The Cancer Journals: Make My Chemo Light

The Beginning...

I try to look nonchalant about being here, like a teenager at her first school dance. I'm cool. I'm a registered nurse after all. I know this stuff. Except this is chemotherapy and this time I'm the patient. Nothing in my life experience has prepared me for this. I am simply terrified.

Every cancer patient I ever transferred back from chemo reels through my mind on a continuous loop. So many, who were so sick, and didn't make it. I often saw them at the end of their journeys.

I want to run.

As if in running I could out run the cancer as well as my fear. It takes a real physical act of will just to walk into the Cancer Day Ward and admit I am who I am, and submit to treatment.

"You're the boss," my oncologist tells me weeks prior while discussing treatment options. "It's your call."

I have previously submitted to having a central line, a flexible plastic catheter, inserted under local anesthetic into my chest. It has two external intravenous ports for the delivery of chemotherapy. I call it my “badge of authenticity”. It was a traumatic experience, but I am grateful for it now, as the nurses don't have to “hot pack” my arm in order to find a good vein for the chemotherapy to run through.

The Chemo...

I ask for a lounge chair for my four-hour treatment, as claiming a bed would mean I actually was sick. Once I'm duly identified by the nursing staff, my treatment begins. I am hooked via my central catheter to the medications we hope will destroy any remaining cancer cells: IV calcium & magnesium; flush the lines; IV steroids & anti-nausea meds; flush the lines; Oxaliplatin and Leucovorin; flush the line; more IV calcium and magnesium; flush the lines. Fluorouracil will go home with me in a infusion pump stored in a fanny pack and attached to my central line. It will run over the next 46 hours and then I will detach it and flush the line at home.

I've asked for a chair near the washroom, as retaining fluids has never been my strong suit. During today's treatment I have lost counts of my trips to the washroom. I am generating some amusement with my 15 minute intervals of unplugging the large medication pump, and wheeling it's mechanical girth across the room. I smile in embarrassment at everyone. They smile back kindly. We are all achingly human here.

I have brought along personal items to ease me through the experience: a sweater and socks for the chills; a nutrition bar for munchies; slippers for comfort; magazines, my iPod and a book for distraction. I look for all of the world as if I'm ready for a cozy night at home, but focusing is difficult. Initially I am engaged in listening to the conversations around me, but eventually the sheer amount of pain in the room is overwhelming and I retreat to my iPod. I feel selfish.

The side effects of chemo vary with the drugs given and the individual patient. While my chemo has been infusing, I have morphed from a mild high caused by the steroids, to waves of fatigue and mild nausea. In two frightening episodes a few weeks apart, I feel my airway close and hear stridor noises coming from my own lips. It's a side effect of one of my chemo medications, responded to quickly by the nursing staff. On the bright side, I still have hair ....rather less and more brittle...but hair nevertheless ! A “Trump Comb-Over” and a cap are sufficient cover.

During treatment...

I diligently watch the nursing staff, like an airplane passenger watches the cabin crew. Their moods, efficiency and attention to detail has become paramount to me. I wonder whose working a double shift; who’s had a quarrel at home; if the treatment team are working 'short' today; how seasoned my assigned nurse is at working with Chemo. A calm, competent nurse goes a long way towards making the unbearable, bearable.

Finally, we're done for this first session. My niece comes to fetch me. I am now really a cancer patient. This has been like a baptism of sorts. I feel tremulous inside; weak; fatigued; queasy.................fragile as crystal.

I realize I'm shuffling as I hold onto my niece's arm. Even though its 25 degrees C outside, I am wearing gloves, a jacket and a scarf to avoid chill winds and cold surfaces, that may result in muscle spasms from one of the chemo agents. I don't feel the warmth of the sun.

"You still have hair," friends exclaim. "You must be doing the chemo light, huh ?"