Halfway Home – Round 3

I awoke at 6:20 Monday morning and lay in bed for just a few minutes listening to NPR’s Morning Edition. I was pleased to hear Linda Wertheimer’s voice and realized that she was playing host. Hooray, she’s back, at least temporarily. (No disrespect to Renee Montagne who is very good, but I am a huge fan of the trio of great women reporters from the early days of NPR:  Linda Wertheimer, Cokie Roberts and Susan Stamberg. It’s sort of like going home again!)  After indulging in that pleasure for a few minutes and catching the morning news at 6:30, I got out of bed to appease the intently staring Sam (he is part border collie, after all). I put on my slippers and let him out into the near darkness, on one of the shortest days of the year.  I prepared both Henry’s (the whining cat’s) breakfast and Sam’s and then let him Sam back in to wolf it down in 15 seconds flat.  That can’t be very satisfying and could explain why he has become such a beggar of late.

Then back to my room to find something to wear that would be comfortable for the relatively long day at the Cancer Center.  Some stretchy black pants that are frayed around the edges, but are too warm and comfy to even consider pitching; a fleece top with buttons down to the middle of the chest, making access to the port easy for the nurses; another layer of fleece, because it is sometimes cool in the treatment pods; and, of course, a hat or head scarf.  After trying on several, I opted for the oatmeal crocheted cloche, which was apparently a good choice, because several people in the treatment pod asked me about it.  At least, I assumed, perhaps incorrectly, that by asking they were signaling their approval!

Then I moved into the bathroom where I applied some makeup to liven my face up a bit.  I had a quick bite and then Lydia, my chauffeur and chemo buddy, and I left here around 7:30.  Despite it being a busy time of day for commuters, we were at the hospital in 15 minutes and I signed in for lab work right away.  When I was paged I went in and met up with one of the nurses, who deftly accessed my port (read: stuck me with a needle with lots of clear tubing attached), took several vials of my blood and then taped the needle and line so it was ready for use during chemotherapy. 

From there it was off to see the doctor for an 8:40 appointment, during which we chatted about my side effects and the results of my blood work.  As expected some of my counts are low, but not nearly low enough to be of concern.  She did suggest I might want to eat some red meat to boost my hemoglobin a bit.  Although we don’t eat a lot of red meat, quite by chance we had already planned to have hamburgers for dinner that night.  Now I can say that the doctor prescribed it.  I like my doctor a lot.  She is extremely competent as well as very patient and pleasant and she giggles at my jokes and comments.  I hope that is a good thing!

From there it was back to the treatment center.  I signed in at the desk, remembered to get my free parking garage pass, and took my pager and waited.  My appointment was scheduled for 9:30 and I was called in at about 9:40.  We were escorted back to pod 3, where the medical assistant took all the standard readings, and then offered me that most wonderful treat of all – a warmed blanket.  She also brought a pillow and a can of cranberry juice, and I didn’t have to pay extra for any of it.  It’s not like flying these days. 

The nurse of the day came by and checked on me, after which the next wait began.  I have learned that despite the attentiveness of the pod staff, the backlog at the pharmacy is what holds things up.  There are too many cancer patients on any given day for them to process all the medications at once.  Fortunately, my pod mates were a friendly group and for the first time I really interacted with the other patients and their companions.  We got involved in helping the man across the way with his crossword puzzle, providing words like pap, and milksop, latkes and halvah.  With my handy iPod Touch and the hospital’s guest WiFi service, I was able to look up and share the definitions of some words with which he was unfamiliar.  He was in his mid-50s and was there with his elderly father as his companion, which I found so very touching.  There was a husband and wife, and a daughter with her elderly mother.  We talked at length about my hat and others they had made or seen.  Then a man came in and took a chair next to me.  Once he was settled in he turned on a little TV that is available on a swivel arm each lounge chair.  He did hot have headphones and, apparently, not such great hearing, because he turned up the volume quite a bit.  That and the fact that the medicines were ready seemed to put an end to the friendly chatter.  By 10:30 we were underway.  There were a few adjustments to my infusion, some of which were made by the doctor that morning and some that were expected changes in protocol.  Most everything goes in one at a time, so the lineup was:

1.    Saline

2.    Dexamethasone – a steroid to help control some reactions to the chemo.

3.    Pepcid – a surprise, but I have apparently been getting that each time and just didn’t know it.  It has certain antihistamine properties.

4.    Benadryl – again to fight off any allergic reactions to the chemo drugs.  During round 2 it gave me a major case of restless leg syndrome, so the doctor decided to cut that in half this time.

5.    Lorazepam – to relax my muscles and thereby reduce the risk of restless leg syndrome.

At that point, 4 and 5 combined to knock me out for 2 whole hours, so I am guessing from past experience on the rest of the lineup:

6.    Emend – an anti-nausea drug I previously had to buy at the pharmacy in pill form for about $370 and take by mouth on days 1, 2 and 3.  My cancer center has now switched its protocol so that it is administered in IV form, and that releases me from having to purchase pills to take at home.  Yay!!!

7.    Some other anti-nausea drugs, which I can’t name at this point.  Maybe I’ll stay awake long enough next time to ask.

The actual chemotherapy drugs:

8.    Taxotere for 1 hour.

9.    Carboplatin for ½ hour.

Last up for the final infusion of the day was the monoclonal antibody for my HER2+ status that I have to have for a full year.  It prevents the HER2 receptors in cell membranes from causing any cancer cells that might crop up from reproducing willy-nilly.

10.    Herceptin for ½ hour.

Then when the infusion is done, and most of the lines are disconnected, just before the needle is removed from the port I was given the usual nightcap:

11.    A final syringe of saline to clear the port

12.    A syringe of Heparin to prevent clots from occurring in the port.

In the midst of all this, I awoke at 1:30 to find that two people had left the pod while I was out, and three new ones had moved in for the second shift.  Lydia was there and kindly fished out a turkey sandwich from her loaded backpack for me to eat.  She is such a good chemo companion, filling her pack with things I might need or want as she sits for seven or eight hours each time, without the benefit of a Benadryl induced sleep! 

We were done at 3:00 and home by 3:30.  Still a bit groggy from the Benadryl/Lorazepam combination, I took another nap, but not before a couple of hugs and the acknowledgement that I am halfway done with this part of my treatment.  3 down, and 3 to go!