First Day of Chemo.

Chemotherapy is a scary word.

From the day I got my diagnosis, I was terrified of the inevitable day I would be undergoing chemo. I couldn't shake the fear no matter how strong I was trying to be. Every day I thought about the terrible images I had seen in life. My curiosity forced me to spend my time googling "what is chemo like" as I was lying in bed at night. I had an irrational fear that as soon as they injected me with the drugs my body would fight back with an extremely intense reaction.

I want to explain what to expect on your first day of chemo so that you don't live weeks with the same inescapable fear of the unknown that I put myself through.

The chemo regimen that I am undergoing is two months of bi-weekly Adriamycin Cyclophosphamide (AC aka the "Red Devil") followed by three months of weekly Paclitaxel and Carboplatin (Taxol/Carbo).

Before starting chemo, I underwent a surgery to place a port in my chest. This port is under the skin and is connected to a catheter that is going through one of my veins. If you get told you have to get a port, do not be scared, This is so much easier than getting an IV each time you go in for chemo and it protects your arm veins from being destroyed by the drugs.

The procedure started with going to the hospital, changing into a gown, and meeting with the nurses, anesthesiologist, and my surgical oncologist performing the surgery.

From the time I went under to procedure completion was an hour. Then, I was in observation for an hour. An xray tech came in to take images of the port to ensure it was placed in a safe spot. I am left with a scar above my port that is a line about an inch and a half. The port is something easily felt under the skin; however, it is totally worth it. This port is where the chemo nurses inject the needle to give pre-medications (steroids, anti-nausea, antacid) and chemo itself.

After the port was in, it was time to get this chemo thing started! My chemo oncologist ordered all my prescription meds so I would have them at home. I got all of those organized and ready. In this prescription pack, I received numbing cream with the direction to place it on my port an hour before before my chemo appointment. (helpful tip: cover numbing cream with press and seal to keep clean and in place).

Ok, the time is here. I walked in to my first chemo session with a pit in my stomach and pushing down fearful tears. Let me tell you... the support of experienced patients and amazing nurses was overwhelming. I will never forget the woman who walked up and hugged me telling me it will all be ok. I believed her and it brought comfort to my morning. I was sent to my chemo chair among the many chairs and rows filled with other fighters. I couldn't believe it was actually happening. I'm a cancer patient. I'm losing my hair. I'm getting poison pumped into my body because of this dang lump... and then I met my chemo nurse.

Wow! What a wonderful person. After many rounds and many nurses, I can assure you each and every nurse has been incredible. She introduced herself and proceeded to explain how the day would go.

First, she cleaned the port area, I took a deep breath in, and she inserted the chemo needle. EASY! The area is numb so this did not hurt whatsoever... just a little pressure. Next were the pre-meds. These are different for every chemo and every person so your experience will be slightly different. My pre-meds consisted of injections through my port and short drips (like an IV drip). For some chemos there is a waiting period between pre-meds and chemo. My first four chemo rounds do not have a waiting period; however, my second regimen has a 30 min one.

Pre-meds are in... time for the long anticipated chemo drug. For AC, there are two chemos administered. One is given in three extremely large syringes slowly pushed through the port line. This one causes mouth sores so while it was being injected I have to chew ice to "hide" the cells from the poison. (helpful tip: bring popsicles or ice cream instead of ice) They call this one the "Red Devil" because it is bright red and causes the most severe side effects. After this comes the chemo drip which runs just like any IV. I was pleasantly surprised and relieved that everything went in with no pain.

Now, the hard part comes at home. Nausea and fatigue will hit; especially when the pre-meds wear off. For me, the most severe effects were felt 3 days after chemo was administered. Please read my "Chemo Survival Kit" post so you have products to help alleviate side effects.

Keeping a journal to log side effects and when they occur will be extremely useful. Every patient is different so after your first round they will adjust medications to better accommodate and control your specific side effects. This will make future rounds easier to handle.

I hope this post provides explanations and answers so that you strut confidently into your first day of chemo!