Treatment One –

I have always been a fan of the “First Day.”  Whether it’s the first day of school, a new job or a vacation, I tend to experience it the same way.  The mix of anticipation, expectation, and uncertainty creates a potent energy that amplifies my excitement.

The morning of my first chemotherapy treatment was one such First Day.  I realize this may sound crazy. However, my preparation included two things I love to do:  plan and shop.

I needed several things to be chemo ready.  A new journal to record everything the nurses said.  New headphones to listen to my chemo playlist.  A new water bottle, as the thought of using the one I carried to spin class was a painful reminder of the life currently on hold.

There were many other things on my list, which of course led to an inevitable outcome.

I needed a new bag!

Now, the term “need” is a relative one in this scenario.  During my chemo orientation, the list of items I was asked to have on hand were all things I either owned or could easily find at a drug store.

But what fun is that?

I decided to prepare for chemotherapy in the same way I approached shopping for my dorm room the summer before my freshman year of college.  I wanted things that would make me feel comfortable and safe.  Things that were pretty to look at and smelled wonderful.

Things that would help me feel like myself.

On the morning of my first treatment, as I packed my chemo bag, the usual feelings of anticipation, expectation, and uncertainty quickly surfaced. I was scared, but I was also excited.  The quicker I started chemo meant the quicker it would be over.

My oncologist was part of a physician practice that was affiliated with a large Seattle health system.  This arrangement provided me with the significant benefit of receiving my treatments at the practice, which enabled a more intimate and comfortable experience.

The treatment room was lovely.  There were ten or so chairs that all faced out towards a wall of windows.  Depending on where you sat, you had sweeping views of either the Seattle skyline or Mount Rainier.

Two full-time chemotherapy nurses staffed the treatment room.  They administered the infusions and attended to the patients throughout their treatment.

The chairs were comfy, the blankets were warm, and all patients had access to unlimited healthy snacks.

As I took in my surroundings and relaxed into my chair, I almost forgot about the chemo. Then I saw one of the nurses pushing a machine with hanging IV bags in my direction.

Here we go.

My chemotherapy treatment was expected to take 5-6 hours.  My infusion included two drugs: one that would take three hours to administer and the other an hour.  Before the first drug, I would receive a 90-minute infusion of pre-chemo meds, such as steroids and Benadryl, which were designed to help my body tolerate the treatment.

A few days earlier I had a port surgically implanted under my skin on the upper right side of my chest.  The nurse rubbed Lidocaine on the area then prepared a needle to access my port.  I gripped my chair waiting for the pain.  Fortunately, the Lidocaine did its job, and I felt nothing.

I was off to a good start.

I asked the nurse, Is it ok if I use one of the outlets to plug in my laptop?

Sure, she said.  Are you going to watch a movie?

No, I plan to work today, I replied.

The nurse looked at me empathetically and said, If that’s what you would like to do, it’s fine, but we really encourage our patients to relax and view the treatment as “your time.”

I just smiled in response, sparing the nurse an explanation of how working was truly the only thing that was guaranteed to help me relax in this situation.

I pulled out my laptop.  Thirty minutes later I could barely keep my eyes open.  I summoned the nurse.

I asked, Why I am I so tired all of a sudden?

It’s the Benadryl, she replied.  You should take a nap.

At this moment I realized I might have taken the “normalcy” approach a little too far.  For as the drowsiness kicked in, I was getting ready to issue a press release on a new product my company was announcing to the market that morning.

I barely had enough time to call one of my colleagues to delegate the assignment before I conked out.

I woke up two hours later.  The nurse came over to check on me.

How are you feeling? she asked. I sensed palpable happiness from the nurse that sleep won out over my laptop.

Despite the grogginess, I was feeling ok.  When do the chemo drugs start? I asked.

The nurse replied, You have already started.  You are almost an hour in. 

I don’t know what exactly I expected, but here I was in the middle of receiving my first chemotherapy treatment, and it felt so anticlimactic.  I think my inner drama queen was expecting to hear the theme song from Jaws as the chemo entered my veins.

I picked up my laptop.  I still had four hours to go, but now I didn’t feel like working.

I looked around the room.  There were several women receiving treatment.  Despite the circumstances, everyone was friendly.  Over the next several hours, the room was filled with energetic conversations.

I was the newbie, and I appreciated the opportunity to ask questions and get a perspective from those who were further along in the experience I was just starting.  The conversations were also an excellent way to pass the time during the long hours of my infusion.

But the person who made the biggest impression on me was another patient, who I did not meet or learn her name.  When this patient entered the treatment room, she went right to her chair, sat down and stared out the window.  For hours, she stayed in this position, never once picking up a book or engaging with the other patients.  She spoke only to the nurses.

I didn’t know anything about this woman, such as what kind of cancer she had or treatment she was receiving.  But I could feel the burden she was carrying.  Although we never even made eye contact, I felt very connected to her.

As I looked down at my overflowing bag of chemo accouterments, it dawned on me that there was no right or wrong way to get through this.  My approach, at least initially, was to distract myself with normalcy.  The woman staring out the window opted to sit in silence, choosing not to have any distraction from what she was enduring.

I wasn’t sure if the route I chose would ultimately be the road I would use to travel through chemotherapy, but I did learn one thing on the First Day – the nurse was right about taking a nap.

And next time, if I chose to work, I would be more mindful of what my “new normal” was and be a bit more realistic as to what I could accomplish on chemo days.

When my infusion was over, I packed my bag and prepared to head home.  Other than being tired, I wasn’t feeling any ill effects of the chemo.  I knew that would come later.

The nurse walked me out and put her hand on my shoulder.  You did great today.  You are going to get through this really well.

I exhaled a sigh of relief.

One down.  Five to go.

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