September 14, 2019 - Chemo Side Effects Week 1

It's been six days since I received my first dose of chemotherapy. As my sweet infusion nurse confirmed, that first day (Monday) was going to be the best that I would feel during chemo, and she was right. We knew nausea and fatigue would arrive, but didn't know when or the severity. Let's just say that it came sooner than I wanted.

Before chemo starts, they give you three versions (mild, medium, severe) of nausea meds to manage the symptoms. Because everyone reacts differently, we would need to figure out the best combo for me. On a curious note, I also have to take a Claritin every day - for BONE pain. Who knew?

As a reminder from a previous journal entry, here is the chemo cocktail that was administered this past Monday:

Part 1: "Dose Dense" AC Every 14 Days X 4 Cycles (8 weeks in duration)

AC is made up of 2 chemo drugs: Doxorubicin and Cyclophosphamide. They are more well known by their Trade Names: Adriamycin and Cytoxan, which they are affectionately called AC. The affection is misplaced because Doxorubicin is also known as the "Red Devil". I will speak more about that later. The entire chemo cocktail is made up of the of the following:

• Aloxi (anti-nausea)

• Dexamethsone (steroid)/Emend (anti-nausea)

• Doxorubicin (chemo)

• Cyclophosphamide (chemo

• Neulasta (white blood cell booster)

In an earlier post, I mentioned the power of the Red Devil, but I may not have elaborated on the toxicity. "Chemo drugs are toxic, said Captain Obvious!" Their job is to kill cancer cells, but they also kill perfectly good cells in the process. AC (Doxurubicin), ie Red Devil is particularly toxic. From the moment of infusion, it takes 48 hours for the toxicity to flush out of my system. This means (in no particular order):

No one can drink after me. (Mason always drinks after me)

No sloppy kisses. (This I will miss)

My clothes must be washed separately from Jamie and Mason's (in HOT water - TWICE). (Thank goodness Jamie likes to do laundry, ? )

Jamie must wear chemo approved gloves to handle my clothes (you can buy anything on Amazon)

Any bodily fluids (i.e. vomit), Jamie must wear gloves to clean it up, then he will have to double bag the cleanup to throw it away. (God Bless Jamie)

Because the Red Devil is so toxic, Jamie and I rented a furnished corporate apartment in Atlanta for the next 2 months. The plan is to receive chemo on Monday and then wait out my most toxic time (48 hours) in Atlanta. We did not want to bring that toxicity home, especially to Mason. It is harder on Jamie and I because of the time away from him, but it keeps our home safe. It keeps Mason safe. I will basically receive chemo on Monday, and Jamie and I will hang out in the apartment until we leave on Wednesday late afternoon. Well, me hanging and Jamie working. Jamie has a nice office setup, so it is business as usual for him, which is a blessing.

Unfortunately, the toxicity and nausea are not on the same schedule. Based on my experience this week, my nausea increased daily, with the worst days being Thursday and Friday. On the bright side, I am at least in the comfort of my home when I feel my worst. I must say, I have totally underestimated both the nausea and the fatigue. It is intense.

We have also been told that the effects of chemo are cumulative, meaning each dosing week (every other week), I should expect to experience more severe side effects and even new side effects. We shall see. Everyone reacts differently, so I am praying that mine stays steady. This I can handle.

In addition, my white blood cells are under attack, which means my immune system is compromised. We have to be very careful of any outside germs or illness. Even the smallest cold could knock me down and require a trip to the ER. I am under strict instructions to go to the ER if my temperature ever reaches 100.4. So, between the apartment in Atlanta and home, I may turn into a hermit for a bit. On the bright side, this is only for the first 8 weeks of chemo. The second 8 weeks is not as severe. Yay!

As I sit and write this Saturday morning, I have a little nausea, but I am managing with one of my prescribed nausea wonder drugs. We are getting better at figuring out which combo works the best for each day and level of nausea. The main goal is to not vomit (sorry for TMI) and be able to eat to keep up my strength. Hydration is actually the most important thing. I am drinking as much fluids as possible.

And, if nausea and fatigue isn't enough, my scalp is beginning to tingle. It is an interesting sensation, and typically indicates hair loss is around the corner. I know that hair loss will be the next big milestone. It is such an emotional topic, especially for women. I am committed to get through it with grace. Some folks experience hair loss between Day 10 - Day 14. Any bets on my day? I am feeling brave these days, so I am planning pictures, videos, etc. We will see how long my bravery lasts. On a positive note, I do have a few cute wigs and hats that I will introduce you to over time. If I can't have my real hair, I might as well have fabulous fake hair!!!

Until next time...