My Chemo 101

Chemotherapy was next on the list.

Did you know that you need to attend chemo class prior to starting chemo? I did not. Back to school again for me and Michelle. We attended our pre-chemo teaching class along with a few others new to the cancer journey. It was quite informative and did provide us with a lot of the answers to our questions prior to the start of the treatment. I have listened to hundreds of powerpoint presentations in my educational career, this is not one that I ever expected to have to listen to.  

To get the process started a central catheter line  (PICC) was installed in the bicep of my arm to deliver  the chemo drugs into my system. This meant another visit to the hospital to have the line installed. It was quite quick and easy but now I have two tubes sticking out of my left arm! Not really a great fashion statement, let me tell you. Thank goodness summer is over so I can conceal them under long sleeve shirts. Not that I am embarrassed about them but they are definitely conversation starters that I would prefer not to have. I'm not really looking for that kind of conversation. A series of drugs were ordered to take before and during the treatment to help with nausea and vomiting as well.

Next was a follow up visit to my medical oncologist to ensure that we were all good to go. A blood test, a weigh in is needed the day before to ensure that I'm able to handle the next dose, and that the meds are created for the next day as they are based on my weight.  It's a bit of a struggle to maintain my weight, and things do seem to be continuing downward,  despite all of the Ensures!

The cancer centre that I attend is a fairly new facility that has great open spaces for patients. The chemotherapy floor has a series of hubs with eight chemo loungers in each hub. There is room for over 24 patients at one time. Can you imagine that! I still can't get over the number of people that are dealing with this disease. It floors me. You are able to bring along one person to sit with you during your treatment. Michelle was by my side for my first treatment. Even though I told her that I could do it myself, that six hours was too long, that she could work from home and then return at the end, she insisted on attending with me.  

My first chemo was the longest (approximately 5 hours) and I received two different types of IV meds and then I went home with a bottle of chemo that is attached to my PICC line that infuses for five additional days. 

At first I thought, I can handle this no problem.  This sounds great. Less time in the hospital, more time at home but let me tell you, having a small plastic bottle strapped to you 24/7 for five days in a row is a constant reminder of what you are going through. Trying to keep it upright, wondering if it is working, waking up in the middle of the night (wondering if the bottle remained attached) and carrying it in a crocheted sling holder (graciously made by some wonderful volunteer) throughout the day did test my patience and limit, not to mention the issues with showering. 

The hardest part was on day five when we were waiting to contact the nurse to remove the bottle once and for all for this cycle. The bottle was supposed to be fully emptied by 4 p.m. Meanwhile 5 p.m. went, 6 p.m. went and the bottle was still not empty. I'm not going to wear this thing again for another night! Finally by 8:30 p.m. the bottle was empty. We survived. Chemo Week 1 was officially over!

I am happy to report that I did not seem to have many side effects at all for this first treatment except for a loss of appetite. I did keep up with the anti nausea medication schedule exactIy as prescribed.  No need to be a hero here!

But clearly, I  need to eat and drink more to keep my weight up. 

Now a two week break and them back to the chemo cycle again!

Richard

My Radiation 101

As I have said previously in my blog, each cancer patient's treatment plan is unique to them. My team of doctors decided that I would begin with 10 consecutive rounds of radiation followed by chemotherapy.

The introduction to the radiation plan actually began immediately following our conversation with the Medical Oncologist confirming that I had esophageal cancer. Just minutes after receiving this horrific, life altering news about my diagnosis we began a series of meetings with the treatment team which consumed the rest of the day. I guess we shouldn't have been so optimistic and parked in the two hour zone! 

We first met with the Radiation Oncologist to discuss the plan for radiation. Next we met with the drug reimbursement specialist, to confirm that we had insurance to cover all of the drug costs. This was followed up with a meeting with the dietician to check my weight and review my eating plan. Finally we were sent downstairs to have pre-radiation orientation. We watched a short video on what to expect and what to prepare for. The radiation schedule was set to begin in one week. We were very pleased with the speed at which the treatment was going to happen but that was a long, tiring and emotional day for the both Michelle and I. We had a lot to process!

I had always told myself that I would never get a tattoo. I don't like them and didn't like the thoughts of having something permanently inked on my body. No offence to those that have tattoos. To each his/her own! That all changed with my cancer diagnosis. I was told that I would need to have four small tattoos placed on my chest in order for the radiologists to properly aline the radiation rays. As this really wasn't an option, I agreed to the four tattoos. That's right, I got four tattoos in one day! Move over David Beckham and Justin Bieber, there is a new bad boy in town! Did I forget to mention that they are only the size of a pin head! They still count as four tattoos though.

Radiation at first seemed scary to me (as I was picturing the CT scan and the MRI scans that I already had) but honestly after the first day, it was actually relatively quick and painless. I was in an out in less than half an hour at each visit. 

The daily radiation routine includes, checking in at the registration desk, changing into your hospital gown, wait to be called in, enter the room, lay on the bed with your arms above you. They turn off the lights and the radiologists them align the lasers with your four tattoos, take measurements to adjust to ensure the all is in alignment. They ask you for your name and birthday at each visit (I guess to ensure that the right patient is being treated). Finally they turn back on the lights, turn on some music and then leave the room to begin the process.

There are two passes of the machine that take a 360 degree rotation around your body. The first I have been told is to ensure that all is good and that everything is in complete alignment. They take a quick scan to compare to the day before during that first pass. Any minor adjustments are made remotely and then you wait for the second pass of the machine. 

On a few occasions that second pass seemed to take a lot longer than over the previous days. Your mind starts to wonder. What is wrong? Is the machine not working? Is the alignment not right ( I don't want radiation in other areas of my body).  Finally the machine boots up and the second pass begins. After I asked, was everything ok? Why was the second pass delayed? Happy to hear that they were actually in discussion with a student radiologist, explaining the process and steps to them. Being an educator myself, I had no problem with this on the job training support.

As I had done with the MRI and CT scans, I found a focal point to ease my mind during the process. A smear on the ceiling, a word or number, whatever it took to take my mind off of what was happening at that moment. 

Medication was prescribed for any possible side effects of the radiation. Luckily I made it through the 10 days with no side effects. One positive to hold on to!

On the final day I received a certificate saying that I have successfully completed my radiation. Not a certificate that I will proudly display or add to my professional portfolio, but glad to have one more step behind me. 

Richard