It is helpful to bring a chemo kit made up of the following items:
* Blanket as the chemo room is kept rather cool
* Slippers and/or socks to keep you comfy as you sit in a recliner chair
* A neck pillow
* Book or magazine
* Have your driver bring you some snacks and a drink or you can pack a meal. The nurses only have crackers, chips, and tap water on hand. You can eat anything that you find appealing; however, you might want to avoid spicy foods.
* Small portable DVD player, a fun DVD, and earphones (optional)
* Small portable CD player, some great music, and earphones (optional)
* A notebook to record your thoughts and chronicle your experience
* Knitting or crochet project (optional)
* Tylenol or other over-the-counter painkillers as needed during or after chemo session
Step 1: Two of several types of chemotherapy treatment plans
A. Should you have the diagnosis of breast cancer or some other form of cancer requiring four or eight chemo sessions, depending on the severity of your cancer diagnosis, you will most likely be given either a combination of A and C (Adriamycin and Cytoxan) or T (Taxotere) and Benadryl. The A and C chemo session takes three or four hours to administer. The T chemo sessions involving Taxotere and Benadryl take two to three hours to administer.
B. For more details about the chemo sessions known as the Red Devil (i.e., A and C: Adriamycin and Cytoxan), please click on this article on Associated Content.com: How to Go Through First Red Devil Chemo Session.
C. Other names for T or Taxotere are RP 56976 and NSC-628503. It is always given in conjunction with Benadryl and either Pepcid or Zantac to help you get through the dosage more comfortably. Additionally, your doctor will issue you a prescription for a light steroid to take the day before, the day of your chemo session, and the day after your chemo session. The Pre Meds for this session only take about an hour to administer followed by an hour-long IV drip bag of Taxotere. You will need somebody to drop you off and pick you up due to the aftereffects of the Benadryl. The three most common side effects of this chemo drug is bone pain, possible severe stomach aches, and messing with your taste perception. Some people additionally lose their hair. Some people have their hair grow back should they have previously lost all their hair due to Red Devil chemo. It is different for every patient.
D. Sometimes you may have a severe enough case of cancer that you will undergo perhaps four rounds of A & C followed by a possible four rounds of T. Understand that every cancer diagnosis and treatment is different. You could have the exact same diagnosis as somebody else and the exact same treatment plan; however, your reaction to this treatment could be entirely different due to the chemical make-up of your body and your attitude. Therefore, this article is the chronicle of one woman’s experience. If you have a different experience, please share it in the comment section for the benefit of others.
E. Should you be getting the A & C combo, please click on the aforementioned article so you will know more about what to expect: How to Go Through First Red Devil Chemo Session.
F. With this one woman’s experience, after having four sessions with the very aggressive Red Devil chemo that causes many chemo patients very harsh side effects, she had four sessions with the less aggressive form of chemo called Taxotere. Oddly enough, she basically sailed through the chemo side effects of Red Devil chemo; however, the first of the four sessions of Taxotere chemo caused rather severe side effects. It will be different for every cancer patient. Thankfully, she never felt the need to throw up during or after any of her chemo sessions thanks to the effectiveness of the prescription pills prescribed and the power of prayer.
Step 2: You will sign in at the Oncology office.
A. The nurse will take your blood pressure. The nurse is used to having people have either high blood pressure or low blood pressure due to a case of nerves about the chemo experience. Most likely, your blood pressure will be much better for your second chemo session than it was for the first as you will know how painless the chemo session will be.
B. The nurse will also draw blood from your arm to get a base line blood count. During the chemo session, they will give you the results of your blood count. They test for four things:
(1) WBC – White Blood Cell Count (also called Leukocyte count)
* For either a male or a female, a “normal” WBC count varies from 4,500 to 10,000 white blood cells per microliter (mcL).
* “The normal range for WBC count is 4,300 to 10,800 cells per cubic millimeter (cmm) or 4.3 to 10.8 x 109 cells per liter. A range of 11 to 17 x 109/L may be considered mild to moderate leukocytosis, and a range of 3.0 to 5.0×109/L may be considered mild leukopenia.” (by Amber J. Tresca)
(2) Hgb or Hb – Hemoglobin (This is connected with your red blood cell counts.)
For a male, a “normal” Hgb count varies from 13.8 to 17.2 gm/dL (grams per deciliter).
For a female, a “normal” Hgb count varies from 12.1 to 15.1 gm/dL (grams per deciliter).
(3) HCT – Hematocrit (This is also connected with your red blood cell counts.)
For a male, a “normal” HCT count varies from 40.7% to 50.3%.
For a female, a “normal” HCT count varies from 36.1% to 44.3%.
(4) Platelets – This controls your blood clotting factors. (also called Thrombocyte count)
* “A normal platelet count in a healthy individual is between 150,000 and 450,000 per µl (microlitre) of blood (150-450 x (10 to the 9) / L).”
Please note: If the results of your blood test are too low, you will be sent home as it would not be safe to give you chemo that day. This will delay your chemo sessions by one week for safety reasons.
Step 3: Where do you go next?
You will then walk to the nearby chemo room. This is a large room filled with recliner chairs, portable tray tables, IV poles, the nurse’s desks, some nurses who will monitor your progress and change out the various IV bags and injections you will receive, a nearby bathroom, and fellow cancer patients receiving chemo as well.
A. They have blankets upon request; however, you may wish to bring your own.
B. They usually have crackers, chips, and tap water available. If you want a real meal, you will need to have your driver get it for you or bring snacks or a meal from home.
C. They probably have one or two television sets; however, to avoid patients who would either wish to watch a show in which you have no interest or would prefer the television remain off so they can sleep, you may wish to bring a small, portable CD player or DVD player with earphones.
D. No children are allowed in the chemo room. Your driver aka guest is welcome to come in and out; however, it is requested he or she only remains about five to ten minutes so there is room for the nurses to do their job. There is usually a waiting room filled with chairs, a restroom, and magazines outside the chemo room where guests can wait in comfort. In this woman’s case, her husband would drop her off, go get some take-out food for her to eat, then drive home until he receives a phone call that she is ready to be picked up.
E. Feel free to bring books; small craft projects like knitting or crocheting; journals to record questions, to take notes on your procedure, and to write about your experience; slippers; neck pillow or regular pillow; prayer shawls; and anything else portable that you could use in comfort while sitting in a recliner chair. A cell phone is also permitted.
F. Tell your driver that the Taxotere procedure typically takes 2 to 3 hours. You could call him or her when you get close to the end of your treatment plan to alert him or her that you are almost ready to be picked up and driven home or to a restaurant to have a meal. Due to the fact that you have received anti-nausea medication prior to receiving the chemo drip, most chemo patients don’t experience feelings of nausea until 24 to 36 hours after the session, if they experience it at all.
Step 4: Per prescription medications to get filled at the pharmacy
1. Should you be receiving the Taxotere chemo, here is the prescription medication you might expect to have prescribed prior to your first Taxotere chemo session: You will either be given twelve Decadron pills or its generic version called Dexamethasone. This is a steroid pill.
A. Please note: You do NOT need to bring these prescriptions with you as you will be taking them at home.
B. How do you take this pill?
If you had chemo given to you on Thursday, the twelve pills will be taken as follows:
* Two pills on Wednesday morning (the morning before you have your chemo session the next morning.)
* Two pills twelve hours later on Wednesday evening
* Two pills on Thursday morning (your chemo day)
* Two pills twelve hours later on Thursday evening
* Two pills on Friday morning
* Two pills twelve hours later on Friday evening
C. Warning: It is possible you may be given a larger supply of these pills for future chemo sessions as well. In any case, you will only take them starting the next three days before, during, and after your chemo session: 3 mornings and 3 evenings as directed above. Save the rest of the pills for those future chemo days. If you have any questions, check with your pharmacist or oncology doctor.
2. Toward the end of your first chemo session, you will very likely be given three more prescriptions to get filled just in case you have negative side effects to chemo:
A. One pill helps to deal with severe nausea. You can take it as needed; however, make certain a full six hours elapses before you take a second one. This pill is called Compazine. Its generic brand is called Prochlorperazine or Prochlorper. Warning: If your nausea is bad enough to warrant taking the same day as you take the prescribed pill you must take associated with your chemo session, it is best to wait at least three hours before taking. Do NOT take at the same time as the pills mentioned in Steps 4: 1 above. If you have any questions, check with your pharmacist or oncology doctor.
B. The other pill you may never need; however, it is good to have on hand just in case you get a fever or your white blood cell count goes too low. It is called Ciprofloxacin. Its generic version is called Cipro. It is a ten-day prescription. Once you start taking it, you need to take all ten days worth of the pill. To clarify, if you start running a fever or get an infection that is not cleared up by taking Tylenol or a similar over-the-counter drug, you can start taking this pill. You get your blood tested the day after plus a week after your chemo session. If the nurse determines that your white blood cell count is too low, she may recommend that you start taking this pill for the full ten days. Other than those two reasons, you may never need to use it.
C. The third pill you can take for potential nausea is called Zofran or its generic version called Ondansetron. Warning: If your nausea is bad enough to warrant taking the same day as you take the prescribed pill you must take associated with your chemo session, it is best to wait at least three hours before taking. Do NOT take at the same time as the pills mentioned in Steps 4: 1 above. If you have any questions, check with your pharmacist or oncology doctor.
Step 5: What happens your very first chemo session ever
If this is your very first chemo session ever, after you get settled in your recliner chair, a nurse will talk you through the process. She will also give you lots of written material that details a lot of what you will be facing. You might like to have your driver be there at that time. That way, he or she will also be able to help you process what you are hearing.
Step 6: Per Subcutaneous Port or Sub Q Port or Power Port
A. Using your Subcutaneous Port or Sub Q Port or Power Port, the nurse will first hook you up to an IV bag of saline to flush out the port. This will take about ten to fifteen minutes for the saline to be emptied into your veins. It keeps your line open while the rest of your medications are being prepared. You might notice a very cold sensation that might feel border-line painful; however, this sensation of potential slight pain should not last more than a minute or so. It may not feel painful at all – just icy. Be warned that this saline drip will give you a slight metallic taste in your mouth while the saline is being administered.
To learn more details about the Sub Q Port, read this article on AC called: How to Prepare for Subcutaneous Port Implanted for Chemo Treatments.
B. When the bag is nearly empty, a machine will start beeping. A nurse will walk over and check it. When the bag is totally empty, the machine will start beeping again. A nurse will walk over and change bags to the next medication you will be given.
C. You will hear beeping periodically throughout the room followed by extended moments of silence. Two to four nurses are present taking care of the needs of up to about twenty patients at a time. The scheduling nurse tries to space appointment times so that no one is kept waiting for long when the machine begins to beep. For example, typically you will be given chemo sessions fourteen to twenty-eight days apart. So if your session was 9:30 on Thursday, you will go every second, third, or fourth Thursday to be given chemo; however, your next appointment may be 9:45 instead of 9:30. The woman on whose treatment plan is being chronicled in this article gets her sessions 21 days apart, every third Thursday beginning the 4th of February 2010 and ending on the 1st of July 2010.
Step 7: You will be given five Pre Meds:
A. Aloxi which is a quick push into your IV. This is one of the anti-nausea medications being administered.
B. Decadron for 15 minutes. This is the IV version of the steroid pill you take the day before, the day of, and the day after every Taxotere chemo session. Decadron is a steroid that helps prevent allergic reactions to the chemo drugs.
C. Benadryl for 15 to 20 minutes. This medication also helps prevent allergic reactions. It also will help you feel nicely drowsy while the Taxotere chemo drug is being administered.
D. Zantec for 15 to 20 minutes. This medication helps prevent stomach aches and nausea.
E. Afterward, they will flush your IV line with Saline before administering the chemo drug. You can expect to once again feel that metallic taste in your mouth while this is happening.
Please note: None of these IV pre meds are painful in any way whatsoever.
Step 8: Administering the Chemo drug called Taxotere
A. The next next step is an IV drip of Taxotere. It takes about one hour minutes for this bag to be emptied into your IV and through your veins.
B. As for potential side effects, it is going to vary from patient to patient depending on your chemical make-up. You might not notice any side effects at all. This author experienced three side effects:
1 & 2. For the first Taxotere session of the hour administered, she had severe stomach cramps and bone pain. Once she mentioned this to her oncologist, she was prescribed Ranitidine Tablets, USP 150 mg. It is generic for Zantac 150 mg. She was directed to take one pill twice daily. She continued with taking this pill when she had her second Taxotere chemo session. After only a week of having her third Taxotere chemo session, she no longer felt the necessity of taking this pill any longer. All bone and stomach pain had disappeared.
3. You might experience a metallic taste in your mouth. You might find that your tongue feels like you burnt it on a scalding hot drink even though this was not the case. Most likely, you can fully smell the food or drink. Your mouth waters in anticipation. You put the food in your mouth expecting to taste something you normally find delicious. Sadly, with many of those foods, you can either somewhat taste the food to a varying percent, you can barely taste the food, or the food literally tastes like nothing. In that case, you will hear many cancer patients taste, “That food tastes like cardboard.”
Not being able to taste many of the foods you put in your mouth is not painful; however, it is extremely boring and discouraging. This author would often eat just enough of the nourishing foods to keep her strength up; afterward, she would feel no inclination to eat. A positive perk was that she lost some weight; however, she was warned to not allow herself to lose too much weight as she needed to keep her strength up.
Step 9: Some of the positive perks of chemo sessions
A. If you had the Red Devil chemo sessions first, most likely you are bald and have to either wear a cap, a scarf, or a wig. Once you get further along with your Taxotere chemo, your hair slowly starts to grow back. This author’s long thick curly hair began falling out on day 15 after her first chemo session that was spaced 21 days apart. By the time she had her second Red Devil chemo session, she only had about 40 strands of hair left. She had her husband shave her head. From that day forward, she mostly wears a cap or scarf. She only wears a wig when she has been hired to give a storytelling performance. So far, no one at the storytelling performances has guessed she is wearing a wig.
B. Many cancer patients will acquire what is known as the chemo curl. Even if you always had straight hair all your life, the chemo causes it to grow in curly. Some cancer patients go from a thick head of hair to thin or the reverse of this. Some cancer patients have their hair grow in an entirely different color than they ever had before. One cancer patient had black hair growing in on the back of her head and snow white hair growing on the top of her hair. As for this author, it is still too short to tell definitively what it is going to be like.
C. Another perk is that many female cancer patients do not have to shave their legs for the most of the months while they were undergoing chemo.
D. This author also had her adult acne condition totally clear up.
E. Some cancer patients gain 30 to 60 pounds due to chemo. This is probably due to having to take too many steroids. This author is has lost close to 15 pounds due to her chemo sessions.
F. Many chemo patients find that some food or drinks they formerly liked, they now do not like and vice versa. Perhaps because chemo depletes your body of needed proteins, this author craves foods containing protein. She formerly drank Diet Cola for breakfast, lunch, dinner, and a snack. Now she cannot stand the taste of Diet Cola. She has been able to fully taste fresh fruit and canned peaches; therefore, she craves that quite often. Most chemo patients can fully taste ice cream and milkshakes; therefore, this author will indulge in that fairly often. The perk is that this author is probably eating a more healthy diet than she ever has before.
G. A last perk, perhaps due to the fact that this author goes around town wearing a cap or a scarf, she gets really good service at most restaurants. Also, this gives her the opportunity to offer comforting words to other people who approach her admitting that they or one of their loved ones has or had cancer. It also gives her the opportunity to share the warning signs of breast cancer so that they will hopefully never have to go through what she is currently going through in the year 2010.
For more information about four signs of breast cancer, please click on: Alert to 4 Signs of Breast Cancer – Lump, Dimple, Rash, or Nipple Discharge.
Step 10: Wrap-up steps
A. You will have a final bag of saline that is emptied into the port to clear the line and flush the port. It takes about five minutes for this bag to be emptied into your port.
B. You will then be unhooked from the IV pole and machine. You will get a final injection of saline that is a quick push of the syringe. This helps flush the port.
C. This will be followed by an injection of Heplock that is also a quick push of the syringe into the port. This Heparin solution helps keep your blood from clotting.
Step 11: The day following chemo
A. The following day, you will return to the chemo room twenty-four hours after your chemo session ended to get an injection of Neulasta to boost the white blood cell count. This injection could cause mild to severe bone pain about twelve hours later.
B. Bone pain can vary from negligible to mild to excruciating dependent on the chemical make-up of your body. If the pain is mild, an over-the-counter pain pill such as Tylenol, Aleve, Advil, or Done’s pills might help. If the pain does not go away and is extremely painful, call your doctor so he or she can issue you a prescription pain pill. If it is at night or the weekend, call the hospital, ask to be connected with the ER, and have them page your oncologist or whoever may be on call for him or her. The nurses will highly recommend this step as you are not meant to endure undue suffering.
C. The first time only you receive Neulasta, you will remain in the chemo room for twenty to thirty minutes so that the nurses can monitor your pain level and take note should you have any allergic reactions to this medication. Future visits will last less than five minutes.
D. You will also have your pulse rate and blood pressure checked when first entering the room and before leaving. Your temperature will be checked only once at the beginning of your appointment.
Please note: The woman who is being chronicled in this article only felt minimal pain the first few times she got this shot. After that, she felt zero side effects at all. The power of prayer and positive thinking can help a lot!
Step 12: Getting your blood tested
You get your blood tested every week following chemo. If your chemo session is on Thursday, you get your blood tested every Thursday. They need to find out your white blood cell count especially to discover whether your immunity level is at risk and whether you need to get your white blood cell count boosted.
A. Occasionally, your blood count results may be so low that you are urged to take what this author calls the fever-preventing pill mentioned in Step 4: 2B called Ciprofloxacin or by its generic version called Cipro. It is a ten-day prescription.
B. Occasionally, your blood count results may be so low that you are prescribed Potassium or Magnesium pills for two weeks.
C. Occasionally, your blood count results may be so low that you are warned to wear a mask when out in public and to avoid entering nursing homes where viruses are frequently being traded around.
D. Occasionally, your blood count results may be so low that you are warned to avoid all fresh fruit and vegetables and salads for one or two weeks as your body as no ability to fight off the bad bacteria found on uncooked fruits and veggies.
E. One patience with Leukemia was warned to not only avoid eating Sushi but to not even be in the same room where Sushi was being prepared as he had no ability to fight off the blood borne pathogens that would float through the air.
Final Tips & Warnings:
* Food may taste metallic or your driver might notice a slight metallic smell in the car that he or she attributes to the car rather than to you.
* Foods you normally disliked may become likeable. Foods you normally like may become less tasty. Salty foods may taste extra salty. Sweet foods may become extra sweet. Some people find that their sense of taste dulls or temporarily gets disabled.
* You may experience constipation or diarrhea. If this is the case, the oncologist will most likely suggest you take a stool softener once or twice a day. Drinking plenty of fluids will also help with this – especially water.
* One woman stated that if she drank a lot of water the day before, the day of, and the day after chemo sessions, she had less problems with diarrhea, constipation, and nausea. Once again, every person will have a different experience.
* You may experience mouth sores or sensitive gums.
* You may experience a scratchy throat.
* The nurse will likely mention that it is permitted to take Tylenol or other over-the-counter pain medications as needed during or after the chemo session.
* You may find that your fingernails break easily, get lines, or turn black.
* You may experience hair loss after only one chemo session. It may take up to three sessions before you notice a loss of hair. It will vary person by person.
* Several cancer patients made the decision to get their head shaved or cut close to the scalp rather than have to deal with patches of hair falling out. This is a very individual decision that only you can make.
* Do drink plenty of fluids – especially water.
* When lying down to sleep, you may find that your throat feels a bit constricted and scratchy. This causes you to cough a bit. When you wake up, this coughing might lead to the feeling of a light case of reflux that leads you to believe that you might be ready to throw up. If it is still in the middle of the night, you could take the optional pill for nausea mentioned in Step 4: 2A called Compazine (or its generic version) If you have any questions, check with your pharmacist or oncology doctor.
* Once again, understand that every cancer diagnosis and treatment is different. You could have the exact same diagnosis as somebody else and the exact same treatment plan; however, your reaction to this treatment could be entirely different due to the chemical make-up of your body and your attitude. Therefore, this article is the chronicle of one woman’s experience. If you have a different experience, please share it in the comment section for the benefit of others.
* How to prepare for Subcutaneous Port implanted for chemo treatments
* How to Go Through First Red Devil Chemo Session.
* Hemoglobin on Medline Plus
* Hematocrit on Medline Plus
* White Blood Cell count on Medline Plus
* White Blood Cell (WBC) count by Amber J. Tresca
* Platelet defined on Wikipedia, the free encyclopedia. Original Source for quote used: Kumar & Clark (2005). “8”. Clinical Medicine (Sixth ed.). Elsevier Saunders. pp. 469. ISBN 0702027634.
* How to debunk some of the myths about Breast Cancer
* How to take the Necessary First Steps should you Discover a Lump in your Breast
* How to go through a Breast Biopsy with the least amount of pain and stress
* How to Be Alert to 4 Signs of Breast Cancer – Lump, Dimple, Rash, or Nipple Discharge
* Changing a Negative into a Positive – Relay for Life
* Video – June 2010 Relay for Life of Greene County, TN