The night after the port was placed on September 13, it was difficult to get comfortable while lying down. The incisions were tender, and because of my vertigo I could not lie on my back. Despite this I felt okay the next day. At least until the premeds I took to prepare for the chemotherapy got into my system.
Because of the side effects of the chemo, I needed to take steroids, Dexamethasone, the day before, day of, and day after the treatments. This helps prevent nausea and vomiting as well as reduce inflammation. There are side effects from this as well, but will write about the side effects I had from all the drugs in a later post.
My oncologist prescribed a bottle of 4mg pills, and wanted me to take two pills, 8mg, in the mornings, and two in the afternoons. She made sure I knew the pills could cause sleeplessness, so I should not take them too late in the day.
I am not used to take a lot of pills, so did not realize that 3pm was too late for the afternoon dose. The drug made me jittery, and I was up a good part of the night working on a puzzle while eating toast with a lot of butter, since it also made me famished.
Friday, September 15, after not much sleep, I got up early to take the steroid pills and get ready for my first chemo infusion. I was jittery from the steroids and very nervous as I did not know what to expect. I had been with a good friend as she got some of her chemo infusions four years previously, but our drugs were different, and it’s not the same when you are the one being treated.
As I applied my makeup I was not happy with what I saw in the mirror. My face had ballooned (“moon face”) and was red from the steroids. I was not a pretty sight. The makeup could only do so much to cover it up.
The incision from the port was not as tender, and the port is located not immediately under the incision, but below it. It still did not feel good to rub the lidocaine cream over the port before we left for the hospital. The lidocaine helps numb the skin that covers the port so that the the insertion of the needle will be less painful.
When we arrived at the hospital a nurse weighed me, then brought us in to what they call the infusion suite. This hospital has done a nice job of making us feel as comfortable as possible. There are many recliners where the patients sit while being treated.
After the nurse checks the blood pressure, pulse, and body temperature to make sure you are not sick, she draws a few vials of blood. She does this through the port by inserting a needle through the skin.
First we both put on face masks to make sure viruses and bacteria will not be present when the needle breaks the skin. Then she disinfected the skin on and around the port thoroughly. After the disinfectant is dry she uses her fingers to feel for the correct place to insert the needle. My port has three raised dots to show where the nurse is supposed to insert the needle.
The first time after the port placement it did not feel good when she was pushing and trying to feel the dots as I was still tender from the surgery.
When she had found the correct spot, she asked me to take a deep breath, then as she inserted the needle, let the breath out. I don’t know if the lidocaine or the breath helps, because like most needles it hurts when it is inserted. It is wider than a normal syringe, and about 3/4 of an inch goes into your body.
After the needle was in and taped onto my chest I could take off the face mask. Now I was ready to have my blood drawn through the tube connected to the needle. The tests check to make sure you are in good shape for the chemotherapy drugs to be administered. If there are issues with your blood count, white blood cells, your organs, or anything else crucial, you are not allowed to be infused, as that could be dangerous for you.
The test results came quickly, and I was taken to see my oncologist to go over the tests to discuss how I felt and any questions or concerns. My heart rate was elevated, as was my blood pressure. Between being nervous about the procedure and having taken steroids that was not a surprise.The doctor gave the green light for the infusion.
I went back to my recliner, put on a blanket that I had received from a good friend, and books, snacks, and other things to keep me occupied on a side table. Sitting around too long drives me crazy so I needed things to do for the hours I would be there. Craig was amazing and stayed with me the whole time, but he had work to do, and I could not expect him to entertain me for hours regardless.
Before the treatment the nurse gave me Tylenol to prevent headaches that the Herceptin could cause. The first 30 minutes of the infusion I was given premeds to counteract the side effects of the chemo drugs. These drugs included Aprepitant (Cinvanti), which blocks the action of neurokinin which causes nausea and vomiting, and Palonosetron (Aloxi). This is also used to prevent nausea and vomiting, but the effects begin within 24 hours after the chemo infusion.
As the premeds entered my system I could smell / taste sawdust. Later I was told that for some the taste is worse than that. I did not think about it then, but during subsequent infusions I sucked on mints during that part. It was nicer than the sawdust taste.
The following 30 minutes I was infused with Herceptin, the drug that only targets the HER2 protein that attaches itself to the cancer cells. Because it is not a chemotherapy drug this can, and will, get infused every three weeks for one full year to make sure the cancer cells will not come back.
The last two drugs, Taxotere and Carboplatin, are both chemo drugs. The first hour I was given Taxotere. It can cause neuropathy (pain or numbness in hands and feet), so during this I had ice packs on my hands and feet to help prevent that from happening. It can also cause mouth sores. The nurse asked if I wanted to chew on ice. Because of my mental state, and being tired from minimal sleep, I had no idea why, even though I am certain she explained. So I did not chew on ice the first time. This was a BIG mistake as I got very bad sores in my mouth and throat less than one week after the infusion.
I took the second dose of steroids at 1pm. It was still too late as it kept me up the following night as well. Found that the ideal time for me to take it was noon, so I set an alarm so I would not forget.
The last 30 minutes I was given Carboplatin. This has many of the same side effects as Taxotere, but no neuropathy, so I was freed from the ice packs.
Between the drugs and saline solution you are given A LOT of liquid. After many trips to the restroom you are still bloated. It is worst the first week or so after the infusions, but is does not completely go away until over one month after the last one. I had to wear larger pants and oversized shirts and lived in sweatpants and sweatshirts at home throughout my treatments. Everything else was uncomfortable.
The Infusion Suite
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