The C Word – Part 5
First week on the Chemo diet plan! Just kidding.
Tuesday July 27th was my first chemo appointment. It was at the BC Cancer centre’s location at Surrey Memorial Hospital. 1:00 pm. Doug drove me there and picked me up afterwards. Still no guests allowed due to CoVid protocols. I checked in and waited for the nurse to call me. She brought me back to one of the treatment pods and got me settled in a big reclining arm chair. She talked through all the precautions having to do with the chemo drugs I’d be receiving. My “cocktail” code was GICOXB. She warned that the drugs could burn your skin so no one else should handle them, not even the oral chemo drug , without gloves. And no joke, the nurses were practically wearing hazmat suits. She talked about how the drugs would be present in my bodily fluids so those shouldn’t be touched by others either, and I should be sure to wash my hands often. No problem there, CoVid has made us all hand-washing fiends these days. But that also included sex: a good ol’ prophylactic would be in order so I wouldn’t burn my husband’s bits. Never has my vagina felt so powerful!!
She also told me that due to the Oxaliplatin, I wouldn’t be able to touch, drink or eat anything cold for approximately 5 to 7 days following my appointment, which I found odd. She explained that the nerves in my fingers, toes and throat would be markedly over-sensitive to cold. She said if something cold got on the back of my throat, it could cause my throat to go into spasms which would make it feel as if I couldn’t breathe, and may be frightening. Fun! I’d brought my huge jug of water along to drink. After a ride in a hot car I didn’t think it was even cool anymore but the nurse still feared it was too cold so she dumped it out and refilled it with room temp water. Then she had me take two of my three different anti-nausea prescriptions.
Coincidentally, I’d been prescribed one of those medications – Ondansetron – for nausea once when I was back in the USA. I didn’t have any prescription coverage at the time and the prescription for eight pills (yes just EIGHT) came to $175.00. That’s over $21 PER PILLl! I couldn’t even afford to fill the whole thing – I asked the pharmacist if they could just sell me half the prescription, which they grudgingly did. My prescription here was for 10 tablets of the same drug. FYI, my non-Canuck friends, the Canadian healthcare system doesn’t cover prescriptions. You can buy or obtain supplemental health insurance to help with prescriptions and extended medical claims like chiropractic, massage, therapy, etc. We have two such plans – one through Doug’s job and one I buy outright. The one I buy only costs $175 a month for the both of us, FYI. So, I ended up paying $0 at the pharmacy. BUT I had a sneaking suspicion that the cost of that medication was probably much lower here in Canada than in the USA, so I checked my insurance claim report. And was I right? You bet your ass. The list price for 10 pills was $71.00 in Canada. That’s $7 per pill. Still a bit expensive, but ONE-THIRD the cost of the same medication in the USA. It’s a medication that works. It provides much needed comfort to people. It lets them live their lives and take care of their families. And so, as usual Big Pharma holds people’s pocketbooks for ransom if they want to feel better. If they want to simply LIVE. Making good health a luxury item for the rich. Which is why I continue to be sickened by Big Pharma.
But I digress…
After I took the anti-nausea pills, my nurse talked me through my oral chemo drug, Capecitabine. This was one I had to take twice a day for fourteen days in a row, then seven days off, then resume the next round at my next appointment. There were four pills per dose to make up the proper amount: three larger ones and a tiny one. She talked through THOSE side effects: mainly being the possibility of mouth sores (brush your teeth and rinse your mouth several times a day!) and “hand-foot” reaction which causes your hands and feet to become extremely dry, cracked, sore and even blistered. For that, they recommend slathering yourself regularly with lanolin-based skin cream.
She got my arm warmed up, my IV ready and attached my drip bag. For this first appointment, I was only to receive the chemo drug, Oxaliplatin, because my wound was still open and not finished healing and the other drug, Bevacizumab, is not a chemo drug per-se, but rather an antibody which interferes with the blood supply to the cancer cells, so it could interfere with my wound healing. She said it’s common to add that at a later date, especially for post-surgical patients.
I’d brought my headphones and my meditation app. I settled in to listen to healing music and work on my knitting during my appointment. I’d also brought along candied ginger slices and saltine crackers to nibble on and combat any potential nausea. The IV bag was to take about two hours to complete its journey into my arm. Doug insisted that I text him a report on how I was feeling every half hour. So, I listened to Tibetan singing bowls, knitted and nibbled in my reclining chair. The nurse checked on me a few times, but I was feeling fine. She asked me to tell her when the vein in my left arm became cold or uncomfortable, and she would wrap it in a warm towel. But it never was, which she found surprising. Perhaps because I was using that arm, knitting; keeping the blood flowing.
Once the bag emptied, they flushed my IV and sent me home. It was a hot day. We were on the verge of another heat wave. I went outside to meet Doug and took a swig of my water. I was surprised to find that it tasted sweet and milky to me. Not what water normally tastes like. It wasn’t unpleasant, just surprising. And the back of my throat felt like I was swallowing bits of splintered wood or gravel. Perhaps that was because the water was cooler than the outdoor temperature, so I was getting a mild case of the cold sensitivity the nurse spoke of. So strange!
I was fine the rest of that day. Just tired and a bit lightheaded. But that evening as we were preparing dinner, I got another shock to my system as I touched the corner of a bag of frozen vegetables and recoiled violently. It literally felt as if there were shards of broken glass stabbing into my fingertips. That nurse wasn’t joking around! After that I wasn’t about to risk drinking ANYTHING cold for awhile. Which really threw me off my nutrition game. My morning smoothies had been EVERYTHING to me! And a warm smoothie is just not that appealing. How the heck was I going to get my nutritional supplements in my system this week? I’d have to be creative. I had instructions to take another two of the same anti-nausea pills that evening before bed. I took them, and my phoenix tears, and slept well.
Wednesday morning, I woke up and still felt all right. The vein discomfort the nurse had spoken of was presenting itself from time to time, but warming up my arm seemed to dissipate the sensation. Again, I was mainly fatigued and lightheaded and my stomach was a little unsettled, but I didn’t really consider it “nausea” per se. I managed to get some of my supplements into a bowl of oatmeal and nibbled on my ginger and crackers throughout the day. We even made it out to the beach for a little while with friends later on. We came home and I thought I’d whip up a little chicken soup for dinner with broth, frozen vegetables and some star-shaped pasta. When I was a little girl, Chicken and Stars was always my favorite of the horrifyingly salty line of Campbell’s soups so I thought it would be comforting. I needed to take my chemo pills with food, anyway. Swallowing the pills gave me that same prickly, splintery feeling in the back of my throat. It’s strange – food wasn’t a problem, but pills or large gulps of liquid made me feel like I was swallowing a small hedgehog.
Now, I don’t know if the vegetables had gone bad or if there was some other problem with the soup, but as I was choking down my pills in the kitchen, I started throwing up. Thankfully the pills themselves didn’t come up, but the soup did. I absolutely HATE throwing up. It is my least favorite activity on the planet. And this was such a different, acidic vomit. I rinsed my mouth out really thoroughly with the baking-soda mouth rinse they recommended and brushed my teeth really well with peppermint toothpaste, which always has helped me with nausea. Exhausted, I headed to bed. What I SHOULD have done is take that extra anti-nausea medication they gave me to take “as-needed”, but somehow, I thought I could do without. I just took a Gravol and went to bed. I woke up in the middle of the night and threw up. Got up in the morning – threw up. That terrible, toxic, acidic vomit that burned the back of my throat so much. A heat wave had taken hold of our region again, and I felt just plain beat. Like I was back at square one. Stuck back in my little air-conditioned bedroom, in my nightie, in bed, with no energy to do anything. All the progress I’d made over the past month since I returned from the hospital just seemed to fly out the proverbial window. I started to cry, but the tears welling up behind my eyes hurt too much. I wondered if it was another side effect. So, I was back in Beverly Crusher’s sickbay with no focus to read or watch or listen or do ANY-thing. I just lay there and stared at the wall and drifted in and out of sleep. It was then that I came to a poignant and insightful personal realization: CHEMO SUCKS.