent me to "recovery."

Moving to Med Onc.

So, we left recovery, and headed to chemo. <<Fun Day!>> 

They took my blood....or tried to take my blood and couldn't get a good vein. So, several sticks later, they had a temporary shunt inserted in my hand.* It hurt. More than just owww, it hurt a lot. But! They were getting a good return, so I said to use it. 

I met with the doctor. She said some scary stuff about the biopsy, but some good stuff too - the good stuff was mostly that it could be just nothing. The scary stuff involved a lot more treatment and changing the plan. If you pray, please pray for good news Friday. 

Starting Chemo

They moved me to a semi-private room to scan in all the drugs they'd put in me. Since it was my first time, they moved me to a private room. (Seemed only polite). 

Emend and Aloxi

They started the drip - two anti-nausea meds into the hurt-y vein. Emend and Aloxi: Emend was benign - no pain; Aloxi burned the vein as it travelled up my arm. It took about 2 hours to get them both injected. 

Then, they decided that the burn-y vein wasn't good for the Adriamycin, because it's a vesicant.** So, they started the process of looking for a vein again. And after a few false sticks, were able to find a really good one....oddly, on the side of my thumb. 

Adrimycin

So, after about three or four hours of being at the doctor, they started the actual chemo! The Adriamycin is hand inserted in big tubes like this: 

There were three tubes, each took about 15 minutes to be injected. They test periodically to ensure that the line has good return. It can burn when injected, but it didn't burn me. The Adriamycin can cause mouth sores because it attacks rapidly dividing cells...cancer...but also cells found in the mouth, throat, and GI track (also why there is hair loss). To combat mouth sores, they try to "freeze" the mouth cells by letting you eat a million popsicles while they inject you. I think I ate 10.

Side note: Adrimycin also makes you pee red for a few days after chemo. They tell you this about 45 times. They must receive a lot of worried calls about why it's red. 

I'll write later about the full side effects from Adriamycin. Today is more mechanical. 

Cyotan

The next drug dripped was Cyotan. It can cause headaches as it is dripped, which occured on me. It felt like dry nose syndrome that went up into my head. Mine occurred 45 minutes into an hour long drip. They said next time they'd drip slower to reduce the headache. 

They flushed me with saline and I was allowed to leave. The headache only lasted around 15 minutes after they stopped the drip.

Oh, and I went to the bathroom. My pee was red.*** I wanted to tell the nurses and ask if it was normal, but after such a long day, I didn't know if they'd enjoy my dry sense of humor.

Chemo Learnz Section

*Note on vein use in chemo: I have a really good vein up by my elbow. I mean, not trying to brag too much, but it's a really good freaking vein. It's my go-to blood-giving vein. HOWEVER, in chemo, they start with lower veins and move their way up. This is for two reasons:

1. Chemo is poison and it blows up your veins. Many veins feed into my one awesome vein....so, by blowing it up, they'd remove the possibility of using any of the lower veins.
2. Even if they could use the lower veins, there's a chance the chemo could "leak" out of the upper vein.

**What is a vesicant? It is a chemical that causes extensive tissue damage and blistering if it escapes from the vein. The nurse or doctor who gives a vesicant drug like Doxorubicin must be carefully trained. If it leaks beyond the vein, it could be caustic to the skin. 

***Note on bodily fluids after chemo: Did you know that after chemo you're toxic for 48 hours? You are supposed to use a separate bathroom from anyone in the house. You have to close the lid and flush twice. You separate your clothes, they should be washed in hot water by themselves. There is no deep kissing. No one should wipe your tears. Or sweat. If you sweat in bed, you should wash the sheets...separately, in hot water.