Sally Redeemed

The eve of yet another chemo treatment has arrived. Number six is tomorrow and at this point I am ready for almost anything that happens in that cancer center. Two weeks ago, for number five, my nurse was the infamous Sally the Drug Pusher. I thought we were in for yet another doozie of a day when she drew my blood. After the nurse draws my blood, the usual routine is to discretely tuck the tubing coming from my port into my bra. Most of the nurses are quite tactful with the process. Sally, however, saved herself a couple of steps and left the syringe attached to the tubing and just shoved the whole kit and caboodle down my shirt. "Uhhh....aren't you going to take that syringe off the tubing?" I asked as I looked down at the excessive medical supplies in my shirt. Giving her the benefit of the doubt, I figured she just forgot to remove it. As she answered no, she continued turning my bra into a supply closet by taping the syringe to my chest. Apparently she thought my concern was with the syringe falling out of my shirt. But really, Sally, I am just disconcerted with the fact that you feel you can just stuff whatever supply you may need later down my shirt.

Oh well. I figured it was what it was and I took the blood samples to the lab. I met with my actual doctor rather than his nurse practitioner (no pooping demos this time, darn). He scheduled a PET scan for September 1st to check my progress. I am anxiously thinking good cancer fighting thoughts in hopes that the chemo has made a decent impact on the cancer.

After speaking with the doctor, it was back to Sally for chemo. Once the pre-treatment drugs were completed, I hesitantly asked Sally for ice, giving her my biggest, most charming smile. While she didn't exactly seem happy with my request, she at least didn't act like finding ice was the most strenuous chore. As she pushed the first three drugs, we chatted about various things like the book that I was trying to read, the restaurants participating in a deal called Devour Downtown, and she even told me some funny stories about her nieces and nephews. Overall, she was pleasant to have around. We found a mutual respect for each other. She respected my desire for ice and I respected her quirky ways of going about things. She still gave me more drugs than the other nurses, but not quite as many as the first time. And this time I actually wanted the Emend rather than trying to ward off her adamant drug sales pitch.

On Friday when I went back for my shot (to boost my white blood cells), Sally was the available nurse once again. She took my vitals and asked how the rest of the afternoon went after the chemo. I let her know that I was pretty miserable, that I felt gross for most of afternoon and evening. Sympathy I was expecting, accountability I got. "Do you think it might have had something to do with the donut, cookie, and chicken nuggets you ate during treatment?" she asked. Sheepishly, I looked down and owned up to my mistake. Normally I don't eat during chemo to ensure I don't feel gross, but for some reason I felt invincible and indulged my cravings for sweets and grease and sent Shane to McDonald's.

I like that Sally called me out. I like that Sally does things her own way. You know, I think I even like Sally.

Don't Forget the Emend!

Preparing for my fifth round of chemo tomorrow, I am feeling strong! The night before chemo always brings a bag of mixed emotions because by the time it is ready for another round, I am feeling so good - 100% recovered from the previous treatment and I know that in less than 24 hours I will be knocked down by another wave of drugs. But I know the drugs, while they may feel like they only make me weaker, are actually making me better.

And now I know to carefully watch the nurse's pre-treatment regimen.

After my third chemo treatment, I was unusually tired. I slept all afternoon, evening, and night. It took a full seven days for me to feel "normal" and during those seven days I felt completely wiped of energy. I simply figured that the chemo was catching up to my body and that was what my recovery was going to resemble from here on out. However, after my fourth treatment, I realized that the nurse from round three forgot a very important pre-treatment drug, Emend. Emend is a powerful anti-nausea medicine (the one that Sally the Drug Pusher so adamantly insisted I take). I sheepishly admit that Sally was right, the Emend is a miracle drug. It does make it a little bit difficult for me to sleep, but thus far I have been successful at finding things to keep me occupied at 2:00 am. The nurse for my fourth treatment remembered this wonder drug and my recovery was vastly different. My energy level was that of a normal human (only slightly lower than the usual crazy-Lori energy level). And I felt 100% after about five days.

My family visited this past weekend and we had a great time discovering Indianapolis. Saturday was a very active day starting with a family run/workout followed by a bike ride and ending with rock climbing. After rock climbing and discovering my new respect for it as a sport (especially one that is meant for long-limbed people), I mentally recapped the day. I basically had three workouts and felt great! It was so encouraging to be participating in normal life, I practically forgot that I am fighting this battle called cancer. But after mastering (I use that term very loosely) a sport for which my limbs are approximately 12" too short, cancer ain't got nothin' on me!

Our six person family bike ride that almost ended very poorly when I was allowed behind the wheel and steered the right side of the bike into a brick wall.

How to Poop*

*Reader discretion is advised
Warning: Personal information and graphic description beyond this point, continue at your own risk.

One of the many side effects the doctor warned me about before we started this whole "let's pump lots of drugs into you" process was constipation. But he mentioned this specific side effect in a nonchalant way as if we would simply cross that bridge if and when we got to it. Well, Doc, we have arrived at the bridge.

A few days after my third treatment, the morning my bowels finally decided to move again, I experienced a bloody stool. Slightly alarmed, I began to run through the list of "you should call your doctor if..." Sure enough, this made the list. So before I left for work, I called in and talked to one of my least favorite receptionists at the cancer center. I had to describe my poop and attempt to answer all sorts of questions regarding its shape, size, and color. The receptionist assured me that she would pass the information on to the nurses and someone would call me back. Great, just what I want - a description of my poop floating around the office while the nurses draw straws to determine who has to call me back.

Since I didn't receive a call back before I went to work, I kept my phone in my pocket thinking this is a semi-serious matter and I should answer the call when I get it. Well, as the hours passed and I still had not received the promised phone call, I assumed this whole bloody stool thing must not be that important. My assumptions were confirmed when I picked up a message at 1:00 (four hours after my original call) from the nurse practitioner that literally said, "Um, Hi Lori. I got your message. If you have any questions you can call me back and if it happens again please call. Hope you are feeling better." You're kidding!? That is the advice I get? You hope I feel better?

Since I didn't have questions and didn't feel like talking to that unhelpful nurse again, I decided to just wait until my Thursday appointment with the doctor to further discuss the issue. However, it was just my luck that when I arrived that day the doctor was too busy so my appointment was with that same nurse. When she asked if I'd had any problems this time (she must have forgotten my phone call), I reminded her of the bloody stool issue. That.was.a.bad.idea. Because in an accent I couldn't understand, she began to describe to me the innermost details of how to poop. She first gave the nutrition spiel about getting enough fiber - making sure I'm eating an adequate diet of whole grains and fruit, yadda yadda yadda. Lady, I work in the health and fitness industry. You don't have to remind me that fiber is my second best friend. Her next instructions involved a ten minute toilet limit. She even so kindly demonstrated how to bring your knees to your chest to make the whole process smoother. Then as she proceeded to the hand demonstration of how the rectum works, things began to get a little awkward. As she crudely gestured, I wasn't sure whether to find this absolutely hilarious or completely disgusting. Then I remembered that I have actually dissected a cadaver, rectum and all, so I could handle her hand demos. After she finished her show and tell of the pooping process, I made my way to treatment room for my fourth chemo treatment. Four out of eight done - halfway there with a fresh insight on bowel movements.

Snack Time

Last Thursday I went for my third chemo treatment. All in all it was pretty uneventful. But as I walked out the door from work, the reality of this new routine hit me. I was just doing what was normal now - leaving work early every other week to go get drugs pumped into my system. But this whole process isn't "normal" and shouldn't have to be normal to anyone. So I took a picture to remind myself that even though each treatment may not be as memorable as the first, each one is getting me one more step towards healthy.

About halfway through the pre-treatment drugs, I asked Shane if he would go downstairs to the snack bar and get me something to eat. The nurse that was lucky enough to be tending to my crazies this time offered up the fact that they had some snacks in the back that I could have. She did, however, offer it with the caveat that "they don't always have snacks." Yeah, I know, after the ice incident I am well aware that nothing is a guaranty around this place. After I accepted her offer, she brought me some Kool-Aid and peanut butter crackers. It was a yummy little snack and she even pulled up my medical tray so I could have a place to put it. And peanut butter crackers and a juice box sitting adjacent to syringes, medical tape, and rubber gloves is just what I needed to remind me that all of this is far from normal.

Sally the Drug Pusher

Note: The names in this story have been changed to protect identities and feelings.

Last Wednesday I went in for my second chemo treatment in hopes that my little white blood cells were up to snuff. After claiming my chair in the chemo room, a new-to-me nurse came over to take my blood. After having it analyzed and cleared by the doctor, I was good to go. Those little neutrophils came through!

I explained to my new nurse, Sally (who is about 4 feet tall, overweight, and has a hair thinning issue), that after the last treatment I got terrible mouth sores. Being proactive with my health care, I told her I would like to try chewing ice for a longer period of time. Ice slows the circulation and supposedly helps prevent/decrease the mouth sores. Sally insisted I only needed to chew ice for the first drug. Okay, fine, you know best, Sally. I quietly accepted her insistence. I also let Sally know about the intense nausea after the last treatment. This time, slightly more receptive to my beggings, Sally informed me there was something else she could add to my pre-treatment regimen.

As she started the pre-treatment drugs, Sally explained to me that with the new drug she was adding I would have to take a steroid for a few days to prolong the effect. She then went into more detail about the effect the steroid would have. With her eyes bugged out of her little troll-like head, she said I would be hyped up and may have trouble sleeping. Whoa, whoa, whoa, Sally. Hold that syringe! I began to protest (mostly for Shane's sake). The last thing I (and my poor husband) need is a push even further over the crazy cliff. Taking charge of my healthcare once again, I denied the new drug telling Sally that I could deal with the nausea over the inability to calm down. Sally, however, was not going to hear it. She practically insisted that I take this drug because according to her, feeling no nausea and extra energy was certainly better than feeling less energy and nauseous. I swear she was getting a cut of the sale. After her continued insistence that I at least try it this time so I can make an open decision next time, I felt pressured to comply.

With the drug push over, it was time to begin the actual chemo. Sally went to the back to fetch the drugs and also to get me some ice. As she returned, she made it a point to sigh and declare, "I want you to know, it wasn't easy for me to get this ice." Thinking she was being funny (because ice is not that hard to manufacture, let alone find), I laughed out loud. Irritated she said, "We usually don't keep ice around here. I had to scrounge for this. So I guess what I'm saying is if you want ice, next time you'll have to bring it yourself." Wow, Sally. Your hospitality and graciousness are overwhelming.

Needing to relieve myself of the troll's presence, I told her I needed to use the restroom before she started pushing the chemo. I watched as she unhooked one of my IV bags and wrongly assumed it was okay to head toward the bathroom. As I began to walk away, Sally started shouting at me. "Hey! Wait, wait, wait!" As I turned around, I caught her glare as she told me I had to take my IV pole with me. Okay, fine. I grabbed the pole and began steering it in what I thought was the direction of the restroom only to be bombarded once again with shouting. As my IV pole slowed from careening to only slightly out of control, I looked up and saw every nurse in the room waving me in the opposite direction. I guess the nurses are used to people who are about 40 years my senior and don't move quite as speedily as I do.

After the restroom fiasco, I finally sat down to begin the treatment. As the final drug began to drip dry, Sally came over with not one, not two, but THREE prescriptions for me to get filled and some Tylenol for me to take, bringing my total drug count up to ten for the day. (Can a liver catch a break?) Along with the prescriptions, Sally also brought over a small tackle box from the fridge containing lots of pairs of earrings. Passing over the fact that she brought these from the refrigerator, Sally explained that a a few years ago there was a lady that wanted women to feel beautiful as they went through chemo. She put her creativity to work and made dozens of beautiful earrings so that each female cancer patient could pick a pair to wear. She named her endeavor "Ears to You." So after the ice search, the restroom tirade, and the extra drugs, Sally redeemed herself by helping me pick out the perfect pair of earrings. 'Ears to you, Sally the drug pusher!

2 is less than 12

My second chemo treatment was scheduled for this afternoon. Shane was scheduled to be in St. Louis in preparation for a wedding this weekend. With only one car, we had some thinking to do on how to get him to a different time zone and me 80 blocks north to the cancer center at the same time. We finally decided that he would fly to St. Louis so I could have the car, and then I would drive on Saturday to join him for the wedding.

With the absence of Shane (my husband, my driver, my entertainment, etc...), I prepared to tackle this treatment independently. I rehearsed the driving directions in my head, packed a book, and charged my iPad. All week, I had been mentally practicing sitting still by myself for three hours. Without Shane there to monitor my behavior, I had to take extra care to put on my "normal" act as I prepared to venture out in public alone. After four hours of work this morning, I quickly changed out of my uniform and scarfed down some lunch. The time had arrived. I made it to the cancer center without getting lost and walked in, bag of time passers over my shoulder, ready for treatment.

The first step was my blood draw. I then waited for it to be analyzed so I could meet with the doctor. As the doctor walked in, his first question was, "What did you do with Mr. Dale Carnegie?" First of all, his name is Shane. Second, I didn't do anything with him. After asking about my experience after the first treatment and checking for all possible side effects, he felt my neck (the origination of the cancer). Up until this point, I have not been feeling/sizing up the lumps in my neck, figuring I will just let the chemo do its work and not be preoccupied with whether or not the tumors are shrinking. He mentioned though that the biggest one felt considerably smaller, and after feeling it myself and looking at it in the mirror I can tell that he is right, it is shrinking!

Next he pulled up my lab work on the computer. He had me read the chart as if I was some sort of med student. The first line of the chart was my white blood cell count. Two weeks ago before any treatment it was 12. This week it was 1.9, too low to give chemo. Chemo targets rapidly growing cells such as cancer, hair, and white blood cells. If the white blood cell count gets too low, chemo cannot be given because it will drop the count even lower, putting the person at a high risk of infection. Being the scheduler, planner, and OCD-er that I am, this throws a wrench my very well planned treatment schedule. I have to go back next week to try again, and I also have to add another step to the treatment regimen. The day after my treatments, I have to go back and have a shot that will boost my white blood cell count.

The good news with this delay is that I will be more than feeling okay to drive the five hours to St. Louis for the wedding. Watch out St. Louis, I'm bringing my dancin' shoes 'cause my tumors are shrinkin'!

WOW! I feel good...

"I knew that I would, now I feel good, so good, so good..."

This James Brown song has been my theme song this week. Everywhere I go, every entrance I make, I am imagining this song playing. Unfortunately, only I hear the music and as I dance around like a crazy, I get some weird looks.

One of the biggest unknowns going into chemo was how my body was going to react. Now that a week has passed, I am able to compare days and gauge the reaction. Immediately following the chemo last Friday, I was pretty nauseous. They supposedly pre-treated me with me anti-nausea medicine before they gave me the chemo drugs, but my nausea was too intense to be anti-ed because as I walked to the parking lot, a wave of nausea swept over me. We quickly went to the pharmacy to get the prescription filled for the powerful anti-nausea medicine, Zofran. Zofran is the real deal. One tiny pill of that and I was good to go.

Saturday and Sunday I felt pretty normal. I was a tiny bit tired, but I think part of that was the 10 hour days I worked that week. Monday was probably the "worst" day. And I use "worst" very loosely, because it wasn't that bad. I felt tired and worn out, but that I could handle. It was the mouth sores that made me want to spit every 5 seconds. Monday morning I woke up with what seemed like lots of little cuts inside my mouth. It felt like I had chewed on shards of glass overnight. The sores left my mouth with an acidic/bloody taste. All I desired to do was to keep spitting to get that taste out of my mouth. Sadly, we don't keep spittoons around the gym and it wouldn't have exactly been professional for me to carry a trash can around all day.

Tuesday the sores were on the mend, and I started to feel like I was getting my energy back. Wednesday came and I was back to my normal self, only much hungrier. The doctor claimed that the steroid they gave me on Friday would wear off within 48 hours. I think for me, it was just kicking in. I wanted to eat everything in site. Everything (and I mean everything) sounded absolutely delicious to me. Even the fried chicken that had been sitting under the heat lamp for 16 hours at the grocery store seemed like a good idea. Luckily something (thank you, Shane) brought me to my senses as I had the chicken in hand heading towards the check-out line, and I returned it to its heat lamp home for some other steroid-crazed person to chow down on.

Since Wednesday I have felt absolutely great. It was a sweet relief to be completely appointment free this past week which hasn't happened since April. Now the weekend is here and I am going to kick it James Brown style, feelin' good.