Chemo Routines

I'm gearing up for my fourth chemo treatment and realise how much has changed since the first chemo in January. Nowadays I'm reasonably calm. I know the drill.

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My chemos were initially planned according to a three-week cycle. My cycle started with the first chemo on January 16, followed by 21 days of recovery before the next chemo. On paper this looked like a solid plan, but reality was somewhat different. One or two days before each treatment, I need to drive to one of the local laboratories for a blood test. Soon after, the results are published in OmaKanta, an online health portal. 

Later that day, usually around 16.00 or so, the nurse calls me to confirm the chemo date – or to postpone it. On several occasions my neutrophil levels have been too low for another round of chemo. Neutrophils are a type of white blood cells needed to fight infection. Neutrophil counts generally start to drop about a week after each round of chemotherapy. 

To prevent such delays in the treatment and stimulate the growth of white blood cells, doctors prescribe Ziextenzo, a subcutaneous injection that I need to administer myself 24 hours after each chemo treatment. Ziextenzo has nasty side effects:days later after the injection my legs refuse to move and it feels as if I have cracks in my hips, bones and spinal cord.


Preparation
The preparation for each chemo treatment starts with sorting out  my medication: Akynzo, Histec and Dexamethasone. The last one is a corticosteroid that prevents nausea and vomiting, common side effects of chemotherapy.  I need to take 2-3 tablets before and up until two days after the chemo. Contrary to what I expected, I haven't been nauseous or  thrown up. Mind you, we even bought extra bed sheets, a duvet and pillowcases, just in case. But the new bedding, silk printed with grey-blue flowers, makes a beautiful addition to our bedroom. It feels as if we sleep in a five-star hotel these days.

My preparations also have practical, non-medical components. As a result of the chemo, my energy levels will be low for a week or so. So, I cook dishes that are salty and easy to warm up, like chicken soup and pasta and store it in the freezer. My husband is supportive, he cleans the kitchen, feeds the cats and helps me as much as he can, but he can't cook.

I also cook plums; I buy laxative powder and plum juice for the first week after chemo. Constipation is a side effect of both chemo as well as pain medication and I wish someone had warned me about the pain and discomfort before I had my  first chemo.  But, bless the plums, I've now got it under control. Moreover, I temporarily change my electric toothbrush for a softer one and start using a different toothpaste and a mouth gel; the minute the chemo enters the veins, my mouth, teeth and throat become sore and dry, and my tongue starts to feel like leather.

Chemo day
On chemo days, my husband drops me off at the hospital. He no longer needs to sit beside my bed; I'm fine with a book and usually chat with the nurses and other patients. 

During the conversation my fellow chemo-goers and I share our gynaecological cancer diagnoses and treatment histories – but not our names. Without exception, they have all  come back for another round of chemotherapy after two, five, or even after 10 years of remission. They tell me about the eight-hour operation, their stomas or the implanted port below the collarbone needed to get medicine and spare the veins in the arm. They also tell me about the new metastasis in their lungs or bones.  As a newbie, I soak up their information. 

The chemo session takes approximately five hours. During the last fifteen minutes, when the nurse has connected the NaCl bag to flush my veins, I go to the mini kitchen for coffee, yoghurt and my dose of salt: a bag of chips. I've never seen or heard of hospitals that offer chips to their patients – but I like it! Munching a bag (don't worry, it's only 40 grams) of chips after the chemo treatment feels like a huge reward.

The Toll of Chemo
The effects of the chemo start the same day. In the evening I get a burning feeling in my stomach. It feels as if a little turbine, something with blades, pumps hot vinegar into my lower abdomen. My overactive imagination can literally  hear the engine's muffled roar.  It's a scary, uncomfortable feeling. Karin, one of my nurse friends, proposed that I should change my thinking. “Try to see it as the energetic positive sound that is needed to get you better,” she suggested.
 
At night time I often go from feeling freezing cold to feeling hot and sweaty. My fingers tingle and my skin feels dry.

Lastly, chemotherapy makes me extremely tired. For days I move from bed to couch and back. My arms and legs feel heavy. I can't concentrate or read a book, and I fall asleep during my favourite TV show. It usually takes four to seven days until I'm back on my feet again, although I must admit that my physical condition slowly gets worse with each successive treatment.

But chemotherapy has not only physical effects. My mood gets low, too. For a week I'm mentally hitting rock bottom. It is also then that the stories of my fellow chemo-goers start echoing in my mind. I have been diagnosed with stage four cancer (as far as I know there is no such thing as stage five) and I wonder how long it will take before I'm back on the ward with even more metastatic cancer or even worse, with incurable cancer.

Despite my gloomy thoughts, I do now recognize my negative thinking patterns. I can't stop them yet but know that within a week I will get excited about my own successfully baked bread or the view of cranes (in Japan symbol of happiness) in the fields again.