Chemo Day

18^th February 2014

Yesterday, Matt and I took our little guy out for a movie (Lego Movie For The Win!) and Japanese food, making a bit of a day of it because we knew that my chemotherapy would begin today. I feel a little like a lamb to the slaughter, honestly. L, my medical oncologist, has warned me that it'll be a rough few months, as the regimen I'll be on is known to have many and unpleasant side-effects.

Today, my friend K has taken Little Dude out for the day with her own son. They'll be having fun at a scavenger hunt and the beach, so that I don't have to worry and Matt can come with me to the ward for my first treatment. I feel nervous, so it helps that she's offered.

As I enter the ward, I'm hit by a scent of bleach, antiseptic and medicine. Chemotherapy patients often have suppressed immune systems, so everything needs to be kept absolutely pristine. In the toilet there's a poster, informing us that chemo patients should sit to urinate, close the toilet lid before flushing twice and so on, in order to reduce the danger we potentially pose to others. A booklet I'm given explains that if I vomit copiously, whatever I've contaminated needs to be double-bagged and removed by the Council's Environmental Services division. Yay! This sounds like a whole lot of fun!

In my more wicked moments, I wonder whether throwing up strategically – perhaps in the office of politicians I disagree with, for instance - could cause an evacuation of places I dislike. Then the moment passes, and I behave myself again.

After a short stay in the waiting area, we're taken into a private room where F, a curly-haired and smiley chemo nurse, takes us through what we can expect for the next few months. I'll be having treatment every three weeks, with a set of blood tests the day before each session to make sure my blood is healthy enough to withstand the onslaught. The first three treatments will be “FEC” - a combination of Flourouracil, Epirubicin and Cyclophosphamide – and will be given by “push”, where a nurse will use syringes to inject the drugs into my bloodstream via a cannula in my vein. After that, my final three treatments will be with a drug called docetaxel, which has a reputation for being less nauseating than FEC, but more damaging to the immune system. When I start docetaxel, I'll also begin treatment with trastuzumab (Herceptin, to give it its more common proprietary name), a monoclonal antibody, which I'll need every three weeks for a year as my particular cancer is HER2+ and the treatment is aimed at reducing the probability of it returning or spreading.

Mmm, tasty toxins!

F explains the side-effects that I can expect, which range from nausea and immunosuppression, to nerve and vein damage. I'm also going to go bald.  I twist locks of my long hair around my fingers as she talks, very aware that I'll soon be unable to do so. While I'm a little upset about the coming indignity, it doesn't seem very important in the greater scheme of things.

I sign a consent form and we finally go through to the ward itself. Reclining chairs and tables are placed around the room, along with water coolers, IV stands, magazine racks and the other trappings you'd expect to see in a hospital ward. Tired-looking patients sit in some of the chairs, many of them wearing headscarves or just displaying their bald heads to the world, and the nurses mill around them, checking IVs, blood pressures and temperatures as well as administering the medication.

Shortly after I arrive in the ward, a patient is removed on a trolley, hooked up to an oxygen tank. Apparently she's had a reaction to her chemotherapy. I feel for her, as well as being rather selfishly worried that the same thing will happen to me.

I get weighed and take a seat by the window, in the cool winter sunshine. After a few attempts, F manages to get a cannula into a vein in my left arm, and starts the saline drip, then disappears to the pharmacy to have my chemo meds made up. I look at Matt, nervously, and take a deep breath. I've already survived surgery, but I'm more nervous about this treatment. It seems somehow more intrusive to have my very bloodstream contaminated with these chemicals, but I know from my research that it's also one of the best treatments for my cancer, so I determine to grit my teeth and bear it. The benzodiazapene relaxant I'm given probably helps me to stay calm, and combined with the anti-emetics makes me a little sleepy.

Here goes nuthin'!

F returns with a tray of huge syringes, each marked with my name, patient number and the name of the drug it contains. The epirubicin is bright orange – the exact colour of Tizer, a viciously-bright drink I remember from my childhood. Later, I'll find that I can no longer look at anything of that colour without feeling nauseated. There are warnings all over the syringes – including one that says the medicine is a corrosive substance and must be kept out of contact with the skin.

Yay me! This sounds like fun...

As F inserts the first syringe into my cannula and starts to push the viscous substance into my vein, I grip Matt's hand and close my eyes. The whole process takes about thirty minutes and during that time, I experience some pretty wild sensations. When the cyclophosphamide push begins, I can taste it in my mouth – a strong, unpleasant chemical taste, hardly surprising since the stuff was developed from mustard gas. Shortly afterwards, my nose starts to run uncontrollably, as do my eyes. Each of the three drugs brings its own immediate effects.

Eventually, I'm done. F leaves me on the saline drip for a while afterwards, in order to ensure I'm not having any other immediate reactions, before removing my cannula and setting me free.

Matt and I decide to go to the Maggie's Centre in the hospital grounds, as it will be a while until G can arrive to drive us home. I have a dreadful headache so we make ourselves a cup of tea and sit quietly in the beautiful building. As I put the mug to my lips, I nearly spit out the tea.

“Matt, I think this cup's had something strange in it.”

“What do you mean?”

“Maybe it's not been washed properly. It tastes of cumin and coriander, really strongly.”

Matt empties out the cup, washes it, and makes me another tea. I thank him, raise the hot drink to my mouth, and take a sip.

It still tastes of cumin and coriander.

Matt just looks at me. Then he takes the mug, takes a swig of tea, and looks at me again, as if I'm completely crazy.

“The tea's fine. It's you.”

Honestly, it really, really tastes of cumin and coriander! I can't believe that he can't taste it, until I take a bite of the biscuit he brought me to eat with the drink.

The biscuit....tastes of cumin and coriander.

Oh. Great. He's right.  It's me.

This comes to be a bit of a theme between us. I find that random foods over the next few months taste of Indian spices, whereas other foods taste of nothing at all, or just have disgusting flavours to me. Chemotherapy seriously messes with your senses.

I give up on the tea, not in the mood for accidental chai. G arrives to drive us home, where I've arranged to have friends come over to take my mind off things, and take the hair off my head before the chemo does.