The day after: Mal de mer

They lied.

At chemo orientation they said we’d feel relatively okay the day after treatment.

Last night (Thursday night, right after treatment), I was indeed fine. Mark and I strolled to the health food store, I cheerfully chug-a-lugged water and herbal tea as directed, ate a light dinner, watched some mindless TV and collapsed into bed by 9:30 p.m.

My eyes flew open at 1 a.m. My stomach was sending out major distress signals. From tummy to throat, unhappiness reigned.

They’d explained this to me over and over. Chemo kills all fast-growing cells. Your entire GI tract is one big mucous membrane, packed with cells that are constantly dying and developing. Chemo turns the lining of your stomach raw. Your stomach signals your brain that it’s not happy. Your brain sends a signal back, “Throw it up.”

The anti-nausea drugs act by blocking one or both of these signals. And they are working a bit. I don’t actually have to vomit. I just feel queasy. Unfortunately, it’s hard to ignore.

I tried to take deep cleansing breaths and clear my brain. “In, fresh. Out, flower.”

But my evil monkey mind tortured me with images of food as if it were trying to trick me into a mad dash to the bathroom.

Embarrassingly, one of my go-to images for relaxation comes from a Clairol Herbal Essence commercial circa 1970s. A cartoon girl with Rapunzel-worthy hair flits through a verdant forest until she reaches a beautiful mountain pool where she disrobes (the hair provides discreet coverage) and takes a refreshing dip (while polluting the water with those pretty effervescent shampoo suds).

Instead of helping me unwind, that image now conjured up the thought of all the water and liquids I’m supposed to drink, 64 ounces a day. The very idea of water was enough to clench my stomach a little more. I ran through various other beverage options – all seemed unpalatable. Getting frantic, I inventoried potential light foods I might be able to stomach. All seemed downright repulsive.

I could hear my stomach warning me as if a miniature mobster from a bad B movie had taken up residence in my body, “You’d better not try to put anything down here -- or you'll be sorry.”

FRIDAY AFTERNOON UPDATE: I wrote the above in the dark hours of despair. Initially I tried one of the antinausea meds Dr. D had recommended for nighttime, because it's supposed to induce drowsiness and stop nausea, but it did neither.

At 3 am, Mark convinced me to take the heavy-duty Emend which I was supposed to save for morning. "This is morning," he pointed out, reasonably enough. It goes down along with Decadron (a steroid). I have just two Emends, which cost a whopping $110 per pill, covered by insurance but I'd gladly pay double out of pocket.

And that did the trick. The nausea finally slipped away and I was back in bed by 4.

I woke up feeling just mildly "peakish." After a lifetime of loving to eat, overnight I have developed a deep disinterest in food. Still, breakfast went down okay and I'm sipping my fluids as directed.

Some folks told me that the steroids (I had IV ones before chemo plus the Decadron) would give me a burst of energy. I had imagined that I'd be bustling around the house, finally reorganizing the linen closet and prepping the garden for winter, if not actually hitting home runs and acing the Tour de France.

No such luck.

Once more I'm pleasing the kitties by lying docilely on the couch all the day long.

Countdown towards chemo

It’s not just Drano they’re injecting into my veins.

It’s actually a carefully crafted “cocktail.” As I understand it (I may be bit shaky on the precise medical terms), the ingredients are Drano, Agent Orange and Round-up. See, it contains something orange – that must mean it’s kind of like a screwdriver, albeit one made with the worst rotgut imaginable.

How toxic is it?

At chemo orientation, they said our partners must wear condoms for protection from our soon-to-be-noxious bodily fluids.

We toured the "infusion center.” Since I’d heard so much about the comfy recliners for receiving chemo, I was picturing that it would have a homey feel, like an upscale birthing center with Martha Stewart-esque fabrics and colors and lots of nice touches to warm it up.

It looks a lot more like an ICU.

There’s a nurse’s station in the middle and maybe 10 patient rooms – actually they’re more like small alcoves. As a cubicle dweller, I should feel right at home.

The décor may be lacking but the people are indeed warm.

Melody, the head nurse, is a friend of a friend, and gave me a huge, welcoming hug and whispered that they’d take good care of me.

The orientation was informative if not totally comforting.

The best news is that retching one’s guts out after chemo is a thing of the past. Patients may still feel queasy, but the nausea-blocking drugs are super-powerful. I’ve been prescribed five separate meds to prevent nausea and that doesn’t count the anti-nausea drugs they’ll give me intravenously. If need be, post-chemo we can return to the infusion center for more IV anti-nausea meds and IV hydration.

Fatigue is another matter. There are likely to be several days of feeling cruddy after each infusion. Since chemo is cumulative, the bad days can get worse and more frequent with each new cycle.

I don’t feel sick. It’s still so hard to grasp the paradox that I am agreeing to be poisoned – in the pursuit of good health.