An Average Day of Chemo

So before this whole adventure began, I admit I was terribly ignorant as to what "chemo" actually was, how it was administered and all that good stuff.  I had a vague notion that it might be given via a shot, pills or IV, but that was about it.  Oh yeah, and it seemed to make people go bald.  So I thought it might be helpful to share how I get my chemotherapy.

Now each cancer type has its own regime.  Some testicular cancer is seminoma and can be treated with radiation in addition to or without chemotherapy.  I have non-seminoma, the more aggressive type and type has different options based on staging and what risk class you fall into.  Despite having the highest stage for this cancer, because I feel into the "good risk" assessment group, I could choose either three rounds of a combo of three chemo drugs or four rounds of a combo of two chemo drugs.  The statistical results of curing the disease are essentially the same, but you can avoid some of the potentially nasty side-effects of the additional drug, Bleomycin.  I chose the longer regime of four rounds.  So today is day three of round four.    Here's what it looks like.

I arrive at the cancer center at the hospital at 11:00 and check in.  Most of the receptionists and nurses know me well by now and we talk throughout the day.  It takes about 20 minutes or so before I get seated in one of the chairs.  I have my favorite, which is tucked away in this little corner with a large window behind it and looks like this:

There is always a pillow on and IV stand next to each chair.  The chair is a recliner complete with footrest and can recline almost all the way back.  Lucky me, today my favorite chair is available and I claim it for my own.  I have to wear a button-down shirt and either a v-neck under shirt or none at all, so that they nurses can access the chest port. I've seen other men who have forgotten and they've had to remove their shirts altogether.  The women, for some reason, never seem to forget to wear appropriate clothing.

First the nurses prepare to insert the IV needle into my chest through my port (see previous post "Because Inquiring Minds (seem) to Want to Know" for more on the port.)  They swab the port site and then spray a coolant on to try and numb the skin.  In the needle goes (barely hurts) and they make sure that the port isn't blocked by testing for a blood return in a syringe.

The first thing I get is 45 minutes of saline hydration. The hydration is important because the chemo drugs are so hard on the kidneys.  Then I get the "pre-meds" which consist of two anti-nausea medicines on Monday (only 1 the rest of the week) and a steroid to help my body not reject the poisonous chemo drugs.  This only takes 20 minutes or so.  Then I get the first chemo drug, Cisplatin.  This takes 45 minutes and is the wonder drug saving my life.  It is a platinum-salt drug; nothing like pumping heavy metals into your veins.  The introduction of this drug in the late 70s is what caused survival rates for testicular cancer to skyrocket from 10% to 70%-80%.  Additional drugs increased the survival rate to 90-100% in the 80s.

My IV bag collection

Then I get the second chemo drug, Etopside, for 90 minutes.  Etopside is a plant-based drug that stops the cancer cells from reproducing by disrupting their DNA.  After that's done, I get another 30-45 minutes of hydration of saline solution. After that the party is over and the nurse removes the needle from the port.  In theory, they could leave the needle in with a little valve attached.  I did this for all of round 1 because the port was still healing.  I haven't opted to do it since because 1) you can't shower with the valve dangling from you; and 2) I have small children who love to have pillow fights, piggyback rides, wrestling competitions, etc on a daily basis and it just gets in the way.  So out goes the needle and a little gauze gets slapped on my chest for me to yank off at night.  The whole process takes about five to six hours, five days a week followed by two weeks off for good behavior so that my body can recuperate.

I typically go to work for two to three hours before chemo and back again for 2 hours to wrap stuff up.  It helps mentally to keep up the work routine, plus it keeps the stress level down by preventing a huge backlog of work from piling up.  At the start of a chemo week, I am feeling pretty good and get a lot done.  By the end of the week, especially round three, I was fatigued and slept/rested during most of the day. For an A-type personality who has to be constantly going, I thought that being in a chair for five-six hours straight would be tantamount to torture, but it actually goes by relatively quickly.  I always eat lunch, nothing too smelly I hope. The dear wife has sat with me almost every day and my parents, siblings and religious leaders have been great about visiting.

Other TC patients have mentioned that the sight of the cancer center or the sound of the pump eventually become associated with the nausea of the medicines and make them sick.  I haven't had that problem myself. Sometimes the sound of the pump can make sleeping a bit more difficult, but I try to associate it with the tick of a clock which I find relaxing.

So that's what my experience has been like.  Just two more days to go.