After 30 minutes of grilling, my oncologist asked me if I wanted forget chemo and just do the surgery. I said, 'no'. I was satisfied. I was ready to go.
"Let's do this!"
My "chemo nurse" (Nurse) for the day gave us a tour of the facility on our way to the place where I would be spending the next five hours. The place is in one large area of alcoves with each containing one Lazyboy with a tray, a couple chairs, a cabinet, an IV holder thingy, and a TV. Nurse showed us rest room areas, and walked us through a nicely stocked snack areas with coffee machine (that make single cups) and a refrigerator filled of water, juice, soda, etc. All meant for Wife and me - as much as we wanted. She talked about folks who are there over breakfast and lunch who either bring a sack lunch or sneak out to Micky-D's or some other place in the neighborhood for take-out. We can do whatever we want for nourishment. We are to make ourselves at home.
As we walked to my alcove; '#11 chemo way'. We passed another guy who was hooked up. I think nurse had just asked me how I felt and I said; "nervous". The guy smiled and said; "It's not that bad". And he looked like he meant it. I had a new member in my support group.
I got comfortable in my Lazyboy and we started the show. Nurse began explaining what was going to happen today while she prepared me for the I-V (heating pad on my hand) then she ducked out to check if my med's were ready at the pharmacy.
We spread out our stuff - computer, newspaper, my 'log book' loose leaf binder. Wife went to get some coffee for her and tea for me.
By now Nurse was back and ready to connect the tubing - my hand was sufficiently warmed. We talked about ports (where they install a connector permanently into your body so they can just hook up the IV without the needle every time) but that's not for me.
First on the menu was plain saline. They wanted to get as much fluid in me as possible to dilute the med's that were coming.
This was followed by three 'appetizers' for nausea:
- a bag of Amend (Aprepitant), the 'expensive stuff', which will be my main defense against nausea for the next three days. (Pills are waiting at Walgreens - $200.00 for three - thank goodness for insurance!)
- a bag with Dexamethasone; a steroid that helps the action of the other two ( I won't pass the doping tests for a few days ).
- Finally a bag of Zofran; the third anti-nausea.
Once the prelims were done Nurse brought on the main course; Gemzar and Carboplatin. (WHAT? CARBOPLATIN?) I thought I was getting Cisplatin. Nurse assured us that this is equivalent to Cisplatin but is less often used because many of the studies have used Cisplatin, spacifically. The Carbo form has slightly milder side effects. It goes in slightly faster so we could get out of here sooner. But you know why? They can't get any Cisplatin because it's in short supply around the world. I've gotta think there's some reason for this happening - some advantage for me. It was meant to be and I'll be better for it.
While all this was going on (and the chemo was going in), Nurse brought a folder of pamphlets and bagan to explain all about drugs was getting, what I would need to do (how to act), and what I could expect to feel over the next week(s). (much of this information is found at: http://chemocare.com/.) She was surprised that I hadn't received this and WE were surprised that we were getting this WHILE the stuff is going into my veins. But there were no surprises and nothing that would have changed my plans.
Nurse went through the folder and explained everything very carefully. She made us feel like we had her all to ourselves for the duration and basically 'we just talk'. She's been on the front lines of chemo for many, many years. She has seen this procedure evolve over the years and seems to know what she's talking about. And most important, she has the time to talk with us.
She said that I should (just the high points are listed here):
- keep hydrated with at least 8 - 8 oz. glasses of water a day. This is less than I'm used to drinking. Fruit juice, fruit, pop cycles, ice cream, malts, shakes, soda, etc. Alcohol and caffine don't count. Dehydration is a dangerous because it leads to lack of thirst, so be careful. I'm thinking; This will be easy - I'm used to drinking lots more water than that in a day.
- keep a steady (if minimal) amount of food in my stomach at all times. Eat snacks and meals. Eat something right away when waking (I do this anyway - I always have to eat something as soon as I wake up, no matter what time of the day or night). All this keeps down the nausea and ill effects on the stomach and intestinal lining (actively dividing cells that are effected by the chemo). Doctors orders to eat? I can really live with this one!
- Keep clean and avoid contact with sick people - like Howie Mandel. Wash my hands a lot - especially when you get home from being out and about. Again; check!
- Be careful not to bruise or cut myself. The chemo is hard on blood cells (red & white cells and platelets) since they are actively replenishing themselves all the time and therefore are blocked from replenishing themselves for the 3 or so days this stuff is in my system. No umping behind the plate. No contact sports.
- Do everything I feel like doing (or that I normally do) during the day. Pay attention to what my body is telling me. Rest when I am tired. Don't over do but don't mollycoddle.
- Have sex if we feel like it. That's what she said.
The first bag of chemical (Gemcitabine) was empty after 45 minutes (that was quick). Nurse hooked up a second - the main course - bag of Carboplatin. This required a connection right at the needle - something about a dedicated line. This should only take 75 minutes since it can go in faster than Cisplatin.
Now that Wife and I were all settled and sufficiently informed (or overwhelmed), Nurse could leave us to digest all this while she attended to other duties.
Wife fetched us each a cup-a-soup (it's lunch time) and some more beverage. It tasted good - no effect on taste buds yet. I made another trek to the bathroom. Gotta keep those fluids flowing.
Wife settled in to a magazine while I dozed off. After a short nap, my snoring woke me up. I fealt refreshed from this power nap.
The oncology social worker, seeing that I was awake, stopped to introduce herself, and some of the services she offers. As the end of the Carboplatin was draining into my vein, Socialworker was talking to us about Gilda's Club when it hit me, for the first time, that I have become a member of a very elite group: Cancer Survivors.