A Page from “The Cancer Effect”

As each day went by after my first chemotherapy, I felt increasingly worse.  I received my treatment on Wednesday and true to prediction,  had reached a low point on Saturday and Sunday.  Nausea was managed by taking the prescribed medicine every four hours before it reached the point of being out of control.  I tried to drink plenty of liquids but found it difficult. The oncology nurses, along with instructions in the chemo notebook, stressed the importance of drinking 64 ounces of liquid per day.  Plain water brought on nausea so I tried flavored waters and Gatorade.  I couldn’t tolerate cold liquids, so I drank them at room temperature. Trying my best, I was only able to get down about half of each day’s requirement.  The worse I felt, the less I was able to drink.

Eating presented additional concerns for my husband as he visibly noted my declining energy.  When I needed to be gaining strength from food, my appetite waned.  It was similar to how I felt the first trimester of my pregnancies.  If something sounded appealing, it shifted to disgusting by the time it was prepared.  Randy tried to tease my appetite by offering my favorite foods.

“How about shrimp or salmon tacos?  I’ll run get some for you.”

“No thanks.  That doesn’t sound good right now.”  Under normal conditions, I never turn down Mexican food.

He was confident I wouldn’t pass up his next offer.  “I can bring you a bowl of mint chocolate chip ice cream!”   I’m sure he was thinking that at least it was a dairy product.  Those who know me are aware of my love for ice cream, especially mint chocolate chip.  Unfortunately, my stomach wouldn’t tolerate ice cream, or anything sweet, during all the months I received chemo.

“I can make you a scrambled egg sandwich.”

“Now I’m really going to throw up.”  He knows I don’t like eggs, even under the best circumstances.

“Tuna sandwich?”

“Are you kidding?”  Unfortunately, my husband doesn’t have a very long list of food he is comfortable making.

“What about grilled cheese?”

“Ok. I’ll try that.”

Looking at the nicely grilled sandwich Randy brought, I sighed, “Maybe a bowl of cereal would taste better.”  After eating two bites of cereal, Randy, who never likes to waste food, reluctantly threw the rest out.  I might sound a little spoiled, but in reality, I had no interest in eating and what I did eat during my worst days after chemo was only due to the insistence of my patient husband.

On Monday evening, I changed locations from my bed to the couch and tried to watch a little TV.  I began feeling strange, so started back towards my bedroom.  By the time I got there, I had broken out in a cold sweat.  Having a sudden urge to vomit, I rushed into the bathroom.  When the feeling passed, I shuffled towards the bed only to be hit by a burst of dizziness, causing me to collapse.

Landing on my bed, I didn’t move, willing the spinning in my head to cease.  Brittany looked up from her homework and ran to get her dad.  When Randy arrived and saw how pale and listless I was, he helped me under the covers and tried to get me to drink.  I agreed to the water if he also brought my nausea medicine.  Placing both on the nightstand I attempted to go to sleep if only to escape how badly I was feeling.

As tired as I was, sleep didn’t come easily.  Thoughts of the last few days rolled around in my head, adding to my restlessness.  I was warned that chemotherapy could be difficult and I tried to patiently endure, but I was beginning to question my ability to do this five more times.  I wasn’t even close to feeling good enough to teach school the day after tomorrow.  Would it be possible to teach at all?  Being sick was hard enough without the guilt I felt for not fulfilling my obligations.

Morning brought no relief from the sickness that wracked my body.  It had been a long night with little sleep.  I felt like I had a bad case of the flu.  Randy brought more fluids and encouraged me to drink.  He also brought some toast for breakfast, then reluctantly went to work.  I looked deathly sick to him and if it weren’t for patients depending on him, he wouldn’t have left.  Years later he shared with me his frightening thought, “Cancer isn’t going to kill her, chemo is.”

With Brittany in school, I was left alone to wait out the day, hoping to feel better soon.  It took great effort to get out of bed and use the bathroom but diarrhea necessitated frequent trips.  It felt like someone had zapped all the energy out of my body and I didn’t care about anything.  I didn’t even have enough energy to worry about school and my inability to teach the next day.

About mid-morning, my cell phone rang.  The caller ID showed “Private Call” and I almost didn’t answer.  It was a good thing I did because it was Dr. Dinsdale, my primary care doctor.  In a concerned voice, he explained that the results of the previous day’s blood work had been mistakenly sent to his office and it didn’t look good.  He needed to know my oncologist’s name so he could fax it over to his attention.  Despite the Neulasta shot I had received, my white blood cell count was zero.

“How are the fluids?  Are you drinking plenty of water?”

“I’m trying to,” I answered feebly, “but drinking makes me nauseated.”

“About how much have you kept down this morning?”

“Maybe four ounces.”

“Claudia, that is not enough. You will end up in the hospital if you don’t increase your fluid intake.”  Right then I didn’t care.  I just wanted to be left alone.

Within the hour, a nurse from the oncology office called.  She explained I needed to come in right away for a Neupogen shot to increase my white blood cell count.  I was to plan on receiving this shot for two additional days.  I told her I didn’t feel like coming in.  She firmly made it clear I had no choice, the Neupogen shot was essential, and they would see me at three o’clock.

As I hung up from this conversation, I wondered how I was going to get out of bed and make the trip to the oncology office.  I obviously shouldn’t drive, but with one call I found Monica willing to drop everything and take me.  Making a meager attempt to get dressed, I waited in bed for her to arrive, trying to obediently drink as much as possible.  Dr. Dinsdale’s warning had finally concerned me and I didn’t want to be hospitalized.  That would require too much energy.