Chemo Day 1 Snapshots | 3

As we walked hand in hand with Rosemarie into the chemotherapy treatment center, I was immediately struck by the strength radiating from Rosemarie and her daughter . Today’s episode takes you through their emotionally charged first day of dealing with metastatic cancer, a day that many of our listeners have faced or will in the future. We discuss the vital role of a caregiver, the importance of comfort items, and the ambiance that awaits at the treatment facility. You’ll hear about the critical pre-treatment blood tests and how they influence the course of therapy, and we'll walk you through a typical day’s schedule, offering a truthful perspective on the process through Rosemarie's and Renee's experience.

In this episode, we also look at the unbreakable bond between mother and daughter, a source of strength during life's toughest challenges. As we share these personal moments, I invite our community at hope love cancer to hold onto hope, to extend a hand of support, and to stand united. By subscribing, you join a community that treasures heartfelt stories and supportive resources.

Thanks for listening. For more information please visit hopelovecancer.com. You can also follow us on Instagram or Facebook.

Transcript

Speaker1:
Welcome back to "tumour, tumour on the wall" presented by hope love cancer as we continue our journey with your host, Eve.

Speaker 2:
Welcome to Episode 3 of “tumour, tumour on the wall.” So far, we have traced Rosemarie's steps through her first 68 years - her surgery, biopsy, and the moment she received her diagnosis. Today is the day we follow Rosemarie, alongside Renée, into her first chemotherapy session. It is an honest look into the highs and lows, the uncertainties, and those big looming questions that tag along. But there is more to it than just the start of her treatment. We are exploring the whole spectrum of emotions and experiences that come with this path. Whether you're listening from home, on your commute, or anywhere in the world, we invite you to join and find pieces of your own story in hers.

It is the 5th of January, a day of waiting and wondering. Tomorrow is the big day – day 1 of chemotherapy. Suddenly there are new roles. Now, they are more than just a mom and daughter. Rosemarie is also a patient with metastatic breast cancer, and Renée is her primary caregiver. These are not just roles, but significant titles that carry deep responsibilities and challenges.

Tobie offered to drive Rosemarie to her first chemotherapy session, understanding the practical needs of the challenging day. Given the uncertainties of how Rosemarie might feel after the treatment, Tobie and Magda suggested that Renée and Rosemarie stay with them for the night. This proposal was not just about practicality; it was also a thoughtful way to lessen any anxiety due to the unknown effects, post-chemotherapy. By staying with Tobie and Magda, Rosemarie and Renée had additional support available, helping to make the post-chemotherapy experience a bit easier to manage.

As Rosemarie and Renée prepare for the significant day ahead, their minds are buzzing with questions that likely mirror those of many of you - our listeners. Whether you have experienced chemotherapy, are anticipating it, or are supporting someone through it, these considerations are universally relevant. 

The first question that arises is: “Will Renée be allowed to sit with Rosemarie during the treatment?” This wasn't just about having company; it was about the comfort and support that comes from having a loved one close by during trying times. They pondered what to bring to the chemo sessions – comfort items like a book and a warm blanket. How will the oncologist and the oncology nurses be?" They were curious about the medical staff's friendliness and helpfulness, hoping this would make the experience a bit easier. They were curious about what the treatment area would be like and what kind of people they would meet there. Would the other patients look visibly ill? What would the atmosphere be – sombre or somewhat uplifting? They also wondered if they would hear any success stories, which could offer hope and encouragement in this new setting.

"What type of chemotherapy will it be? Is it the “red devil”?" This question is less about the intimidating nickname and more about what Rosemarie can expect. It's about getting a clear picture of the treatment's nature, its effects, and how it's been effective for others, easing some of the anxiety that comes with uncertain terms. "The duration of the chemo drip – how long will it take?" Understanding the duration of the treatment can help to mentally preparing for what lies ahead and to plan the day better.

"What happens after the chemo is done for the day?" They braced themselves for the immediate and long-term effects of treatment, from physical responses like nausea and hair loss to emotional and mental health considerations.

With these questions in mind, Rosemarie and Renée approached the day of the treatment. In each part of their journey, they stepped forward 'blind', not knowing what was next, a path many of you may relate to. Rosemarie was ready to face the realities of chemotherapy, turning her concerns and questions into firsthand experiences.

 Renée packed an entire small travel suitcase for their first day of treatment - a blanket, a pillow, food, water, a nausea bag, colouring pencils, a reading book, games, magazines, a list of questions for the oncologist, medical card, jacket, and more. Rosemarie just shook her head at this scene before her. When Renée mentioned that she was going in prepared, Rosemarie gently pointed out, with a soft sigh, that they weren't staying overnight. Looking back, this suitcase might have seemed a bit excessive. A more practical approach might have been to call the centre beforehand and inquire about what they did or did not provide. Reflecting on it, Renée realised that the stress of the moment had a way of temporarily paralysing her usual practical thinking.

The day's schedule unfolded as follows: arriving 1.5 hours before the oncologist appointment to allow time for necessary bloodwork and medical forms; meeting the oncologist for the first time; discussing the treatment plan and other matters; proceeding to the first treatment session if the bloodwork was fine; visiting the pharmacy, and finally returning home.

When Rosemarie arrived at the centre, she was first directed to the labs for her tests. The results would be ready before the session started. Rosemarie did not know that she would need blood tests before every chemotherapy session yet to come. So, why are these blood tests required before each chemotherapy session? What is the purpose behind them? These tests are crucial for her safety and for her oncologist to understand how her body is doing and how well she's responding to previous treatments, including checking cancer markers. They also help monitor her blood count, which tells the oncologist if she's healthy enough for the next chemotherapy session. By examining her blood, they can assess if the treatment is working against the cancer. It is a way to make sure each treatment is not only safe, but also effective for her.

Upon returning from the lab, Rosemarie encountered a substantial amount of paperwork at the centre. Among them were the common forms encountered in healthcare settings. She filled out a Demographic Sheet, providing basic information. A Consent Form was signed, outlining her agreement for various medical procedures. A shorter version of a Medical Power of Attorney or Healthcare Proxy form allowed Rosemarie to designate someone to make decisions on her behalf when she was too ill to do so. She decided to put Tobie and Renée on the list, considering practical reasons.  Renée would be overseas at times, and Tobie was close by, making it a practical choice to have two people she trusted in this role. She completed an Advanced Directive, specifying her healthcare preferences in case she could not make decisions herself. The Release of Information Form allowed the medical team and specific individuals or organisations to access her medical data as needed. A Medication Consent Form was used to document her approval for specific treatments, and a Medical History Form captured her medical background.

While Renée was standing in line at the reception desk handling her mom's paperwork, she noticed another woman standing nearby and their eyes met. They shared a warm, understanding smile and soon began talking as they waited. The woman was Ronél, also there with her mom, Cela, who was undergoing chemotherapy. Cela had been through surgery for Stage 1 lung cancer, where they removed a quarter of her upper lung. The chemotherapy was just a precaution, as the surgeon was certain he had removed all the cancer. Ronél mentioned they were seeing a different oncologist. It was a brief conversation, but it meant a lot to Renée. Talking with someone who understood, who was in a similar situation, brought a little comfort. Feeling a bit more connected and less alone, Renée walked back to Rosemarie, ready to face the next part of their journey.

It was now time to meet the oncologist. She was a friendly, soft-spoken oncologist with a neutral tone, not attaching much emotion to her words. She discussed the treatment plan, which involved six chemotherapy cycles, each spanning three weeks, totaling 18 weeks. The cycle consisted of chemo in week 1, chemo in week 2, and a week of rest before repeating. The first week's session was longer, lasting approximately 4 hours and involving a combination of two types of chemotherapy - not the infamous 'red devil.' The second session of each cycle, week two, was a bit shorter as it involved only one of the chemotherapy treatments. The week of rest is like a little pause for the body to recover, reduce side effects, and optimise treatment effectiveness, ultimately enhancing your quality of life. After the discussion, there was time for questions, and then they were off to the treatment area.

The treatment area featured reclining chairs arranged in two large circles, with additional chairs available for family members accompanying each patient. Family members could also opt to sit in the reception area. The center provided blankets for comfort, and volunteers prepared sandwiches and handheld food for the patients. Additionally, there were refreshments such as water, coffee, and tea available.

Renée remembered that almost all the chairs were filled with patients. The room was a mix of individuals who looked healthy, some who appeared unwell, some wearing wigs, and others still having their own hair. The atmosphere was surprisingly quiet, with the nurses actively engaged in tasks like mixing chemotherapy or adjusting drips. Some patients were dozing off in their recliners, while others immersed themselves in books, had earphones on, played games on their phones, or even knitted. Patients had brought their own reading materials, and a few looked up and offered warm smiles as they entered the treatment area, as if saying:” Welcome, we understand. We are all in this together.”  Renée saw Ronél, her mom, and dad, and moved towards them to find a seat close by. The two moms also connected instantly. Tobie decided to stay in the waiting area due to limited seating and space.

Rosemarie was given a handful of pre-chemotherapy pills, each with a specific purpose. The anti-nausea pill was to prevent the discomfort and vomiting often associated with chemotherapy. Steroids were included to reduce inflammation and allergic reactions, while also helping with nausea. Antihistamines were given to prevent potential allergic reactions to the chemotherapy drugs, and a medication to protect her stomach lining, like a proton pump inhibitor, was used to prevent gastrointestinal issues. Watching her mom take those medium to large pills, Renée realised she had trouble even with small ones, particularly the discomfort and anxiety associated with swallowing pills. This experience made her think about the various challenges families encounter when a loved one is going through cancer treatment. This shows a simple but common problem in healthcare - the struggle with taking big pills, which adds extra stress for patients and their families during serious illnesses like cancer.

Before starting the IV chemotherapy, Rosemarie also received a hydration drip. This was to make sure she was well hydrated and ready for the treatment. As the drip started, she began to feel sleepy, a common reaction to the medications. During this time, a nurse came over to talk about the side effects and the extra pills Rosemarie would need to take after chemotherapy.  During the talk, the nurse emphasised how important it is to switch arms with each session of the IV chemotherapy. She explained that doing this helps avoid problems like vein irritation and scarring, which can happen when the same vein is used too often. Why?  Because chemotherapy drugs can be tough on veins. She also pointed out that using the same vein all the time might make it narrow and hard, which could make it harder to give IV treatments later on and might even affect how well the drugs work. Renée listened carefully, but she couldn't help worrying. Her mom was so drowsy – was she really taking in all this important information? Renée believed that a pre-chemotherapy briefing or a written guide would have been beneficial to fully understand what to expect during the treatment. It may have even enhanced the overall experience.

As they left the center, Renée carried what felt like a small bag of pills, a harsh reminder of the new reality. Yet, there were still more prescriptions to be filled at the pharmacy. That morning, before even starting chemotherapy, Rosemarie had taken more pills than she probably had in the last few years combined.

These pills were not just a one-time thing; they were to be a constant companion for the next 18 weeks, each one scheduled meticulously for every day of the treatment plan. Rosemarie who had always been healthy and basically medication-free, now found herself relying on a lot of pills to manage the side effects of her treatment and to support her body through the exhausting journey of chemotherapy - pills for acid reflux, pills to protect the inner lining of her stomach, different kind of nausea pills and then all the pills of chemo on day 1 and day 8 of the 21-day cycle.  Renée took on the task of organising these into a daily plan, making sure they matched the chemotherapy's 3-week cycles. They now had to get used to this new part of their daily lives.

The first night after starting chemotherapy, Rosemarie slept peacefully. The following two days surprisingly went well too. In fact, she felt better than she had in a while.  Renée and Shawn even joked that it seemed like the chemotherapy was having a unique effect on her, making her feel better instead of worse. But then the fourth day arrived, and with it came some of the expected side effects. Rosemarie started to experience nausea and a significant increase in tiredness, marking the beginning of the more challenging phase of her treatment.

As day 4 concluded, we can only wonder: What does the future hold for Rosemarie and her family? How will they navigate the complexities and uncertainties of the treatment ahead? In our next episode, we will delve deeper into Rosemarie's journey. The oncologist hadn't specifically mentioned remission or palliative care, but they held onto the possibility of remission. We will track their experience through the chemotherapy cycles, the emotional highs and lows of awaiting CT scans and cancer marker results, and adapting to new routines like choosing wigs, changing routines and managing more medications. It is a story about adapting to life's unexpected challenges and maintaining hope.

Tune in for the next episode to hear more about their story. It is also a story of a mother and daughter facing big challenges together, showing just how strong their bond is. And remember, as they go through this tough time, they're proving that together, they can handle anything life throws their way.

And to leave you with a thought until then, in the words of Haruki Murakami: "And once the storm is over, you won’t remember how you made it through, how you managed to survive. You won’t even be sure whether the storm is really over. But one thing is certain. When you come out of the storm, you won’t be the same person who walked in. That is what this storm is all about."