A Year on Chemo

May 9 marked an entire year on IV chemo. Chemo - that thing I said I would never do again. Treatment so toxic the nurses hooking me up to it are required to wear special protective garments to avoid coming into contact with it, while I get it pumped directly into my bloodstream. Treatment that we hope is killing my cancer, but which also takes out my hair follicles, my bone marrow, and the cells in my mouth and digestive tract.

What does a typical week on chemo look like? Monday morning, I apply an anti-nausea patch to begin working on the anticipatory nausea I feel. Tuesday morning, I dress carefully. I need to wear something with a low enough neckline that they can access my port. On the second treatment of each cycle, I also have to avoid anything with long sleeves, so they can access my arm to apply the wearable injection I get. Before leaving for chemo, I take Ativan for nausea and anxiety, and apply a numbing cream to my port so that I don’t feel the giant needle stick when they access my port. Once I’m called back, I smear Vicks under my nose to block out the smell of the solution they use to clean my port site before accessing it. I pop a fresh piece of gum to block out the taste of the saline they use to flush my port and make sure it’s working correctly. I think my sensitivity to these smells and tastes is partly a Pavlovian response from my first time going through chemo in 2011; my body associates that smell and taste with the sickness I feel afterwards and just jumps straight to sickness. I have a handheld fan that helps to circulate the air and give me a cool breeze on my face. I no longer use the heated seats in the infusion center because my body has started associating the heat with feeling sick.

The nurse will draw several tubes of blood from my port and then start my bag of IV fluids. It’s hard for me to drink much in the days following chemo, so the bag of fluids really helps to restore what I’m missing. Once we’ve gotten good lab results, I can begin treatment. While there are many results they are interested in, the important one at this point is my neutrophils (a component of the white blood cells). If they’re too low, chemo is a no-go. I’ve only had that happen once; now I give myself shots every day for four days after getting chemo to stimulate my bone marrow into making more cells. We also check my liver enzymes, which will tell us how well the cancer is contained in my liver, and my hemoglobin. If my hemoglobin gets too low, I’ll need a blood transfusion. I’ve been hovering on the edge of the threshold, but so far have been able to avoid that.

Then I get my pre-treatment oral meds – Pepcid, Tylenol, and Benadryl, to prevent a reaction to the infusion – and a bag of an anti-nausea drug called Emend infused into my port over the course of 30 minutes. The Benadryl on top of the Ativan make me a little loopy, which is why I always have a driver to take me to chemo. Plus, the distraction of company helps so much!

Then it’s time for the main event. Two nurses come in with the bag of chemo covered in brown plastic so no light can damage it. They do a time-out and ask me my name and date of birth. They double-check the drug and the dosage with my chart and confirm with two sets of eyes. Then they start the chemo to run for the next 60 minutes. As the infusion goes in, I start to feel really full, bloated, and gross. We’ve reduced how much extra fluid they give me for dehydration in order to minimize this part of the experience, but it’s still one of the biggest struggles for me on chemo days. I’ve started wearing clothing that’s loose around my middle so I don’t have any extra pressure on my stomach.

After everything is done infusing, I repeat the process of Vicks, gum, fan so they can take out the needle accessing my port, and I get to go home, where I usually go straight to bed to sleep off what I can. I’m often wiped out the next day, too; other times the fatigue lasts even longer. And the nausea means I’m never quite sure what will sit well on my stomach. I try to do soups, which get more liquid into my system and are a way to get my veggies in when eating them raw isn’t possible. Smoothies are another way I try to get sneaky liquid into my diet. For some reason, water is the hardest beverage for me to get down, even though it’s my favorite. I’ve been on a quest to find something I can drink more than a sip of, although not much seems appealing. And I have to be careful what I eat and drink when I’m nauseated; often that food or beverage will become associated with the nausea and start making me sick.

Because of ALL this, I have to say that this has been the hardest year of my life. Every week, doing something my mind and body rail against. Every week, hours spent in the cancer center. Every week, flinging myself on God’s mercy and grace to get me through. I am so very thankful for each one of you who pray for me, who send me encouraging texts, cards or care packages, who remind me that I’m not alone in this fight, who give me the gift of your presence with me at my appointments. I couldn’t do this without support.

And yet a year is a long time. Support tapers off. It’s easy to forget things are still hard. Maybe even harder than they were at first, when you had more energy for the fight. So I mark this occasion. I honor myself for making it an entire year. It’s only by God’s grace. Though I said I would never do this again, here I am, doing it. “I can do all things through Christ who strengthens me.” I’m not killing it. I’m not a superstar. But I am getting up each day and facing another one in His strength. To God be the glory.