Friday, July 3, 2009

5 - Chemo Week 1

Chemo Week 1

The treatments begin with chemo as well as radiation for the first week. Understand that chemotherapy drugs are, well, poisons. They are supposed to kill you, partway, or more precisely kill part of you. The idea is to kill that *part* of you that happens to contain *all* the cancer. The smaller the target, the less "collateral damage," the better, of course, but something still dies. Since cancer cells reproduce faster than normal cells, they are more impacted than regular cells by drugs that interfere with their reproduction. Other fast-growing cells are similarly affected, for example, hair, the mouth, most of the alimentary canal. One feels like crap while this is going on, "half dead," though half is an awful exaggeration. As I said before, I was lucky: I had the lightest, least debilitating treatment ever.

The chemo doctor's office has a sign on the door: No children. There are immuno-compromised patients in here. These patients with their chemically-suppressed immune systems cannot tolerate even simple diseases in this condition. Any infection that is normally simple could become serious. I am very unhappy to consider that this includes me.

The environment for this treatment is very comfortable. At the back of the doctor's office is the chemo room, a very large room lined with chairs and IV trees, thirty identical comfy leather recliner chairs and eight-foot steel stands on wheels with steel branches on top to hang IV bags from. I can only imagine the delight of a furniture salesman when a customer walks in and says, "I like that big, expensive, plush, leather recliner over there. I'll take thirty of them." He would never suspect.

This room is the corner of the building with two walls of bright windows, but the blinds are always partly closed. The clientele aren't usually interested in bright, sunny, cheery surroundings. Instead, there are tubs of blankets, quilts, and pillows all over, to keep one warm while cool poisons flow directly into one's veins. I see people cocooned into the chairs, listless, some napping, a few reading, some with iPods. Many of them are wearing hats or scarves on their heads, or obviously syntho wigs, to cover the hair loss that we all associate with chemotherapy. They look so much worse than I feel. I am so lucky.

At the beginning of the radiation treatment, there are two types of chemo. Both of these go in through the port-a-cath in my shoulder. The first drug is mitomycin C, a small plastic baggie of nasty purple stuff that drips in over an hour or two on the first day. The second one is 5FU, 5-fluorouracil, which is pumped in over four days, Monday through Friday. The 5FU treatment happens twice, once in week 1 and again in week 8.

The pump is in a fanny pack, fairly bulky and obvious. I go to work one day with it, but since I don't want people at work to see it I decide to work at home for the rest of the week. I haven't yet told anyone at work except the boss, and I think the fanny pack would make it pretty obvious that I had drugs being pumped in.

The tubing from the pump to my shoulder is subject to occasional pulling, for instance when I place the pump on the floor outside the shower. The entry point of the needle is covered with a large waterproof bandage, but I'm afraid that an inadvertent jerk on the tubing will pull out the needle. So I fashion a strain relief for the tubing, a down-up-down serpentine path for the tubing, with chevrons of adhesive tape attaching the tubing to the chest in two places. Works cool. Might not be necessary, but I feel much more secure with it in place. Also, the sterile strip over the needle entry, being in place for a week, causes a bad rash that takes weeks to heal. The rash and the slow healing are probably both related to the immunosuppressive effect of the drugs.

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