Bulldozing Phase 1 Chemo

The new ME — lost all the hair after phase 1 chemo

Yes, the tests were difficult to go through, but my doctors now have a baseline of each organ and my health statistics. With triple-negative and stage 3-C, the plan was first to control the spread immediately. The sequence I have to follow is chemotherapy, surgery, and then radiation.

I am impressed to see how medicine and technology have influenced, challenged each other with innovations and will continue to do so. Chemo medication cocktail designed for each individual is based on all the tests, blood work, the stage, and the type of cancer. Every individual reacts differently to chemo medications because it depends on the cocktail, number of cycles, support system, mental and physical strength, and many other factors. So the chances of you knowing a breast cancer survivor or someone dealing with it getting the same medication or treatment as I am is very slim.

From my kids, and we have it laminated.

This year for mother’s day, I had my mom and sister visiting me — quite special, and my kids made it even more special with their sweet gifts, which we have stuck around the house.


Mother’s day celebration

The phase-1 was tough on me on some days, and I am sure it was equally tough on my family to see me go through it. After the second chemo round, I had to shave off my hair. Robin took care of it with his clippers — while my kids, parents, and sisters were cheering for me all along. It turned out to be a fun evening. Some things go a long way — this is one of them because everyone around me pretended to be cheerful when I know deep inside how it must have hurt them.

My four chemo sessions
The injector to connect to the port — that’s why the numbing cream is used

The chemo coach prepared me and lined up a systematic pattern for my phase-1 chemo. There were no surprises, validating my earlier comment of how much technology has been able to identify some of this to the T. These harsh four sessions were bi-weekly, giving enough time for my body to recover from each session.

The chemo sessions were usually a 4-hour process with blood tests, meeting the oncologist, followed by the chemo medications through IV.

The process starts with IV, steroids, nausea medicine, and then the chemo medication

The clear chemo medicine is given through IV, and the orange is injected through the port.

The hydration visits on the next day of chemo are such a blessing — it gave me the same feeling after a good spa visit.

One of the medicines in phase-1 was an injection — you can see the orange color in the picture. You feel very crappy at the end of the session — a mouth filled with a medicinal metallic taste, your stomach feels extremely nauseous, your head feels as if you just got down from one of those crazy roller-coaster rides. Nothing feels right or good after the session.

I had to take the nausea medication for the first four days of phase-1 and sleeping pills. I did pretty well the first 3 hours after the chemo for all four sessions, but I would be miserable the rest of the day. The nausea medicines were a blessing; otherwise, I cannot imagine getting through it without sleep with so much going on inside your body.

One of the side-effects of nausea medicines is constipation. Your food intake is limited with small portions and lots of water. Milk of Magnesia has come to my rescue for several days.

Towards the end of the chemo session, the nurse would also insert the Neulasta — for my white blood cell recovery. My nurse would attach the on-body injector (OBI) to my stomach, and, after 16 hours, the Neulasta Onpro would deliver a dose of the drug. Chemo doesn’t kill only cancer cells; it also destroys other dividing cells in the body, including helpful cells such as white blood cells (WBCs). With low WBCs — there is an increased risk of infection. Neulasta aids in increasing the depleting WBC count. I would generally feel more fatigued on the 5th and 6th days of my chemo cycle — which used to be the weekends. The WBC count would go almost to zero — yes, you read it right to zero for me from day seven to day nine, and then because of the Neulasta — my bone marrow would know to create more WBC on day ten. So my counts are all back to normal by day 14, ready for the next chemo cycle.

On-body injector for WBCs — the thin blue strip is attached to the skin — take it out after it dispenses

Neulasta also has its share of side effects — the most consequential one for me was bone pain. Neulasta stimulates our immune system to produce more WBC, which leads to more histamine being created. The release of histamine causes bone marrow swelling and pain. On day eight, after each of my chemo cycles around 5 pm, I felt intense heat inside of my neck, almost knowing that my body would release WBCs. Bone pain would follow. I did take Claritin as suggested but did undergo a terrible, unbearable pain after my second chemo cycle. I was prepared well with Aleeve and Claritin for my third and fourth, so the pain was much under control.

Another significant pain that I experience was in my right breast. With the lump disintegrating slowly, the tissues within the right breast keep realigning, causing a lot of pain. While the left is hanging on its own with no attention, the right continues to seek attention, especially at night periodically. It feels like someone is squishing and pounding it within, making some nights tough to sleep with the pain.

Magic mouth wash has been a huge blessing these days — I would get mouth sores from day 7 to day 10 for all four chemos, and I just could sense that things are not right with my body. Then, from day 11, everything magically would start becoming normal for me within. I was blown away by the WBC mechanics in my body.

During the chemo process, I would partake in my meetings and complete my work. However, it is the evenings of the day of the chemo that I felt useless and would just want just to snuggle and sleep.

To be honest, I dread going for my chemo and completely hate it. Even though I am fully aware that it is all for me to get better, knowing what I would be going through in those two weeks after the chemo never made it a happy journey to the clinic. Some days I get on my Peloton to take revenge on cancer — to remind it that it got the wrong woman.

Bones and the nerves give a terrible pain — my bad days

When I look back at my phase-1 chemo cycle, I believe I did pretty well with my health, no infections, managing my emotions (not including the outbursts to my sisters and Robin), and keeping the iron and energy levels up, keeping an overall positive mindset.

I wrapped my phase 1 of 4 harsh chemo cycles in June and have started my phase-2 weekly chemo cycle. I will also share my phase-2 experience … it did not have a great start.

Impact of Chemo

  • After growing out of those selfish teen years where I thought only about myself, I was asked to do the same now. It has been tough for me to do that — but with low energy levels by the end of the day, most days, my focus is on me, my work, and catching up with my kids to learn about their day.
  • I am learning to listen to my body — there are days when I called it a day by 6 pm and went to bed. I just couldn’t mentally and physically push anymore. I am also aware that I am the same person who wants to enjoy life to the fullest, but I understand that it will take time for normalcy to return.
  • Loss of appetite — the only time I feel hungry is after my morning workout. The rest of the day, I eat because it is time to eat.
  • I drink 2 liters of water every day.
  • I have lost 13 pounds since diagnosis.
  • The most depressing thing a foodie like me has to deal with is the impact of chemo on your mouth. After the first round of the chemo cycle, I began to lose taste, progressively getting worse slowly. The rough texture of food resembles medicine that lingers on the roof of my mouth, the end of my tongue, and the left side corner of my mouth. I get mild sores between the 8th-11th day of the chemo cycle. My mouth is also very dry. I can feel the texture of the food and, by memory, know how it should taste. Water seems to be the only thing that has remained constant tastewise during the process, and sometimes it even tastes sweet. Eating is a continuous challenge because it annoys me that everything tastes so terrible. I am told it gets better after 1–2 months of the chemo cycle, and I am waiting for that day.
  • My food includes grilled fish with just salt and spinach, mild seasoning — I cannot handle any spice: mixed lentil pancakes, boiled eggs, guacamole, boiled chickpeas, red beans. Sour cream has helped me on and off with the eggs and grilled fish. Chicken liver comes back periodically depending on my hemoglobin levels. If the level goes down, then I would have to go back to iron infusions. So I balance my diet to maintain to levels.
  • The chemo medications cause an increased amount of gas released in the stomach. As a result, I fart a lot, including farting in public and the grocery store. I blame it on my chemo belly.
  • The hair follicles started hurting after 3–4 days of the chemo. With the summer heat and A.C. at home, my scalp started getting inflamed. So I have to use the cap or scarf as needed.
  • My infection rate is very high with the WBC going low; I managed not to develop anything for the first three cycles but then, with the change in weather, ended up getting dry cough during the fourth cycle. So I had to take antibiotics for a week to beat the cough. It had its side effects.
  • Even with the pixie cut, hair would continue to fall when I combed. So I decided to shave my head, and Robin used a number 1 clipper to shave my head. The lint remover helped me get rid of the remaining — it was a fun experience to use it as my hairbrush for a week.
My post-chemo schedule, using a new hairbrush and the big water jug
  • I use baby shampoo for my scalp.
  • Feeling randomly emotional — some days, I wake up in the morning with tears, and I have no clue why. If this happens within 2–3 days after the Chemo, then the tears have the smell of the medicine. My towel smells of the medicine. After a workout — my family can smell the medicine coming out of the sweat pores.
  • I don’t enjoy watching shows or movies. I feel dizzy when there is fast movement on the screen. So I have been watching YouTube food blogger shows.
  • I have also developed what I call the Chemo clean. I keep cleaning my kitchen platform, even after my family cleans it. In general, I am unable to bear clutter around the house. So I try to clean it, but my family feels I shouldn’t strain much. This pattern has got extended to my laptop and phone as well. My desktop, emails, phone apps are all organized.
  • Even in the 95F weather of Austin, I feel cold at night, so I wear socks to bed since diagnosis. I’ve become such a clean freak that I wear the socks only in the bed and feel it shouldn’t get any dirt on them.
  • I start my mornings wondering if I will naturally have a bowel movement or need to take Milk of Magnesia’s help. I just realized that there might be a considerable coverage toward my stools but couldn’t help — that is my new reality. Chemo causes constipation, and antibiotics cause diarrhea, so I wonder who will win the battle between them some mornings.
For Constipation and the magic mouth wash for mouth sores
  • Magic mouthwash has been my rescuer for mouth sores. The days when my WBC count goes low — which is the day seven after chemo to the tenth day — the magic mouthwash has helped me sail through. It’s truly magical as it numbs your mouth for some time giving you much-needed relief. You keep it in your mouth for a minute and then swallow it.
  • I also have to clean and brush after every meal to not lead to mouth sores. Chemo kills saliva generation in your mouth, so it’s very dry, and any food particles can bring soreness or infection.
  • I know so much more about my blood now. The analysis gets done every week, and it is pretty impressive.
  • I get ready now in 8 minutes which includes a shower.
  • For most people, the monthly menstrual cycle stops during Chemo. I got mine going just the same way.
  • No waxing — because the hair growth stops everywhere.
  • Impact on sexual desire: mouth soreness, constant medicine taste, nausea, and many other factors have affected my sex life, leaving no energy for it.
  • I also have to take many notes these days as it’s difficult to remember everything, difficulty finding the right word, the chemo brain fog.
  • I enjoy work calls as everything is still normal there for me. On the contrary, I fear talking with my family and friends as I might hurt them, given the mood swings.
With my enthusiastic mom — she is soon to hit her 100 rides.
Before haircut and my first pixie cut
  • As my friends and family have been saying — I want to bake the Christmas rum cake for all of them.

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