comforts of chemo

Hey there, fine followers!

It seems like yesterday (and years ago!) since Wade had his surgery. In actuality, it’s been about 6 weeks. 6 weeks tomorrow.

The planned recovery time was 4-6 weeks. He can officially lift, carry, push, pull, and drive a vehicle tomorrow. Which brings us to the final phase of the Magic protocol. A refresher…

1. nine weeks of chemotherapy (we’ll call it Round 1)

2. surgery

3. nine more weeks of chemo

So, today was the first day of Chemo-Round 2.

We left the house at 7am and pulled into our favourite parking spot at 7:28. Entered through Victoria building, as we always do when Wade has chemo, radiation, scans and appointments. We walked down the dusty hallway, past the stacks of cardboard boxes and bags of discarded paper that often litter that corridor, past the PET Scan place and the Pharmacy.

A right turn brought us down the next hallway, taking quick glimpes of the framed photos & paintings that hang, for sale, on its walls. Stopped at the Dickson Building gift shop (though there are far more magazines & snacks than actual gifts) so that Wade could pick up a Globe & Mail. Up 3 floors to the Radiology department where we registered with the others, primarily ladies in their 50s and 60s waiting for mammograms and bone density tests. I’ll be there someday. Sooner than later actually. Ugh.

Once Wade was keyed in to the system, we headed to 3West, the same rainbow-bright area where Wade had his Picc line inserted in June. A familiar face approached as I searched through the contents of my purse in pursuit of my phone. Wade was in his mint green johnny shirt, legs crossed ankle to knee [with grey socks, black shoes, and hairy legs], reading the paper. It was the nurse who’d assisted with his first Picc Line insertion. She recognized Wade right away, which was nice. We exchanged friendly hellos, and she got caught up on Wade’s progress. Then they disappeared behind the giant yellow door. He emerged about 40 minutes later, bid the cheery nurse good-bye and changed back into his jeans & golf shirt.

Then we headed down the Dickson elevators, over to Victoria and up 11 floors to our destination. During the elevator ride, my mind was blank-ish. I thought about stuff we should pick up at Superstore. Made a mental inventory of Wade’s clothing. Wondered why my shoes suddenly felt too big. Very insignificant thoughts, considering our location and tasks for the day.

But when the doors opened, and I saw the registration desk, I was reminded of why we were here. It was go-time. Time to support each other, as we always do one way or the other, through the next step. Long days at the hospital, the side effects, the waiting, and the worrying. As good as Wade is feeling, matters such as hemoglobin, neutrophil, and white blood cell counts are always of concern.

To be perfectly honest, it was comforting to be back on the Chemo Unit. I initially wrote that sentence as ‘oddly comforting’, but I’ve changed it because it’s really not that odd. This is the floor where our fears were first calmed by Dr. Oncologist and his wonderful but now retired 😦 colleague/nurse. This is where kind, patient, hard-working Nurses took excellent care of Wade’s body and our spirits as he endured Round 1 of chemotherapy. This is precisely the place where Wade felt his worst, but not long after, his best in a very long time. It felt good to be back.

Wade had a snack in the waiting room, and we watched Canada AM until his assigned nurse called out his name. Happily, we saw that she was one of our favourites. In fact, the team there today looked the same as it did back in June, July & August. It was if we had never been away. As Wade settled into the chair, a few of the other Nurses waved, approached, and asked how he was. They’d heard of Dr. Surgeon and Dr. Oncologist’s optimism, and were thrilled for us. This went on throughout the day.

All in all, it was a good day. The actual administration of his 3 chemo drugs went really smoothly over the next 5 or so hours. It’s a multi-step process that goes a little like this:

1. Pre-hydration – 1 litre of saline

2. IV Anti-nausea meds – 2 or 3 different ones that I don’t know the names of right now – Zofran & Maxeran I think?

3. Epirubicin – Chemo drug #1, which is the cherry Kool-Aid looking stuff slowly pushed through his Picc by way of 2 large syringes and the gentle hand of his Nurse

4. Picc line flush – about 100 mls of saline

5. Steriods – the main one is called Decadron (Dexamethosone) and is supposed to help with nausea and vomiting and to stimulate appetite

6. Continued drip of more  (or the same?) anti-nausea meds

7. Cisplatin – Chemo drug #2, which is the most brutal in terms of nausea but easy in terms of administration – just a slow drip from a little brown bag on his IV pole for approximately 2 hours

8. Another Picc line flush

9. Post-hydration – another 1 litre of saline

10. Fluorouracil (5FU) – Chemo drug #3, which is stored in his ‘baby bottle’ and will be slowly pumped into his body via his Picc line. A small heat sensor secured to his upper arm will help to administer the drug in perfect timing, so that it will empty on the morning of his next bottle change appointment, Monday November 22nd, at almost exactly 10am. Very cool!

And that’s it. Once we had his bottle situated in the knitted sock, we were off to buy a new fanny pack – Wade wore out the old one last time.

We will soon return though, tomorrow at 8:30AM to be exact. After Wade’s start date was finally confirmed, we had requested an appointment for supplemental hydration, given our experience during Round 1. The new Nurse working with Dr. Oncologist was hesitant and didn’t seem to ‘get’ why we would need, want, or ask for such a thing. But we pushed for it, more than once, and eventually got it. And I’m certain we will need it. We really miss Dr. Oncologists original nurse. She was an absolute dream!! Anyway…

A few more specifics, just in case you’re interested:

Round 2 will be exactly the same as Round 1, minus the radiation.

Radiation was done urgently during Round 1, Cycle 1 due to Wade’s hemoglobin counts, which were very low. Not typically part of the protocol, but necessary in Wade’s case at that time.

There will be 3 Cycles to Round 1. Each Cycle will last 3 weeks. On Day 1 of each Cycle he’ll receive the above chemotherapy medications. On each Monday in between, he’ll have to visit the Chemo Unit to have his bottle of 5FU switched out, so that he is receiving it continuously, 24-7, for the next 9 weeks.

A final note:

You might remember that Cycle 3 of Round 1 was much more tolerable than Cycle 1 and 2. At the time, we hadn’t realized why…

But now we know that Dr. Oncologist made a snap decision to lower Wade’s dose by 20% for that 3rd cycle in late July/early-mid August. Wade had such a difficult time with nausea and vomiting (especially during Cycle 2) and was struggling to maintain his weight. So, Dr. Oncologist felt that a more tolerable dosage was a necessary. He wanted to make sure Wade could be as healthy and strong as possible for his surgery. Actually, you must remind me to tell you of a funny part to that story!! Not tonight, but soon, I promise 🙂

So….as a result, this first cycle of Round 2 is will also a 20% decrease in dosage, so as to avoid shocking Wade’s body too terribly after such a long gap in chemotherapy treatment and such a major reconstruction of his internal organs. Cycles 2 and 3 will be upped to the maximum dose.

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It’s now 11pm on Day 1 of Round 2.

So far, Wade has had some mild to moderate nausea and one or two ‘gags’ as he calls it (dry heave/wretch). But, he was able to eat a reasonable dinner so I’m pleased. He is exhausted and was in bed asleep by 9:45pm. But, so far so good!