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Starting treatment soon -- what happens the first day with chemo?

StruTanToot
Posts: 108
Joined: Aug 2012

I am scheduled to start radiation and chemo on Monday, Aug. 27. I'm done with the radiation planning and have the simulation on the Friday before I start.

No one has specifically explained the chemo part. Can anyone tell me what my first day will be like? I guess they will set up the delivery system for the chemo, and I assume it will be a picc line.

Also, the chemo oncologist told me he likes to hospitalize patients during weeks one and five when they are receiving chemo. I told him I did not want to be hospitalized. I want to be at home to look after my little dachshund. That might be silly, but she is the light of my life and she'll be with me when no one else is.

Anyway...are the weeks of chemo rough? I was told I would be okay for the first three weeks. However, since the doc said he likes to hospitalize patients the first week, I'm a little concerned that something might happen.

Any info is very much appreciated, and as always, thank you for the wonderful support you all provide.

mp327's picture
mp327
Posts: 2855
Joined: Jan 2010

I know some people are hospitalized during chemo weeks. However, I believe more people are not than are. I was not. I had a port, not a picc line. The chemo (Mitomycin) was delivered by IV in the infusion suite following a couple of drips with anti-nausea meds. After the Mito finished up, they hooked the bag of 5FU up to my port, put the bag in a fanny pack that I wore around my waist. It really wasn't a big deal, except for the fact that bathing was a challenge. I really don't understand the need for hospitalization, as I got along fine. After hearing some horror stories about nausea and vomiting on day one of chemo, I fully anticipated the same to happen to me. However, I had no issues, except light queasiness in the evening of day 1, which was effectively controlled with the anti-nausea meds I had at home. I can understand hospitalization if there are other mitigating circumstances, but if the patient is otherwise fairly healthy, I see no reason for it. My second chemo week was a little rougher, due to cumulative effects. By that time, I had developed thrush in my mouth and my appetite had gone to zero. But again, I don't think being in the hospital would have changed any of that. The chemo cycles for this treatment are 28 days. The first 14 days, your immune system is being attacked and those two weeks may be the roughest during both cycles. Around day 14 is usually when the blood counts are at their lowest--this is called Nadir--then they will begin to rebound. By the time the second chemo round comes around, you might be feeling fairly good, except for any skin issues from radiation, which is another subject. The first two weeks of the second chemo cycle will probably be your last two weeks of radiation. At the end of that, you will probably be dealing with cumulative effects of both the chemo and radiation. That said, you can get through it--most of us on this board did without any major problems.

It's very important to stay well-hydrated--drink lots of water! Also, eating protein in every meal or snack will promote healing. Things that can help control nausea in addition to the meds are: ginger tea, hard candy (such as Jolly Rancher or lemon drops, which I carried with me at all times), soda crackers, 7-up, gingerale. Diarrhea can be curbed by eating the BRAT diet (Bananas, Rice-white, Applesauce & Toast-white). Imodium AD can be effective or you might want to ask for a prescription for Lomotil. If you have diarrhea, it is vitally important to replace the fluids that you will lose, so again, drink lots of water! Also, one more tip--do NOT use toilet paper, as it's much too abrasive. Get some flushable wipes that do not contain alcohol.

Sorry, this is probably much more information than you were asking for, but I hope you will find at least some of it useful. You will get through this--REALLY, you will!

StruTanToot
Posts: 108
Joined: Aug 2012

Thank you for all the helpful information. I put all the products you provided on my "to get" list.

As always, thank you for replying, sharing, and encouraging.

Hammah's picture
Hammah
Posts: 4
Joined: Aug 2012

Hi,
Your post to me was spot on. back in 04 I was diagnosed with stage 2 squamus cell carcinoma anal/rectal cancer. the first day of chemo I had a port installed on my left side of my chest. my difference from you is that they hooked up a bag with both the 5FU and the Mitomycin which pumped directly into my heart over the weekend so by monday morning I was ready to start radiation treatment. my only complaint was that they only gave me a local when they installed the port. the nurse said I would feel pressure on my collar bone when they did the procedure. (yeah right) the second week of chemo I said I wanted to be out and they complied. I found out that the first week of chemo they had undermedicated me. so, the second week at the end of my radiation they made up for it and gave me a much more powerful dose of the two chemo meds. I will not go into any further detail about my treatment because I'm sure you have already "been there, done that" However, that said I am happy to report that I have been totally cancer free since Dec 04 and am checked regularly. One thing I will tell you is that during that time I lost about 20 lbs due to my only eating soup and drinking gatorade. solid food was not an option for me as you already well know. but guess what? we made it and modern medicine technology is getting better every day. rock on lady.
Hammah!

mp327's picture
mp327
Posts: 2855
Joined: Jan 2010

I am SO glad to hear that you are doing well! While treatment is for only a short time, it can be a bumpy road for some. However, once it's over, most people recover quite nicely and go on with life that is for the most part normal. I'm happy for you and thank you for coming to this site to share your story--we need to hear from long-term survivors such as yourself! Stay well and keep on rockin'!

mxperry220
Posts: 358
Joined: Mar 2011

I had no problem with the chemo. I had two rounds of chemo-Mytomycin and 5FU as I mentioned previously. I had a port implanted in my chest rather than a pick line. This had to be done surgically before any treatment. It was removed about a month after treatments. I have read on this thread others that did have adverse reactions to the chemo. Each person is different. I was in good health before cancer diagnosis.
Mike

StruTanToot
Posts: 108
Joined: Aug 2012

It's nice to hear that there is a chance chemo might not be too horrible. Thank you.

Cheyenne's picture
Cheyenne
Posts: 72
Joined: Apr 2012

The first day wasn't quick. I had to have the picc line "installed". That involved a rather long procedure of finding the correct vein, running the line, getting an x-ray to make sure it was in place and then getting the mitomycin as well as having the pump put on and started. Then I went for radiation which took probably about 45 minutes. It takes some time to get placed exactly and then I had 19 different "beams".

The chemo the first day was no problem at all. They give you medication to keep you from getting nauseous and it works well! It also made me REALLY hungry! I felt like I had a ton of energy. During the week I started feeling bad. On Thursday I was sick but it only lasted about 24 hours. Once they took the picc line out on Friday I felt great! We actually went out to dinner on Monday because I was feeling so good.

I will warn that the experience is not the same for everyone. Some people react to the chemicals adversely. I think most get through it O.K. Some don't get sick at all.

I hope that helps and I hope it all goes really well for you.

StruTanToot
Posts: 108
Joined: Aug 2012

I think I can handle to the picc line if it is removed after the first week and then another one is inserted for the fifth week. I've read where the picc line is left in for the entire treatment period.

It's nice to hear that your experience was not horrible. I realize it's a wait-and-see deal on how I will respond, but it's good knowing some people get along okay during treatment.

Thank you.

StruTanToot
Posts: 108
Joined: Aug 2012

From what I've been told, my first day will be pretty much like yours...picc line put in at 11:00 (about two hours), radiation in the afternoon, followed by chemo and getting instructions on the fanny pack.

Thank you for the info and encouragement.

modern
Posts: 1
Joined: Aug 2012

Expect a blood test -> Get ready to wait -> Calming techniques
Food, drink, and clothes. Check with your doctor, but most recommend you eat normally before your treatment.
Here comes the treatment. Once your IV is working successfully, they’ll start administering medications through it.
Hair and fingers. New studies have shown that keeping your scalp and fingers cold during treatment helps protect them from damaging side effects.
. You can do it! I wish you strength, love, and survival.

kirby77
Posts: 48
Joined: Jul 2012

So far, not so bad. My first day was very rushed, the PICC was inserted the week prior.
My infusion nurse, gave me my pre-medication Kytril and Decadron over 30 minutes and then infused the Mitomycin over about about 30 minutes to an hour. After it was complete, she initiated the 5 FU, instructed me on the pump(fannie pack) and sent me on my way to my first Radiation treatment.

All was very uneventful, but I have to say I didn't get a chance to be overly anxious because of the time factor.

The first night I had a huge meal, and later ate an entire box of "Hot Tamales" you know the cinnamon candy. I didn't sleep well. The next day, I had the hiccoughs, likely because I was still too full. I took a Zofran.
Overall, my GI symptoms have been limited to some queasiness, feeling car sick when in the car, and feeling too full.

Radiation, first week impression, it's over before it starts, my scrotum does feel slightly sensitive, like it had a heat lamp over it, but not burned yet. Nothing really to pin point.

I can not wait to detach from the chemo line. I will keep the PICC for the duration until my second round of treatment. I wish they would pull it out and reinsert, but I guess the cost of doing so, prevents this.
I am not sure if the Decadron made me feel more depressed or not, but I am totally down. I have completely shut down, in terms of isolating, and just wanting this week to be over...!
It seems unfathomable that I have 32 more radiation treatments in front of me. I am looking at the first week of October in terms of completing treatment. I have set a goal to return to work on October 15th. I hope it's possible.
I am glad Strutantoot decided to stay at home with his baby, it would be hell to be in hospital for this week. At least at home you can flop around in your boxers and t-shirts and most of all not talk to every single person that comes into the room. I have my big yellow lab hear to scratch on and look up at me with his sad understanding eyes.

Rants from a madman, but the days are passing and now I have the first week of treatment nearly behind me. Thanks all that pathed the way.

Cheyenne's picture
Cheyenne
Posts: 72
Joined: Apr 2012

They took my picc line out and reinserted it for the second round.

mp327's picture
mp327
Posts: 2855
Joined: Jan 2010

I'm glad your first week was pretty uneventful. It's understandable that you are feeling down and not anxious to be around people. I felt the same way and pretty much holed myself up in my house except to go out for treatment. Luckily, that all lifted after treatment ended and I had some healing time. Getting the chemo disconnected will make you feel better, I'm sure, however, keep in mind that your blood counts may continue to go down during the second week, so you may feel very fatigued. Be sure to keep up with the fluids and rest as much as possible--your body needs that! Have a restful weekend and thank you for keeping us posted.

eihtak
Posts: 822
Joined: Oct 2011

Kirby, You are one week down, thats great and one week more than you were last week. I think most of us felt kind of like closing out the outside world, thus the importance of this site. Take the time to focus on you, rest, read, meditate, whatever your body tells you. Its enough some days to just get upand go to radiation. Its a tough time, but look at the big pic. and you'll see it as a short period on the whole scale of life. (Much easier to say when done, I know) I'll have you in my thoughts and prayers.

StruTanToot
Posts: 108
Joined: Aug 2012

Thank you for the info. As a male, I paid particularly attention to your info on effects on the scrotum. I also mentioned my concerns to the nurses when they were doing the simulation.

Here's what they plan to do to protect that area...they put square bandages under the scrotum and I think around it. The doc used the phrase, "up and forward," and seemed to instruct that the sides be pressed inward to narrow the space. They taped things to keep them in place. It was no uncomfortable or anything.

The doc said the lower part could have some irritation.

Is the procedure above similar to your experience?

Marynb
Posts: 1134
Joined: Aug 2012

Hi Kirby,

I don't know what you do for a living, but going back too soon is probably not the best idea. Maybe part time? Your body is going to need time to recover. I was so wiped out after treatment.....

Marynb
Posts: 1134
Joined: Aug 2012

Hi Kirby,

I don't know what you do for a living, but going back too soon is probably not the best idea. Maybe part time? Your body is going to need time to recover. I was so wiped out after treatment.....

torrance
Posts: 118
Joined: Jan 2012

I had a picc line that stayed with me through my second round of chemo. My husband found a special "wrap" for it that made showering so much easier than plastic wrap. I highly recommend getting one of these if you get the picc line. My chemo nurses had me drink some super duper ice cold water before they started and then had me munch on ice chips while the Mito was given. It apparently dilates the blood vessels in your mouth and can prevent mouth sores. (Probably the same idea for the head and hands someone mentioned.) It worked for me as I did NOT get mouth sores. The strangest thing did happen for me, the first morning after I started chemo I fainted out of the blue! So of course, as directed I went to the ER and everything checked out fine and off to radiation I went. With my PICC line I had to have the "dressing" changed once a week and that is when I discovered I was allergic to the "choloraprep" they use to clean the site, so I was dealing with hives and itching like crazy at my picc line, as well as being allergic to adhesives! I had very mild nausea that was handled with the Zofran.

I am soooo thankful I wasn't hospitalized during chemo weeks, so much easier to rest and get comfortable at home. I would have been absolutely miserable with out my three little four legged friends.

Joanne

eihtak
Posts: 822
Joined: Oct 2011

Just a ditto on previous comments. Martha always covers it so well. I did have a mild allergic reaction to my first chemo (severe shaking and chills) about 2hrs after leaving the clinic. They had me come back in, gave me benadryl and observed for a while. After that I always had benadryl prior to chemo. I was hospitalized later on but for issues unrelated to chemo. My tumor placement required that I have a colostomy and the rsdiation caused my colon to prolapse outside of my body!!!! Yes it was loads of fun! All good now though. As far as protien goes, I got to the point that my taste buds were also near gone and I could not keep much down so anything was worthwhile. I did eat small amounts at a time of greek yogurt, protien drinks like Boost, and occasional cheese dishes. You will be in my prayers for smooth sailing and quick recovery.

Marynb
Posts: 1134
Joined: Aug 2012

Hi there. I finished treatment a little over a year ago. I want to reassure you that you can do this! I remember the level of anxiety that I felt before treatment. Of course, no 2 patients respond similarly. For me, the treatment was nowhere near as bad as I had anticipated and feared. It was tough, but you can do it! I was not hopsitalized during any of the chemo treatments. For me, the chemo was not bad at all. No nausea...I was out to lunch in Boston soon after the infusion. I had a chemopack through a pic lne. After a brief rest, my sister and I left the hospital and went out to a restaurant on the waterfront, i covered the lines and pack with a sweater. What really helped me was drinking a lot of water. It felt a tad like morning sickness when I woke up in the morning, so a little cinammon toast helped. The doctor had given me a prescription for antianxiety, but I never took it because I did not need it. Keep a bottle of water with you at all times......room temperature. For me, the chemo was not a problem until further along in the treatment when my white blood count got too low. Radiation effects were quite painful for a short period of time. I used the cream they recommended, and a hand held shower with room temperature water on a very low setting. Also, I had no hair loss at all. I washed my hair every day with baby shampoo and did not blow dry. Treat hair very gently.

Prayer helped me. Knowing that everyone was praying for me was so helpful. Also, I had my sistrer with me to laugh with. As bad as you may feel, laughter helps! So, know that I will be praying for you as you begin your journey to wellness! Have faith!

StruTanToot
Posts: 108
Joined: Aug 2012

Thank you for the prayers and support and advice.

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