Paul's Heart

Anticipatory Nausea

Some call it anxiety.  People who do not understand what we went through (or some of you reading this – going through) say we are doing this to ourselves.  I call it “anticipatory nausea”.

It is when you know what to expect when you follow the exact same steps just prior.  Everything will be the same.  You sit down in the chemo chair, they insert the line, perhaps you can actually taste one or two of the drugs, the needle comes out, and it is off to the races, the trophy being the Porcelain Cup, all the while rapidly going downhill with nausea.

There will be certain things that trigger the nausea.  I was okay for the first treatment because I had no idea what to expect.  But there was one negative thing about that first injection that I took.  It was a metallic taste that hit my tongue, the second it hit my veins.  Clearly, this was going to be my trigger.  The taste lasted as long as the infusion which was about twenty minutes or so.  I finished my chemo, and then as I said, had to get to the bathroom at home immediately.  Just for the record, eight cycles, never vomited in my car.  Once just inside my apartment (I had three flights of stairs to go up).

The second injection went without incident.  So in my head, it had begun.  Approximately two days before the beginning of my new cycle, my stomach would start to turn.  I began to taste that one drug already.  This was impossible I thought to myself.  When I arrived at the oncology office, I asked Brenda, my nurse, if I could have a mint to suck on while getting the infusion.  She said that she did not see why not, as long as I knew I would probably vomit it later.  I told her that I was hoping to overpower the taste that the one drug left in my mouth while it was being infused.  I also mentioned that this anticipatory nausea was causing me a lot of anxiety to which she had me take some Ativan to help me relax.  Unfortunately it did not work.  Nor did the medication given to me at the oncology office.

One major side note here, research has developed much better anti nausea meds to help lessen the side effects of nausea.  Ask for it.  Your mind is already working hard enough dealing with all the other toxicity that you are having done to you.

Final thought, following the completion of my eight cycles, at what would have been the time of the month for the next cycle, I could no longer taste that one chemo drug like I had the previous seven months.  The psyche is so powerful.

Hodgkin’s Disease – How I Got Through My Treatments

My world instant ground to a standstill when I found out that I had cancer.  On one hand, the natural reaction was to wonder if I would find success in treatments, or if I would be like so many before and succumb.  It seemed to take forever just to get all the diagnostic stuff completed.  Yet treatments needed to begin soon for me to have the best chance of survival.  It just took so long to get started.

Radiation seemed like the easiest choice because it would only go six weeks, a total of 30 treatments lasting about a minute each.  I looked at it as having been through x-rays, this would not have been much worse.  Fatigue was the biggest issue for me and totally underestimated.  All of a sudden I was going to bed at 7:00 in the evening.

The decision of which treatment to pursue was mine.  The oncologist had recommended chemo followed by radiation.  But I was too obsessess with what I believed that chemo would be too tough for me to handle, physically and emtionally.  Any knowledge I had of chemo came courtesy of the media, and of course, no movie or television show ever showed chemotherapy being a cakewalk.

Unfortunately, my oncologist was right with his call.  I was wrong with mine.

I came back from my honeymoon at the end of May, completed a CT scan, and new disease had been discovered.  There was no option at this point.  I was going to go through chemotherapy.  I had never met anyone who had gone through it.  I had a list of side effects to expect, nausea and hairloss, the typical issues.  But now I had to prepare originally for six cycles.  Cycles in my case meant months.  I would get half of my chemo cocktail in one appointment, get the other half the following week, and be given two weeks to recover.  But after those six cycles were complete, my oncologist felt the need to do either an extra two cycles of chemo, or additional radiation.  I had it in my mind that with my body and mind already involved with the chemo, and planning to get that far, I would be able to handle an additional two rounds of chemo.

So there it was, emotionally, I had to plan for eight months of chemotherapy.  Eight months is two thirds of the year.  Eight months seemed like an awful long time to look ahead.  It was overwhelming.  I had to find a way to convince myself that an easier approach could be had.  How could I reduce eight months, 240 days down to something that I could feel like was not forever?

Here was my formula for getting through chemo:  eight months of chemo, which would equal sixteen injections, of which only half of those injections would make me vomit, which the nausea would only last maybe a couple of hours after each injection = sixteen hours of nausea.  I have spent plenty of days with the flu and other virus when the nausea has lasted longer than that.  I could get though this.

The first thing that I had to do, just like in sports, take one day at a time, just like one game at a time.  It would do no good to look ahead when I had not finished the prior treatment.  So when I got through the first injection, the one that would cause nausea, I knew I could get through the second injection the following week.  Of course, after I completed the second week, I had completed one cycle.  I was able to get through one, I would be able to get through the next cycle (the second cycle).  Once that cycle was done, I was already 1/4 of the way through, and could get through the third cycle because I got through the first two.  Then I reached the half way point, and as tough as it had been, I knew I could get through the rest.  Each month, I treated the same way as the cycle before.

In month eight, my body had a different plan.  I had developed a fever, and my blood counts had dropped.  Chemo would have to be altered or postponed.  The truth is, I had tolerated seven cycles of full dose chemo, I did not want to accept anything less, so I asked the oncologist to delay the treatment by a week to allow my body to get stronger.  He agreed.  This is why you do not mark dates down on the calendar.  It was a huge disappointment not to get finished on the day that I had planned all along from the beginning.

And then it began, the final cycle.  Nothing was going to stop me at this point.  The following week, I came for the final injection.  And that is when I knew I made the right decision in choosing my oncologist.  Brenda, my oncology nurse was removing the catheter for the final time.  “Paul, when you get out of this chair, I want you to picture the biggest marching band you have ever seen in your life.  They are lined up down the hallway playing a victory song just for you.  You did it.  You have beaten cancer.  Now go live your life.”