What is chemotherapy like? A simple question perhaps. I like the way that Josh Kizler describes it. Josh is a 31 year old fighting germ cell or testicular cancer. He writes at his new blog Emerging Environments I had difficulty choosing which of his posts to publish. He writes in a very clear and accessible style. Following Josh on his cancer journey will prove rewarding.
I will narrate a typical day of chemotherapy for me. Reading this, whoever you are, please consider that every component of cancer treatment—the cancer, the patient, the specific treatment drugs, the reaction to those drugs (both direct and side effects), the circumstances, the emotions and attitudes—are all unique.
note: I receive chemotherapy for five consecutive days, seven plus hours each day. In narrating my experience with chemotherapy, I drift between the five days, which are markedly different from one another.
The Alarm Sounds
My alarm sounds at 6:30 but I usually awake in anticipation ten to twenty minutes prior. My mind ranges from clear to fogged, but I am thinking only of the clinic, my infusion, the IV. The morning sky doesn’t resemble sky and is always cloudy, as is the air in my room and the feeling in my clothes. Only the cold sink water evokes another sense.
Half Breakfast and Commute
I step downstairs and figure something small and quick to eat at the table or in the car en route to treatment. The car ride feels like the rest of the morning. There is nothing to be happy about. All thoughts beyond treatment—its efficacy, my future, my family—vanish. I count the days left in my cycle and assess my physiological state at that moment.
Entering the ITA
Mom or dad and I enter the infusion treatment area and wait at the entry point. The receptionist calls us in and I present my license. No paperwork. We sit in the waiting room with other patients and families. There is little observation occurring. Everyone is tuned in to their own day.
Vitals and Chair Selection
At 7:30 I am called in and my vitals—weight, temperature, blood pressure, and oxygen saturation—are taken. I am weighed on the scale and the other measurements are taken in my seat of choice. I usually arrive before the crowds and take my pick of chairs, sitting beside the glass wall, facing one or two other chairs depending on the side of the room. The legs lift and the back reclines.
On days one and four I receive a new IV. I pump my fist several times. The nurse examines my veins by touch and sight. She places a heat pack around my forearm and we sit together until she removes the pack. She touches the vein more and assesses its sufficientness in taking the IV. She places the IV, and then secures it.
On days two, three, and five the nurse checks the IV and completes any necessary adjusting, which is not uncommon.
I take two to three anti-nausea medications, depending on the day of the cycle. By day five, swallowing the pills themselves nauseates me slightly.
The First Bag
The drip begins. It’s 8:00 or just thereafter and the sun has started to peek through the window. Over the course of eighty to ninety minutes a liter of saline solution drips through my veins, prepping my liver for etoposide and cisplatin. There is nowhere to go, nothing to do. The cisplatin is coming.
As the first saline bag drips towards its end the nurse brings the etoposide. She steps away to find a confirming colleague to verify my identification and the drug that I am about to receive. “Please tell me your name and date of birth”, the colleague says to me, proceeding to read my patient ID number. The colleague departs and my nurse hangs and attaches the etoposide, which is diluted with more saline solution.
I receive a half bag of manitol to increase urination and protect my liver. Its mixed with more saline solution and takes time to administer.
More Saline Solution
The second full liter of saline solution is hooked up.
The nurse returns with a confirming colleague. My cancer cells can feel their proximity to the approaching bag. Name and birthdate…patient ID number. Saline and cisplatin.
I pee a lot. This is one of the things I do while receiving chemotherapy. It is an activity. I return my chair to an upright position, pass my two blankets to my mother or father, slip on my slippers, check that my IV wires aren’t caught behind the chair arm or elsewhere, unplug and roll the IV stand from out behind the chair, and carefully walk to the bathroom. I pee into a plastic container marked with CC levels. I check the level and write the number on a tally sheet with my initials pinned to a corkboard in the bathroom. I dispose of the urine in the toilet, flush, and wash my hands, carefully working my way around the IV stand in the process.
The Final Liter of Saline
The final liter of saline begins. There is no joyous ceremony, but a concluding feeling that fills the air between me and whoever has accompanied me to chemo that day. Soon the IV will be detached. Three quarters of a bag remain. Half a bag. One third. Less. Ten minutes. The nurse returns to liberate me.
Peripheral, Seconded Activities
I play Scrabble, cribbage. I send text messages and surf the Internet. I talk to whoever is with me, the nurse, other patients. I make and receive phone calls. I nap briefly. I eat. My mind is present in all these activities but my body is consumed by everything else. I could very well just stare at the wall and be occupied.
There is a clock on the wall of the ITA. I only check it to note when I pee and towards the end of the day as the final liter of saline drips. The IV acts as my clock for the duration of the day, shifting hour from one bag to the next, chemical to chemical, nurse visit to visit. I don’t know what time it is. I only know the chair and the drip that transitions from saltwater to poison and back.
As the nurse provides me with anti-nausea meds and works on my IV a bus awaits outside. As the saline solution starts to drip the bus makes its way towards me. The driver grips nausea and fatigue, which fill up the first 12 rows. In the back sits fluid retention, tinnitus, and hair and balance loss. Once the etoposide begins the driver has already started rolling over my legs. During cisplatin administration he idles on my core, sucking the joy and wellness from my body. The feeling is all physical. The draining of blood, of emotion, of force—it is all physical.
From Departure to Return
Everything occurs in between chemotherapy sessions, on chemotherapy’s schedule, in light of chemotherapy. The IV stops but I am still on chemo. I exit the ITA, walk to the car, commute home, and enter the house on chemo. I take the drugs on the couch, in bed, while eating. The chemo doesn’t stop.
from: Emerging Environments