Orientation is often for something fun - like college orientation or new job orientation. Chemo orientation is not fun. Well, let me clarify - it was useful, but I would prefer not needing to have chemo orientation. But such is life.
My hubby picked me up and we went to the appointment. It was understandably pretty quiet on the ride over there :-( I checked in and they gave me a wristband. Wristbands are also something usually associated with fun - you get one at the skating rink, at concerts, bars, and even WowZville. This is not a fun wristband :-( We were instructed to go to the 4th floor. As we were walking to the elevators there was someone in a wheelchair that was coughing up a storm. Since I had to go to the bathroom anyway I chose to do it then so we didnt have to be in the same elevator, whew. The elevator opens on the 4th floor and I see signs for Chemotherapy and a small waiting room. Sigh, it kindof hits home. It was a little confusing as there was a waiting area, but then there was an arrow that showed Chemotherapy was down the hall with some chairs there. I walked as far as I thought I could without being in the wrong place then decided to sit on the chairs in the hallway. As we were waiting I saw someone walking out with a headscarf. Sigh. Then she called my name, introduced herself and we walked in. We walked past several empty stations(booths?) into a conference room. She then set up a dvd with information on chemo. It went over everything very slowly and listed all of the potential side effects. I could see my hubby had his head in his hand for awhile. I have done a lot of online research in addition to both of my parents had chemo, so I was a little more informed. Still scary though, I just think I was better prepared.
Then she came back in and went over the 3 drugs I will get. She had printouts from a website I had already been to - chemocare.com a website that Scott Hamilton is associated with. Some of you may not know, but Ice Skating is my favorite sport. I did not get into it until I was an adult - but I did take lessons off and on for about 10 years. I still go occasionally. But I digress (it is so easy to start thinking about something else since almost everything is more fun than this). I did think it was a good sign that out of all the websites out there she chose to print the information from the website he is associated with.
I will be getting a total of 3 drugs. All chemo is scheduled for 3 weeks apart. The first 4 sessions will be with Adriamycin and Cyclophosamide. The second 4 sessions will be with Taxotere. This is commonly refereed to as ACT Chemotherapy and is common for Breast Cancer (I asked the nurse how long she has seen this kind of chemo and she said they have been using it for the 7 years she has worked there)
She also went over the side effects and some info about how each is administered.
In general, I get labs done the day before, then start with a review of my labs. Then I get situated and get the IV set up. I do not need a port-a-cath (yippee!!!) but I asked about the specific location of the vein and she said wherever it is good, but made some reference to the back of my hand or my forearm. As an aside - when I had surgery to remove a cyst from my wrist I had an IV on the back of my hand and I think in some ways that hurt more than the surgery site. So I really hope for another location, but I can tell you that my left side inside my elbow (the "normal" place they take blood) is bruised already from the injections for the MUGA scan and Bone Scan. Plus I'm sure I will have one more for the sentinel lymph node biopsy on Monday. So basically what I am saying is I look like a druggie right now, sigh. OK, back on track - there will be saline flushes in between (or before/after) not sure - I just know there will be saline flushes. She said overall it will take about 3-4 hours. I come in, they review my labs and if they are good they start mixing the drugs. They don't start mixing until I am there, labs reviewed and am ready to go.
Adriamycin - it is in 2 syringes and is red . . . yes red. I soooo want to google why it is red, but my "ignorance is bliss" self defense mechanism is in place right now regarding this. I will google it later to find out after I am done though. She said that one will be first and only takes about 15 minutes to receive. Side effects include urine that is reddish or pink for a day or two after injection (can you say fun??) and Hair Loss. I saw online someone refer to Adriamycin as the Red Devil . . . sounds like fun, huh??
Cyclophosamide - is given after the Adriamycin and takes about 30 minutes to infuse and comes in a bag (I think). Side effects include Hair Loss and Loss of Fertility. The latter is one I am still struggling with how to deal with. Well, I am struggling with Hair Loss too, but it will come back, fertility on the other hand may never come back. I asked the oncologist about things to help lessen the effect. She didnt know about those, but I have an appointment on Tuesday and will ask her again about some things that Dr. Google told me about.
Taxotere - the nurse said this one is a lot easier for patients after they have done the first two. This is given intravenously but you take steroids for 3 days before and 3 days after. I forgot if she said why, but chemocare.com says it is given to reduce the severity of fluid retention and allergic reactions. I believe the nurse also said it helps to increase your appetite.
We also talked about nausea and she said that they give me an anti nausea medicine to take 3x a day for the first 3 days, then give me a prescription for a backup in case that doesn't work. And she said if those didn't work then they have other ones. She flat out said that if I have nausea or vomiting then something is wrong because they can control that.
She also told me that I have to call or go to urgent care/emergency room if my temperature is over 100.4F, have a cold or flu symptoms, vomit that looks like coffee grounds (cause it means there is blood in there) or a host of other things. The temperature thing worries me a little since for me a "normal" temperature is often in the 99's and on the day of my appointment with the surgeon, oncologist, etc my temperature was 100.1F and as some of you know your temperature rises in the second half of your cycle . . . but loss of a period is also a common symptom so I'll just have to wait and see . . . I don't want to go to the emergency room/urgent care.
She also said that all of the chemo drugs will affect my white and red cell counts as well as platelets. There will be a lot of tests and maybe even some injections to help. The low point, or nadir of my counts will be dependent on the drugs, but for Adriamycin and Cyclophosphamide it is 10-14 days after infusion. What I read is that for the first week after you feel bad, the second week you are really immunosupressed and should stay away from likely germ sources and the third week you start to feel good again (only to start the next treatment).
Then she gave us a tour of the place so I could get an idea of what is going on. And then she also gave me a blanket that was donated from joyfulfoundation.org which was a nice gesture. The nurse seemed really nice, but nervous. It was late in the day on Friday so I'm sure she wanted to go home, but she was patient and answered all of my questions.
Still scared . . . but more educated now.
Oh, and the whole time my stomach was going crazy - I think the mystery drink I was given for the CT scan did not agree with me.
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