Scared. As the date approached, I was really dreading it. I felt really bad last time - really bad and wasn't sure I was ready to do it all over again. Also I was just starting to feel better so I was not prepared for feeling bad again. Plus I had a lot of things to take care of since I had been mostly out of commission for a couple of weeks. I did start to feel better, but right at that time it was my low immunity days when you are supposed to avoid exposure to germs and crowds of people.
For those of you lucky enough to not know how chemo works (or at least how my chemo works) I'll try and give you the cliff notes. After chemo infusion (yeah, that is what they call it - not sure if I can think of infused vodka in the same way ever again), your body goes through a recovery phase. The first week is when you feel the worst, the second week your immunity is at its lowest (which means your white blood cells are there lowest), and the last week you start to feel better (just in time for the next dose). My chemo is every 3 weeks. Some people have the chemo every 2 weeks - this is called "dose dense". I know that 2 weeks after my first round I was not ready for another infusion, so my hats go off to people who make it through dose dense treatment.
The day before chemo, you go in for bloodwork. For the first one I had White Blood Cells(WBC), Creatinine, Liver Function Panel (Alkaline phosphatase, bilirubin and ALT), Blood Urea Nitrogen and since I am of childbearing years a Pregnancy Test (HCG). Bloodwork for the second round was White Blood Cells, Total Bilirubin, Creatinine, and a Pregnancy Test - only for some reason they did the test 3 times?? When I went in before the first round they never gave me a urine collection cup. When the people in the chemo formulation lab got all my other results without the pregnancy test, they called me wanting me to come in again. I had literally just given a urine sample 2 days before that when I had the sentinel node biopsy and I asked if they could use those results. I think they ended up using some leftover blood from one of the other tests for the HCG test to spare me from coming in again, so now I am in the system to have both a blood and urine HCG?? Still not sure why there were 2 blood HCG results, but whatever I am not pregnant, that is for sure.[sorry for the tangent, just a sore spot with me] So the nurse and the Chemo Formulator both look at the results before it is mixed. I think people who have dose dense chemo have issues with their white blood cells getting too low (called neutropenia or being neutropenic) and they get a shot of Neulasta/Neupogen. From what I have read on the internet, these shots are painful so I am doing whatever I can to keep my white cells up (eat protein, fruits, veggies and go for a walk every day).
So before Round 2 of chemo (Adriamycin and Cyclophosphamide) I was scared, mainly because I felt so bad after the first round and was just starting to feel somewhat normal (not 100%, but a heck of a lot better than I was). So, even though I was scared I knew why I was there. I got my IV hooked up, had some saline flushed then I saw it - the two giant syringes of the "Red Devil" (Adriamycin). The nurse started them and as usual, I cannot watch. After a little while she noticed that my skin was turning red, so she went slower. Then she did a saline flush between the syringes, but it was still red. She set up more saline flush. I went to the bathroom right after - and my urine was pinkish, a known side effect for the first couple of days.
After the flush she started the cyclophosphamide drip. This one was easier and goes in about 30 minutes. Last time I had a runny nose and started sneezing almost right after the infusion started, another known side effect (some people get sinus pressure, others get runny noses or sneezing). I was surprised when about 10 min into it I didn't have any sinus issues. I was watching tv and talking to my hubby, but then when it was about halfway/two-thirds done I had a couple of sneezes. Hopefully next time I wont have any sneezes.
After that we were done, and I chugged a bottle of water. Despite just having a bunch of fluid pumped in me, I was thirsty, but more importantly I wanted to help flush the chemo out. One of the things I did differently this time was drink a lot of water the couple days before the infusion. This is supposed to help lessen the side effects like nausea and fatigue and to help prevent a Urinary tract infection(UTI). Since the chemo is excreted through your urine, it is important to stay hydrated and go frequently. I do not want a UTI so I have been drinking water and sports drinks like they are going out of style.
As I was going to bed I noticed my hands and feet were swollen from all the IV fluids. The next morning my left arm(the one that had the infusion) was swollen and you could see a darkish "halo" around my veins. The skin is also very sensitive to the touch. Fun times, thank you Adriamycin. It wasn't until a couple days later when I figured out what happened - my fingers were falling asleep during the infusion. When she set up the IV it felt weird - I don't know how to explain it, but it felt weird/different than last time. The nurse, Ann, even re-positioned the IV and tape - it felt better, but still weird. She also got a warm blanket for my arm. Several years ago I hit my "funny bone" really REALLY really hard - so hard that I lost feeling in my ring and pinky fingers for like 4-6 hours after. I periodically have those two fingers fall asleep on me, but when they fall asleep they don't get all tingly like normal, they just go numb. Being scared and hooked up to an IV I guess I dint realize what was happening, but she did have me move my fingers when it was getting all red along the vein - and I was able to move them. FYI - she set up the IV on the back of my hand, with the vein that is right below my ring finger. I guess with Adriamycin you have to start at the hand and work your way up the arm with each treatment and once you go up, you cant go back down - I guess that is one of the reasons it is called the Red Devil.
So I survived Chemo #2 . . . and afterwards the nurse even said that my face looked better - I guess she is trained to see the fear in peoples faces.
This chemo started at 1:30pm, so it was 4:30pm when we were done. After it was done I was hungry! A good sign. So I went home and ate - probably a little too much as I felt stuffed, but I was happy to be hungry. I still have a good appetite, but today is the last day of my routine steroidal anti-nausea meds so we'll see what happens to my appetite tomorrow. But for now I am eating anything that sounds appetizing, which I am still learning about since my tastes have totally changed. Bland food and carbs are what is the most appealing right now. I have been eating/craving a lot of rice, cereal, mac and cheese, potatoes(french fries and chips), pasta, sandwiches, bananas, cheese and milk. I have been making myself eat veggies, fruit(I am craving some, but make myself eat others), protein shakes and high protein greek yogurt. oh and dried fruit too. One of the side effects I haven't mentioned before is constipation. I also ate a lot of high fiber foods the day before chemo to help with that. And every time I eat after I try and eat something with fiber.
So far this round has been better (except for my left hand/wrist that is still a little sore), but I think mainly because I do not have a cold like last time, but hope that the things I did differently this time also helped.
Oh and this chemo does cause hair loss, which already happened . . . I am working on a post about that.
