Just before 9:00 a.m. on the last Monday of September, Patrick and I showed up at the oncology clinic for my first chemo infusion. Shortly after checking in, I was escorted to the treatment area in the back. Vital signs were measured, and weight recorded.
Several comfy, leather recliners lined the walls of the large treatment space. I chose a seat on the interior wall to my left because from there I could look out the windows on both the adjoining, and the opposite wall. A nurse that I recognized from my recent five-day hospital stay was there to access my medi-port for the first time.
The port is situated about three inches below my left collar-bone. It looks something like a very large mosquito bite, and feels like a marble under my skin. Attached to the port is a catheter that threads into the superior vena cava. My surgeon explained that having a direct route to the heart saves the smaller veins from being damaged by the harsh chemo drugs. He warned me not to let anyone but a nurse trained in using the port to "go near it" because of its potential to introduce bacteria straight to the heart, which would then efficiently pump them everywhere.
My nurse that morning displayed with gloved hands the harpoon that she intended to punch through my skin and into my port in order to "access" it. It resembles a hefty paperclip, bent at a right angle. She disinfected the area around the port, then sprayed a smelly and not-so-numbing numbing agent over it, and then stabbed that thing right into me (gahhhhh!). It hurt! She arranged the attached catheter into a gentle turn, then covered both it and the needle with a clear, sticky dressing as big as the palm of my hand. I stared out a window during the stabbing and sticker-ing and mentally congratulated myself for not passing out. I'm kind of a wimp when it comes to most procedures, especially ones involving harpoons.
Blood was drawn and analyzed in the on-site lab. (Chemo spells disaster to blood cells, so a complete-blood-count precedes every treatment session to determine whether or not the patient is healthy enough to proceed.) Anti-nausea meds and a steroid were hung on the I.V. pole and slowly dripped into me via the port. The oncologist and the hematologist each filtered in and out several times, checking, asking, reassuring. Then the oncologist brought the MRI report in and announced, "There is nothing to concern us with this report. Nothing with balance, and no cancer there." What a relief! My wobbliness would diminished as I recovered from surgery.
Once the first round of meds emptied, others were hung. Oxaliplatin, the heavy-hitter, and Leucovorin, which is a "helper" to another drug went in over the next four hours. When those finished, the nurse unhooked me from the various bags of meds, and attached me to a portable chemo-pump instead. The pump would administer 5FU (fluorouracil) continuously over the next forty-six hours.
My new companion, the pump, was about the size of a paperback. It was tucked into a black polyester carrying case that I could sling over my shoulder like a really ugly purse. A long, thin hose snaked out of it and connected to the harpoon in my chest. It chattered quietly every couple of minutes. This pump would literally be attached to me via the harpoon in my port for the next two days whether I shopped, showered, or slept. I understood logically that the pump was a triumph of biomedical engineering, but emotionally it felt like a ball and chain.
Before letting us leave, the oncologist double-checked that I was in possession of her business card, and encouraged me to call "any time, with any question". She reviewed the potential side-effects I might experience, giving special attention to oxaliplatin. My impression of the lengthy exchange boiled down to this: Watch out for all things cold! Do not touch them! Do not eat them! Do not even think about drinking them! COLD is not your friend for now. Have a nice day.
I thanked the doctor, scheduled the next four treatments, and then we left. We stopped in to pray at the church across the street before finding a place for lunch. It was well past one o'clock.
Next stop: Wendy's drive-thru, where side-effects first materialized. The grilled chicken sandwich that I ordered (minus tomato) seemed--to my chemo-soaked system--to have the texture of styrofoam. It was as though I could feel each fiber of the chicken breast snapping and squeaking against my teeth as I bit through it. Just remembering it sends a shiver down my spine...chicken-flavored styrofoam...gack.
Next, I cautiously--so very cautiously--grasped the paper cup containing Patrick's ice-cold Diet Pepsi. I ordered none for myself because two minutes earlier at the drive-thru speaker I had imagined myself a Good and Compliant Patient. Being face-to-face with a delicious, frosty drink however, made me think that "Mostly Compliant" might just work. The touch-test revealed no problem and so despite my oncologist's earlier admonition, I took a tiny, little sip of the icy cold soda.
...and then my brain exploded. The End.
Ha! Not exactly. What really happened is that the roof of my mouth was blasted with an instant freeze-ray. In a split-second I felt awake. Every nerve ending seemed suddenly jolted to attention. I was "awake" as in, someone just plunged me into a vat of ice water, awake. I felt shockingly, bracingly AWAKE.
And since that went over so well, I took another sip.
Me: Wow, this is great!
Patrick: You are so weird.
Me: Gimme that drink.
Got home; got nauseous. Blarghhh...nausea...Zofran...tried to sleep with the chemo pump chattering away. My mind was drowsy, but my body was abuzz. Sleep didn't happen. I prayed for perseverance. One down. Eleven more to go. The treatments stretched out ahead of me like hurdles on a never-ending track. It seemed almost impossible that I'd ever reach the end of them.