First chemo: Deflowered and doing okay

Wearing HazMat gear – a Smurf-blue gown and green surgical gloves – my nurse Monica entered my chemo room carrying two huge syringes filled with red-orange fluid.

It was Adriamycin, the most potent cancer-fighting drug. Patients call it “the red devil” or “the red death” for its devastating side effects – nausea, hair loss, mouth sores, exhaustion. I’d already heard a full disclosure that those effects could include cardiotoxicity – damage to the heart muscle – severe enough to cause congestive heart failure. Each patient has a lifetime quota of how much “red death” they can safely receive. My current treatment will amount to just under half my lifetime allotment. So if I get cancer again, there will still be a few magic arrows in my oncologist’s quiver.

“Are you ready?” Monica asked.

This was the moment I’d most dreaded, the one that had kept me up last night.

“Let me send Mark to get some ice chips,” I said. “I heard that keeping them in my mouth while you administer it might prevent the mouth sores.”

Monica laughed. “There’s a real trend now among patients who think that. It’s fine if it makes you feel better.”

I was a little disappointed that this tip – which I’d gleaned from other chemo patients – didn’t have a nurse’s seal of approval, but figured I might at least get a placebo effect.

Once I’d loaded my mouth with ice, making me feel like a squirrel preparing for winter, Monica inserted the first syringe into the tube that dangled from my port, and slowly pressed the plunger.

I watched the Kool-Aid-colored fluid flow through the clear tube and could see when it started to enter my body.

And I felt – nothing.

There was no sensation from the fluid, no burning, no buzzing, no tingling.

In fact, Monica had warned me that if I did feel burning, I should tell her immediately and she would stop, because that would indicate that the stuff had leaked. It can cause third-degree burns on flesh, but doesn’t have the same impact on blood vessels.

That anticlimactic moment typified what turned out to be a tedious day of waiting and schlepping.

We showed up at the cancer center this morning laden with three bulging bags of supplies – food, hot and cold beverages, books and magazines, a laptop, a giant 3-ring notebook the center gave me and expected me to lug in for each treatment, my seven bottles of prescribed meds and vitamins (so they could double-check them).

When I went to the VAD (vascular access device) room to get blood drawn, a motherly nurse named Vivian exerted herself to be extra comforting, because she could see I was shaking from anxiety about my first time.

“It won’t be as bad as you think,” she said. “Just this one little needle stick may be the worst part of the whole day.”

And she was right. Inserting the needle into the port was just a pinprick. Once it was in with a tube connected, it stayed there all day so they could both draw blood and administer drugs through it.

“Some patients really grow to love their port because it saves them from getting stuck all the time,” Vivian said.

“Love” might be overstating it, but I could definitely see the advantage.

Then it was back to the waiting room, then back to the VAD room for another blood draw, then a wait while they called my doctor to see if she wanted yet another blood draw (she did).

For the vital signs tests, three different technicians each called their patient at the same time, creating a scene like the cash registers in Filene’s Basement. Each patient had a support person and a technician, so there were nine of us milling in a narrow corridor, the three patients waiting our turns to sit in the single chair. It was clear I was a newbie, as the other two were already bald. Mark and I tried (unsuccessfully) to tuck our giant bags discreetly out of the way.

We met with Dr. D, my oncologist, who was as efficient as ever, this time focusing on the post-chemo meds.

Friends have asked if I like her, and I do, but that’s almost irrelevant. Much as it pains me to resort to martial clichés, the intensity with which she’s outlined my situation has made one thing clear: This is war.

You don't pick a general who's nice, namby-pamby or conciliatory. Dr. D is someone who will marshal all available resources to eradicate the enemy that has invaded my body.

“The first time is your best shot to get rid of cancer,” someone told me. "If it comes back, they can't do as much. You want to do everything you can to knock it out now."

My fervent hope is that this phase will be the one and only time.

That's why I'm doing the dose-dense chemo Dr. D recommended. The theory is that by hitting them every other week, the cancer cells won't have as much time to recover before the next onslaught. Of course, neither will the healthy cells that also get destroyed.

After still more waiting and then some waiting, we were finally ushered to the infusion center and into one of the alcove/rooms where a portly middle-aged man sprawled on one of the two recliners, being tended to by a pair of nurses. My face fell. I really, really didn’t want to spend the day making strained conversation with a guy who looked like the banker dude from “Monopoly.”

But the nurse coordinator wheeled us right around and whispered to me: “I’ll find you another room, hon. I like to keep the same gender together.”

I could have hugged her.

It made for yet another wait, but she not only found me a different room, it was a private one, usually saved for disabled patients.

“We like to make things easier for your first time,” she said.

Monica hooked me up to the pre-chemo drugs that forestall nausea. A pump emitted a monotonous whirring and thump every other second as it pushed the drugs into me.

Then it was time for the Adriamycin, which took 20 minutes to administer via the syringes. Next up was another chemo drug, Cytoxan. It has its own litany of side effects, many of them similar (but not as intense) as those from Adriamycin, plus a few others, such as bladder infections. That got pumped in for an hour.

All day long, we heard lengthy (and repetitive) discourses from everyone – doctor, pharmacist, nurses, nutritionist – cautioning about the side effects, discussing all the meds to take to stave them off, advocating that I drink drink drink fluids to flush all the poisons from my body. Believe me, I’m motivated.

“You should feel okay on your chemo day and the day after because the IV steroids will still be in your system,” we’d heard at orientation. “But Day 3 – Whamo! That’s when you’ll start feeling tired and cruddy. Day 4 will be bad. By Day 5, you’ll start feeling like you’ll live. On Day 6 you’ll see more light at the end of the tunnel, and by Day 7, you should feel okay.”

After six hours at the center, three of them getting the various meds, it was finally time to go home.

“You’ll probably want to get a buzz cut before your next chemo in two weeks,” Monica said in parting. “By then your hair will be falling out in big hunks.”