In the Chemo Chair

Today might be my last chemo treatment ever. Maybe. I said the same thing a month ago, so you just never know. The uncertainty leaves me somewhat apathetic: should I celebrate? Should I not? Even if I knew this was my last treatment, apathy is a normal response. Yes, it's fantastic to say good-bye to the annoyance and crumminess associated with chemo, but it's also a little scary to walk away from the cancer-fighting coverage of these drugs. 

I'm officially a chemo veteran: I've sat in this chair more than 25 times and I took an oral chemotherapy for six weeks. I've dragged loads of friends along to keep me company and make me feel more like we're on a coffee date than hanging out while my cancer gets poisoned.

If you haven't had the dubious privilege of stepping behind the "Infusion Clinic" doors, here's a glimpse:

It's long. There's a lot of waiting. The nurses are really nice. Mostly, they make you feel safe and try to make you laugh. But if you're an emotional mess (like I was last time), they are wonderful - you might even get a great hug or two.

My experience isn't like everyone's. For example, my aunt talked about being in the bull pen: a circle of recliners full of people getting chemo. In my clinic, we all get our own cubicle. Not exactly private, but the illusion works. I'm sure there are people who are bothered by the bull pen set up, but it seems like it could be a built-in support group. I would have liked it. 

Here's what my cubby looks like. The nurse's side:

And the patient side. Peaceful garden view, nice flat screen, iPads to borrow (laptop is mine, using free wifi), free beverages (although the soda is mine, which sounded good before I went in, but never sounded good while I was there. Finicky patient!).

When I come in, we stop at the scale for a weight (any big swing up or down might mean trouble), and then I'm ushered to my cubicle for vital signs. 

I get comfy in my vinyl recliner (vinyl for easy clean-up between patients) and wait for the nurse to come and get my IV started. First IV action: a blood draw.

Here I am with my IV hooked up - subtle! :)

And then more waiting while the lab runs the blood work, because the results could mean I don't get treatment that day. Twice I've been "kicked out" of chemo because my platelets were too low. That creates it's own emo roller coaster (can we get the dose adjusted appropriately? what happens if this doesn't work?).

While I'm waiting, the nurse usually asks some key questions. Have I fallen recently? How are all my systems working? Any pain? Nausea? If there's nothing wrong, you say "no" a lot, but this is where the nurses shine, because if there is anything wrong, they can help you through it, or get the doctor to help you out. And if there's nothing wrong, you can chat about their kids or their mom's recent trip to Europe or whatever else interests you.

If it's a "doctor day," the doctor will stop by while the labs are underway. From my comfy recliner, I can ask all my questions, get prescrip refills, answer all her questions, and let her listen to my heart and lungs. I admit I've eavesdropped on the doctor next door before, but usually the clinic buzz creates a white noise. My friends and I are usually contributing to the white noise, too, so I don't think about privacy very often - plus, there isn't much I feel the need to keep private. We're all talking about nausea, constipation, etc, anyway. 

Once the labs are done (it usually takes 30 minutes or so), the doctor gives the go-ahead for chemo and we wait again while the pharmacy mixes the drugs. Since chemo drugs are so expensive, they don't prep them ahead of time because they can't be used for someone else or saved for next time. It would literally be hundreds, sometimes thousands, of dollars down the drain. (Well, technically into the chemo waste bin - we're not dosing the salmon with wasted chemotherapies.)

Waiting for the pharmacy takes another 20-30 minutes, depending on how busy they are. More time to chat with my friends. Some people sleep, read, watch TV, surf the net... anything you can do in a regular recliner, you can do at chemo.

And they have special restrooms for chemo patients. So we don't get your germs, and so you don't get our chemo cooties. That's a technical term, of course! Actually, the risk is minimal, but most chemo leaves the body through the urine within 24 hours, so there's a little chemo exposure potential if someone's messy. Just a little - we don't have to use a separate bathroom or do any special cleaning at home.

Finally, after being here for 90 minutes or more, it's time to roll! 

First, pre-meds. This is the beautiful part of cancer treatment that has come such a long way in the last few decades. These prevent nausea and other side effects. Wonderful.

Then, the actual chemo. Depending on the drug, it could be a syringe pushed into the IV over a few minutes, or a bag of fluid that runs over several hours. Which translates into more waiting/visiting/napping/YouTubing.

And then - the IV pump beeps, the nurse returns to remove your IV, and suddenly you're free! After all that sitting and waiting, I'm usually exhausted. I'll sneak through afternoon traffic, trying to psych myself up to get some things done when I get home.

Tonight, I have a week's worth of Bible study to do before tomorrow morning, and another big chunk of prep for my student group tomorrow night. But then, this would be the perfect time to watch Footloose. I'll probably walk my dog, look at the Bible study, and fall asleep on the couch. Chemo's always a good excuse to slack off. :)