So many people are curious about what goes on when I say I’m off to chemotherapy, so I thought I’d give a little taster of a chemotherapy day!
Disclaimer: If you’re squeamish, don’t read this one!
Injection. The first thing I do every morning (not just chemo day) is take my injection. I’m on daily anticoagulant injections for 6 months until my PICC line is removed because I managed to get a blood clot in my arm within a week of having my PICC line fitted. (I mean really, what are the chances of that.)
Tip: I always ice up for 5 mins before injecting – these injections are a little stingy and this really helps!
Healthy Breakfast! The doctors have advised me that there’s nothing I can really do to keep my neutrophil counts up (my immunity to nasty bugs, viruses and infections) but I tend to think of this as my very last shot to get some nutrients in me and give them a spike. It’s a mental thing. If my neutrophil counts are too low, I won’t be able to have chemo today, so I want to give it everything I’ve got.
I load up on blueberries, raspberries, banana, nuts, chia seeds, cacao nibs, anything I have in the kitchen really to get some goodness inside!
Set Off. If I’m well enough, I’ll usually try to walk the 40 minutes to the hospital. I tend to feel at my best on the morning of chemotherapy as I’ve had 7 days to recover from the last hit so this is a great opportunity to do some gentle exercise. I also have a long day of sitting down ahead of me so it’s good to get moving. Last week it was raining so I caught a tube instead and used the extra time to grab a coffee with my housemate.
Welcome to the Chemotherapy Day Unit. I arrive at the ward and catch up with the nurses. I’ve got a great team at my hospital and we tend to spend more time chatting about funny dating stories, cooking and what we’ve been up to than medical talk.
I love that we’ve built the kind of relationship where we can be a little silly. If you’re having something uncomfortable, like an implant inserted into your tummy it helps to be able to say ‘STOP SMILING WHILE YOU DO IT’ and be overly dramatic and laugh it off. I can get very anxious about having treatment every week and this really eases my nerves. I also always bring someone along with me. It’s a long day so you need a fun companion and you also never know when you might need to hold someone’s hand – that’s the nature of hospitals!
PICC Line Dressing. First things first, my PICC line dressing needs to be changed. This has to be done weekly to prevent infection – we have to be super cautious about infections as my immunity is so low from the chemo. What might be a minor infection for someone else could have serious consequences if you’re on chemo.
What is a PICC line? It’s almost like a little plug. When I have chemo, or have my bloods taken, or sometimes when I have certain injections, the nurses use my PICC line to access my veins rather than pricking me with needles each time. It’s essentially a long line that runs through my vein and all the way up to my heart. It’s staying in my arm until treatment ends because my veins are too tiny to be able to have chemo via a cannula, like a lot of patients do. To be honest, I don’t really notice it any more. I still get squeamish having my dressing changed, but as my nurse said the other day – I’m definitely getting tougher.
(Pros: no nasty needles / no risk of the chemotherapy leaking out and burning you / you can’t feel it after a while. Cons: the procedure to insert it isn’t that fun / it gave me a blood clot / you can’t lift weights, which makes workouts limited.)
Next Up, Blood Test. The doctors use this to check whether my body can take the chemo this time. They’re looking for all kinds of things: neutrophil counts, vitamin deficiencies, liver function. I was refused treatment a couple of weeks ago as my immunity was too low to be able to take another hit of the ‘poison’. It was actually pretty heartbreaking. When you’re told you’ll finish chemo on a certain date, not a day goes by that you don’t open up the calendar on your phone and count down how many days are left to go. My treatment was pushed back 7 days and I felt cheated – someone moved the goalposts. In hindsight, I was so ill that weekend that it’s obvious to me now – of course I couldn’t have taken the chemo. But in the moment, it can be hard to see past that. Since then, I’ve been told I need to slow down and rest more. I’m a very active person and even when I’m at my weakest I struggle with this – my mind wants to be out running and working and doing all the fun things 26 year olds should do but my body can’t keep up. I’m learning.
Observations. Next, my blood pressure, temperature and weight are checked to ensure all is in order before we start chemo.
Coffee Break! My favourite part of the day. It takes about an hour for the blood test results to come back so this is when I grab my chemo pal and we head down to my favourite coffee shop for a quick brunch. This is a really important part of the day for me as it’s my chance to take a breather and reset. The more and more chemo I have, the more anxious I get about having it. For the first 12 weeks of my treatment, I’m having weekly chemo and after a while that can become quite overwhelming. You’re back in the chemo chair before you’ve really had a chance to recover and for me, my symptoms get worse with every chemo. It’s important for me to have some fun around the procedures so that my day isn’t ‘just’ chemo.
Results. This is when I either get told I have to go home and wait for my immunity to bounce back (or whatever part of my body is playing up right now) or I get the go-ahead to have chemo today.
Providing I get the all clear…
The Cold Cap Goes On. Oh the joys of the cold cap. This is a hat which can help to save your hair during chemo. It’s super pretty. My sister fondly calls it ‘the medieval torture contraption’. It doesn’t work for everyone and even if it does, it’s usual to still lose a lot of hair throughout treatment. I’ve managed to keep my hair so far, but it’s seriously thinned. I’ve had 12 rounds of chemotherapy (4 cycles) and I would estimate that I’ve lost about 40%. I’m not sure if it will hold out for another 4 cycles, but let’s just wait and see.
The hat works by essentially freezing your scalp so that the chemo is less likely to attack the hair follicles. The first twenty minutes are like the worst ice-cream headache you’ve ever had. I snuggle up under about 4 blankets and drink a hot tea and try to distract myself until it passes. After the twenty minutes are up, you become numb to it.
Here is a stunning shot of me mid-cold capping:
Pre-Chemo Meds. While the hat is doing its thing, I’m given a whole load of different drugs to prepare me for the chemo. One of them is given as an injection and within seconds makes me so sleepy that for the next few hours, I’m pretty zoned out. This is when I usually take a little nap.
Chemo Time. I have weekly paclitaxel which takes an hour to administer and every three weeks, I have carboplatin too, which adds on another hour.
Lots of people ask me if I can feel it when the chemo goes in: the answer is no, I can’t feel a thing! I’m usually napping at this point from that injection I mentioned or if I have the energy, I might watch a movie. I can’t really concentrate on much through chemo as I’m in discomfort from the cold cap and my mind is foggy from all the medicine so we choose super easy watching. Think Paddington Bear kind of movie.
Chemo’s Done: Cold Cap. After all the chemo is done, I still need to wear the cold cap for another hour and a half or so before I can go home. I get pretty restless at this point!
Home Time! By the time I go home, it can often be a good 7-11 hours after arriving, depending on how the day’s been. Any number of problems can come up that might cause a delay.
At this point, I’m exhausted. I will struggle to form a sentence, sometimes even a word, and I often sound like I’m drunk. Walking in a straight line will require all my concentration and I’ll be dizzy, faint and a little nauseous too. This is why you need your chemo pal.
Fun Time! I always do my best to do something nice after chemo. No matter how ill I feel, and even if I fall asleep on the table (yes, I’ve done this), I try to get out for dinner or at least have a bubble bath and a movie night with a friend. From the day of my diagnosis, I’ve been insistent about doing something fun after every scary thing. If you do that, trust me- you can get through anything. The fun thing will pull you through it and it’s also important for your memories. When I look back at every chemo session and every scary surgery and procedure, even the day of my diagnosis, the things I think of are the fun things I did that day. That’s my little trick!
Last time, we got pizza! X