One Round Down (15 to go)

Today was the big day. First Round of Chemo Day. And boy was it a busy one. After dropping the dog off at doggy daycare, and picking up some breakfast delights at my new neighborhood co-op (where I received a frowny look for choosing to use a disposable plastic straw), my friends Chelsea and Kelly drove me to MN Oncology at Abbott for Chemo Day 1/16.

First on the schedule was getting all set up for a Clinical Trial / Research Study I’m participating in about reproductive and sexual health during cancer. I met with the research scientist, signed some documents, and took the first survey. This study is around quality of care, so no special medicines, just surveys (and likely enhanced doctor:patient conversations) over the course of the next 5 years.

Then, one of my Oncologist’s Physician Assistants, Lisa Hanson (GO BLUE!) conducted my bi-weekly Exam that gives me the “all clear” to get chemo. I’ll meet with either my Oncologist, Dr Tsai, or her team every other treatment to ensure my vitals are strong and over time they will also be validating that my tumor is shrinking. Lisa confirmed my body is ready to go for chemo, and off I went to the treatment room.

I think there are a lot of unwritten rules in the Chemo Treatment room. We probably broke all of them. But our goal today was to make Chemo fun, so we don’t care. While we were waiting between each step of the process we played some Giant Uno, did a mad-lib (sort of, I fell asleep in the middle, oops!) and had lots of snacks and beverages. We packed for a 3 day trip, but we certainly weren’t bored (at least I wasn’t bored, I can’t speak for Chelsea and Kelly while I was indulging in a few bird naps along the way).

Editors note 1: Arianna has a unique classification of naps, because she really loves naps. For future reference: A bird nap is <30 mins, a cat nap is 30-60 mins, and a dog nap is 60+ mins – generally in the 90-120 min range. Over 2 hours is no longer a nap. That’s a sleep.

Editors note 2: this blog doesn’t have an editor, as made obvious by the grammatical mistakes rife throughout this blog. In this case, and editors note is just a way for Arianna to speak in 3rd person. Its odd, she knows.

Anyway, back to chemo day … before the actual chemo drugs can be administered, there are a few critical steps that always have to happen:

• The nurse needs to get access to your Port – this is done using a butterfly clip & needle device where the needle is poked in to the port, and then the butterfly clip is used to secure it. I was afraid this would hurt, so much so that I had the PA write me a prescription for numbing cream for next week. I was freaking out for nothing. It barely pricked, and once it was in, it didn’t hurt at all (assuming I kept my bra strap away from the port site – which has been a continuing challenge in all facets of life since having the port implanted last Thursday)
• Once the port access is made, the nurse flushes a bunch of saline into the port, and then draws blood to validate white blood cell counts and organ function are where they need to be to “deal” with the chemo, and in my case, an extra few vials for the clinical trial I’m participating in.
• Then its time for “pre-treatments” – because all chemo drugs are vile stuff – and especially some of the ones I’m taking, there are 4 drugs I will always get before the chemo is administered, and they’re given in 20 minute IV doses – making for a one hour treatment infusion:
  1. Kytril, an anti-nausea drug that helps with the IMMEDIATE nausea effects of chemo (there are other drugs I have in pill-form for post-chemo nausea). This drug is good for keeping nausea at bay, but causes headaches and constipation – weee!
  2. Dexamethasone, a steroid that helps with nausea but causes anxiety, sleeplessness (note the time-stamp on this post) and moodiness (yay roid-rage!)
  3. Benadryl & Pepcid, anti-histamine drugs that help combat potential allergic reactions to the chemo drugs (more on this in a bit)

Once the pre-treatments are done, it’s finally time for the Star of the Show – CHEMO!  This happens in two acts, since my first 12 week course is a combo of two chemo drugs: Paclitaxel (aka Taxol) & Carboplatin. The Taxol goes first, and comes with a real party platter of side-effects. Additionally, Taxol is known to cause allergic reactions in some recipients (see the Benadryl and Pepcid above). If an allergic reaction to Taxol occurs, it will happen within 10 minutes of the IV being administered. My chemo nurse, Erin, got the bag set up, and then prepped the “in case of emergency extra steroids and anti-histamines” on my IV cart in case I reacted poorly. She also left me with a little metal bell and told us that if I started feeling pain in my back,  got flushed in the face, or had trouble breathing, I should immediately ring the bell and all the nurses would come to fix the problem. She then walked off to her next patient, and I leaned back for another bird nap.

About 3 minutes later (as validated after the fact by one of the nurses) I got REALLY nauseous, and in the 2 seconds it took me to sit up, I went from nauseous to feeling like all the blood was rushing to my head, leaving my lungs without any oxygen to breathe (Kelly and Chelsea confirmed my face got REALLY red).  I reached for the bell giving it a slight jingle before Kelly got hold and rattled the hell out of it. Within 10 seconds, every chemo nurse in the joint was at my station and within 20 seconds the Taxol was shut off, I had an oxygen monitor on, a blood pressure cuff, direction on how to breathe despite the feeling like I couldn’t (with backup oxygen in case I needed it) and the reserve steroids and anti-histamines were pushed directly into my port.

And then I almost lost my shit. I had emotionally prepared for nausea, fatigue, pain and a whole host of other problems, but I didn’t think I would be allergic to the drug I needed to save me. So I assumed this was it, I wouldn’t be able to take more Taxol and things would be BAD. So I started to cry, which did NOT make the breathing trouble any easier. Fortunately, my medical knowledge is crap, and my allergic reaction doesn’t mean I can’t take Taxol. Today it meant that once my body was back in working order, they could restart the Taxol, but at a 30% slower rate. Next week I take 5 steroid pills 12 hours before chemo, and another 5 pills 6 hours before chemo to prep my body, and then I get a CRAP TON of anti-histamines and steroids as part of the IV pre-treatment. So hopefully today’s allergic reaction was a one-time deal – cause it was NOT fun for anyone (and super props to Kelly and Chelsea for being calm, and emotional respectively, their yin-yang of reactions made me know it would be okay, but also that it was okay to lose my shit temporarily in the middle of the madness. They are AWESOME).

The second chemo drug of the day, Carboplatin, was a breeze. No reactions, and it was injected at 100% speed – making it a super-quick-by-comparison 30 minute drip. And just like that (6 hours later) I was done with my first chemo treatment. On advice from a friend to commemorate each chemo round’s completion, I got my first of 16 crystal stones for my new custom Made by Bailey chemo necklace, my first (of 16) jean jacket patch from Chelsea, and my first “chemo fairy” gift (from my mom, the OG tooth fairy, and newly self-appointed chemo fairy). Here’s hoping to a warm January so I can wear my jean jacket covered in patches unbuttoned to show off my gem necklace.

Unfortunately, I had a really awful reaction to the Taxol today. And it was scary as shit.

Fortunately, I have a plan to prevent the reaction from occurring again, so next week’s round of chemo will be faster, easier, and way less scary!