First Round of Chemo Cocktails

After meeting with the oncologists in Victoria, I went to the Nanaimo Cancer Clinic to meet with the GP Oncologist who I would be checking in with on a biweekly basis while going through chemo.  A nurse brought me in first to take my weight and blood pressure as a starting marker. The GPO then came in to talk to me about the treatment I would be going through. The first 4 cycles I would be treated with was a harsh combo of chemo drugs, Doxorubicin and Cyclophosphamide, which had side effects such as hair loss, nausea, fatigue, and mouth sores. The second half of my treatment I would be given a less harsh chemo drug called Paclitaxel with side effects including possible allergic reactions, bone and muscle pain, and neuropathy (tingling of the finger and toes). The GPO also checked my breast as it had recently swollen up due to a hematoma (a buildup of fluid which my body should reabsorb). She then checked the lymph nodes and was concerned as a couple felt enlarged. My arm had been bothering me over the last few days but I had just waived it off thinking it was just part of the healing process. I was set up with an ultrasound appointment before my chemo on Friday to see if there was any cause for concern.

The following day, I went in for my heart function test to determine whether my heart muscle was strong enough to handle the chemo drug I would be taking. A radioactive dye was injected into me to help highlight the heart cells and tissues and then it was time to sit and wait about 45 minutes to let the dye work through my system. Once I was brought in for the test, I had small pads put on my chest to detect my heart beat and then the machine was lowered to about an inch from my chest to get close enough for the images. The test took about an hour and they let me know that if I didn’t hear anything from the doctor, that my heart was good to go for chemo in a couple days.

Next up was bloodwork which I would need to get done the afternoon before treatment every 2 weeks to determine whether my blood counts were high enough to handle the next course of treatment. If the counts were too low, there was the possibility of treatment being delayed which was the last thing I wanted. I wanted to get this chemo done and over with as quickly as possible. Thankfully I am not afraid of needles, but I was starting to look like a bit of a pin cushion at this point and was over being poked so many times!

The night before my first chemo appointment, I could not sleep. I was excited in a way to get things moving and to kill whatever cancerous cells were left in my body, but I also felt nervous about how my body would react to the treatment. This wasn’t going to be an easy part of the journey. A couple hours prior to chemo, I went in for the ultrasound of my breast and lymph nodes that my GPO had ordered. The ultrasound tech seemed concerned about the fluid buildup in my breast but I let her know that I was told it was a hematoma and was normal to get after surgery. She spoke with the radiologist briefly and came back to let me know that my doctor would receive the results soon. All seemed well at that point so I left to head down to my first treatment in the cancer clinic.

One of the nurses brought my husband and I into one of the side rooms to give us a quick chemo teach session which included contact information in case I needed to get in touch with one of the nurses or oncologists, information on getting through chemo in terms of eating and staying active, and information on some of the side effects I may experience. There was a piece of paper I now needed to carry along with me at all times which had a list of the chemo drugs I was on in case I ended up in the emergency department at some point. Certain drugs could counteract with chemo so there were certain medications I may not be able to take, such as Ibuprofen. My body would also be at an increased risk of infection as my immune system would be compromised throughout treatment with my blood counts being so low.

I was then shown into the chemo room which had about 10 big recliner chairs in it for patients. I picked one of the chairs at the far side and got settled in. The nurse came over to give me my first dose of anti-nausea medication and then got me started on an IV of saline for a few minutes. Once I was a bit hydrated, I was ready for my first dose of my Doxorubicin aka the “Red Devil”. This stuff is the bad stuff. The nurses have to fully suit up while administering the chemo medication as it is highly toxic. It's bright red and is given by slowly injecting it into the IV port over a course of 20 minutes. While the drug was injected into my system, I had to suck on a popsicle and ice chips to help constrict the blood vessels in my mouth to help ward off getting mouth sores. The nurse advised me not to be alarmed when I went to the bathroom later on as the drug would turn my pee bright red for a few hours.

Once I was done with the Red Devil, I was started on a drip of the other chemo drug, Cyclophosphamide, which took about an hour and then I was free to go home. Other than feeling a bit foggy, I felt otherwise pretty good and thought, “Ha! I’ve got this!” That is until I got home. By the time we reached our house, I had to drag myself to the couch and lay down. I felt nauseous. I was tired. I couldn’t talk or move. I just felt all around awful. My husband tried to get me to eat but I couldn’t do anything. All I wanted to do was to sleep this bad stuff off and wake up feeling better.

The following day, I woke up feeling not a lot better but managed to get a small amount of food in me. I had to take a combination of three anti-nausea medications in the morning with food and then another pill at night to ward off the nausea for the first three days after treatment. I already hate taking pills, and the last thing I wanted to do when I was feeling sick was to try and take a bunch of pills. I would also be starting my Neupogen injections the following day for seven days in total to help get my white blood cell count back up. My husband would be learning how to do the injections so that he could give them to me at home since I would be getting them after every treatment cycle.

A couple of days after chemo, I got up early to for the MRI of my liver and abdomen. I was dreading being stuck in a machine for up to an hour as I had felt so awful the last two days. When we got to the hospital, I had an IV put in so that they could inject a dye into me for the MRI. The MRI took about 45 minutes and I had to lay there very still while they took images of my abdomen, all the while the machine buzzing and moving around me. Once finished, the technician told me the results could take a few days. I wanted so badly to know right then what the scan showed and if everything was okay.

Two days later, I had a bit of a set back. My lumpectomy site opened up and started oozing out. I dropped everything I was doing and went to the urgent care centre immediately. The doctor on-call looked at it and let me know that it was infected and he would be putting me on a course of antibiotics. I was so bummed. I thought the site was almost healed, but now instead I had a big whole where the lump had been taken out. I would need to get set up with Home and Community Care to clean, pack and dress the wound until it was healed. The site needed to heal from the inside out so that the skin didn’t grow over the top with an empty pocket inside as bacteria could continue to grow inside and become infected again.

My family doctor needed to set up a referral to home and community care so while I was there, I asked if anything had come back from the ultrasound a few days before. She left the room to check and when she returned I knew the news wasn’t good. The breast was clear; however, two lymph nodes were identified as being enlarged, suspicious, and possibly cancerous. Although I knew there was the possibility of more lymph nodes being affected, it still hit me hard and was disheartening and felt like another step back. I had hoped that everything cancerous was removed, but it just confirmed to me that I still had a fight ahead of me.

Feeling a bit defeated and having a bit of a pity party the next day, I got a call from the oncologist at the Cancer Agency with some good news, the MRI came back all clear. The hugest weight felt like it was lifted off my shoulders and I cried tears of joy. One scan was checked off, now one more to go! I just hoped for the same good news with the bone scan. A few days later, I showed up to the hospital to have another radioactive dye injected into me and then returned four hours later once it had circulated through my system. The bone scan itself took about an hour with images taken of each section of my body from head to toe. The hardest part was waiting for the results. Test anxiety rears its head and gets the best of you at these times. It’s all I could think about and I hoped that everything would be okay but kept reminding myself too that I didn’t have control of what came back, whether it was positive or negative. When I seen the GPO the following week, I asked for the results and she let me know that it all came back clear as well. The last bit of weight was lifted off my shoulders and I finally felt like I could tackle this thing head on.

One down, 7 more to go!