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Yesterday I had chemo school. It was actually called "TLC" for Treatment Learning Class, but I like chemo school better. Juan and Beth went to school with me. There was one other patient, an older gentleman. A chemo nurse named Alice was our teacher and she was really nice.
The class was scheduled to last 90 minutes. It totally lasted twice that long and I don't know how they could ever fit all the information in 90 minutes. It was really useful to me, even though I already had heard or read about many of the things that might happen. We also got a tour so it's kind of nice to know where I'll be going on Tuesday and how they shuffle you around and all that.
What did I learn and get more details about...
My chemo drugs must be pretty strong and typically have a big impact on all the components of your blood. Of course this was interesting to me since I work at the Red Cross blood center. I can expect my red blood cell count to go down and possibly become anemic; my white blood cells will definitely be diminished; and also my platelet count will probably be lower than normal. I shouldn't need any transfusions or anything like that but sometimes people do, and Alice said sometimes you might see patients there getting a transfusion of RBC or platelets. That could be interesting for me since I see all the blood and platelet donors here at work... another reminder of how important our donors really are! Thank you again blood donors! You can't get a transfusion of white blood cells (in fact we remove the WBC from other blood products because it lessens the chance of adverse reaction in patients - it's called leukoreducing I think.) I will be getting that Neulasta shot to boost my WBC.
The big side effect that is pretty much a guarantee is fatigue. This can result in part from the low RBC counts. Keeping my calorie intake and especially protein up will help. Light exercise like walking every day will help. A big thing is to keep your weight stable. They don't want you to lose or gain weight. Whatever! I would be happy to lose 10 or even 15 pounds, ha ha!
Nausea can be another side effect but there are so many good drugs that they can usually keep this under control. Alice said they make a guess about your potential for nausea based on a few things... did I have morning sickness during pregnancy (no = good), do I get motion sickness (no = good), am I a smoker (no = bad [well not really, only bad in that I'm more likely to have nausea]), do I drink alcohol (yes = good [but I get terrible hangovers if I drink too much, wonder if that means anything?]). Oh, and you should know the nausea medication causes constipation... awesome. So then you can take more medication else to help with that.
Besides the nausea, I can expect my taste buds to change which also might make eating not as enjoyable. Maybe I'll start to just love the taste of broccoli and hate cookies (and don't tell the nurse, but in turn lose that 10 pounds!). I have a feeling that's not how it will work. Cookies will probably taste extra good and I'll gain 10 pounds instead! The nurse said sometimes people do gain weight... she didn't say why but this is my guess.
Also you are more apt to get sores in your mouth. My friend had already told me about a mouth rinse with salt, baking soda, and water that the nurse also suggested. So I'll be mixing up a batch of that to keep in the bathroom and hopefully won't have a problem with this. I hate canker sores and can hardly imagine having more than one at a time.
Hair loss... yes, dear Alice confirmed that the two drugs I will be taking both cause hair loss and I can say goodbye to my messy curls mostly likely between day 12 and day 19 post treatment (that's the first treatment). So if my hair follicles follow suit, that means I could start losing clumps of hair anywhere from February 28 to March 7. The silver lining is I shouldn't have to shave my legs or anywhere else for a while. I really hope I don't lose all my eyebrows and eyelashes. I might but might not. If for some reason my leg hair keeps growing I will be totally pissed!
Another side effect one of my drugs in particular causes is neuropathy. This is when you have numbness in your hands and/or feet. It can be painful or tingly or just plain numb. It should go away after treatment although can be permanent sometimes.
So now I am in yet another holding pattern. Waiting to find out how I will really feel after I have these toxic drugs in my system. It is so crazy to think this medicine is going to harm my body, my healthy cells, in so many ways while at the same time increase my chances at living a long and healthy life down the road. Why can't some scientist doctor develop a way to target only the cancer cells? They are obviously different from hair follicle cells, skin cells, cells in the mouth, etc. in some way (like a way that kills you eventually which is pretty radical). On a molecular level? I have no idea because I'm not a scientist, and I obviously don't remember as much from the Bio and Chem classes I took in college as I would like! I think I even took advanced classes (back when I thought I was going to study natural resources I took lots of science classes) but I don't remember very much.
This waiting and wondering is definitely causing me a little anxiety. I'm not normally one to feel very stressed or to really notice reactions to stress in my body the way some people do, but I can tell this is effecting me at least some of the time. My stomach hurt last weekend and I'm pretty sure it was just stress. It also could have been some cheese and crackers I ate... how long had that cheese been in the fridge? My mind spins and spins, and it feels like I am thinking of a thousand things at once. I hate when I can't turn my mind off!
In the class yesterday I had a moment where I noticed my heart beating, maybe pounding, and I kept thinking, "I can't believe I am here! I can't believe I am learning about chemo because I am going to have chemo! I can't believe I have this stack of papers and information about cancer sitting in front of me because I have cancer!" I don't remember what the nurse was saying, but then she asked how old my kids were, and I couldn't even open my mouth. I couldn't make a sound, much less say the names and ages of my kids out loud. My kids! A few tears leaked out. I was able to keep myself from full on crying, but it was hard. And then I was fine again.
At the end of the class Alice gave us a tour of the MSTI facility. I was able to answer her question about my kids and she just had the kindest look on her face. The tour was really helpful and I feel a little better knowing where I'm going on Tuesday. She walked through the process of getting blood drawn, seeing Dr. Bridges, meeting the pharmacist, and so on.
The fact is, the unknown is scary. So much in life is unknown, everything really. You don't know what is going to happen any given day or the next week or year. I think we all have said things like, you don't know what's going to happen tomorrow, I might get hit by a truck. It's true, you might, but it also incredibly intangible. I don't think it's something that actually causes most people anxiety on a daily basis.
You don't know you're going to get cancer (or any other life-changing diagnosis). The day before I went to my check-up with Dr. Fealko I never imagined my life would change forever. Then she noticed that lump. Although in the beginning, I honestly wasn't that freaked out. I think the unknown was a bit of a blessing at that time. Cancer was still intangible in my world. After I had the biopsy, then I was more worried. Suddenly it was 50-50... I was either going to get a call saying it was nothing or a call that would literally change my world with a single word: cancer. We all know how that ended.
I noticed after I was diagnosed that I was hyper-anxious about random things. We had a big snow storm and I was so scared to drive in the snow. I have driven in the snow quite a lot... I don't love it, but I know I can do it. But now I felt like maybe I needed snow tires. I felt like I might slide off the road or into another car at any moment. I was a little terrified to drive to Tekoa for Christmas. I thought about getting some chains (we've made that drive countless times in the winter and never once needed chains). I imagined us crashing. All of us sliding into the Payette or Salmon River. People would say, "Can you believe Shana was diagnosed with cancer only to have her family die in a car accident?"
I find that I suddenly feel obsessed with certain, totally random things. Like Juan's undershirts. Hello, random! But after folding clothes the other day and seeing how worn some of the necklines are I can't stop thinking about getting him new shirts and making new rags. I bought some the other day only to realize they weren't the right ones. I didn't look to close because I was only focused on new shirts.
I have done a lot of waiting and dealt with a lot of "unknowns" for the last 3 months and 2 days, to be exact. These unknowns are different. They are tangible, for the most part. I know I have to do chemo. I don't really know how I will feel. When will I start to feel it? How long will it last? I know things that might happen, but will they happen to me? I am so thankful for Krista and Jennifer who have shared their personal experiences with me (and also for chemo school), because it lessens the unknowns to a certain extent. They have both been so open with me. So willing to talk about very personal things. Things I'm sure they would rather forget. I cannot thank them enough!
I am by no means excited for next Tuesday, but I am so ready to get it over with. Since I found out I am going to do chemo I have had these weird moments where I think I can't wait for February 17. Then I think, that is crazy!!! There is no way in hell that I am excited for this! And then I realize my body... my mind... is so anxious about it, and I just want to eliminate the unknown. I guess I am "excited" in that sense. And so, if this is my circus, then let's get this show on the road!
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