A Path Through

February 28, 2022 marked the day where my path through this journey lead to my first chemotherapy appointment.

Now, in our lives there are many first; first smile, first tooth, first step, first love, first heart break, first marriage (we are going to just skip THAT one) and so on. However, I have to say I have never thought that “first chemo appointment” needed to be part of this, but hey there is a first for everything!

As it typical with “first” times, there is learning that needs to happen and with chemo, this all takes place before the drugs even enter your system. As I have promised to bring you all through this journey, here is a bit of a detailed walk through of my first steps, for those who may follow in my path, or those who I truly hope never have to.

Disclaimer – Given where we live, all of my cancer related appointments are at either Surrey Memorial Hospital, Jim Pattison Outpatient, or the BC Cancer Center- Surrey.

Arrival – When we arrived, we were checked in at the main reception and told to wait for our nurse. Minutes later, I (along with my husband and who was my chemo buddy for the day) were warmly greeted by the amazing Jacine; who through the course of the day, was voted to have the best eyebrows of all the nurses in the unit. I didn’t know this was a “thing”, but I agree that her eyebrows were gorgeous!

From there, we were lead through a large set of double doors into the chemo “room”. So, I have to share that there is a really large sign on the doors that states “THIS IS NOT AN EXIT”. For some odd reason (perhaps stress) I found this immensely funny as all I could thing was there was no escape.

Once through the doors, it was time to get “carded”. All cancer patients are provided with a card (more of a small 4-page book) that has space for your appointments, but more importantly, it has your assigned cancer ID#. This ID allows full access into your cancer journey. Appointments, test results, treatment plan, etc. It also allows anyone who may need to provide you guidance on issue management to have quick access to all information before providing you direction.

The Tour – The first stop was the desk where the clerical support team sits and Jacine handed over my ID card to their trusted hands. This team is responsible for booking your chemo appointments, reminders on your lab workdays (you must have blood work done the day before each chemo session), and booking in check-ins with your oncologist. They are telling me where to go, when to be there, and why. For a girl who still has not handed over my schedule to our trusted admin assistant at work, I will need to get used to this new world!

Next stop is to quickly walk through bathroom protocol (getting exciting isn’t it)! All bathrooms in the chemo areas are for patients only. Chemo friends need to leave the chemo area and use the bathrooms in reception. The reason for this primarily that everyone in treatment is a bit…shall we say…toxic. Yup, there is an entire routine for going to the bathroom when you are on chemo (who knew?!)

For me, the next few steps were the most overwhelming. The chemo “room” is actually made up of a maze of MANY small chemo pods; where there were four recliners, each with a seat for your chemo support person; or three chairs and a bed. Each chair/bed had a corresponding number and letter (this would make far more sense to me later in the day).
The sheer size of this space is a bit much to take in as personally, I have found that you can become very focused on YOUR cancer and seeing so many people undergoing treatment, it is a reality check that you are not alone in this journey. There are many more warriors fighting this battle.

My Chemo Spot – My first chemo treatment would be in seat 7A which was a lovely reclining chair complete with a seat for my buddy (not half as comfy but a chair none the less). There was also an IV pole that had been set up with waiting bags of medications that would prepare me for the big guns. I must say that if my little spot was a home, I was sitting on PRIME property! Within ten feet of the nursing desk, across from the bathroom AND the water/ice machine, and right beside the medication cart. I know…it is all about location, location, location! The original plan was that I would be in the chair for about 4 hours; however today I would learn that timelines for chemo are fluid (no pun intended).

Time to Learn – Once settled in and comfy in the chair, it was time for Jacine to put on her educator hat as she began to walk through a mountain of information.

Lesson One: Who to Call – Resources that are available if I need them; nurse phone line for issue management through the day, on call oncologist contacts, and a red sheet with two cards (one for me, one for my husband) to be presented at the triage desk in the event I need to report to emergency. Basically, we got the 4-1-1 on the 9-1-1 resources available to us.

Lesson Two: Treatment – This was the biggest learning step, my treatment protocol. For the record, I have been designated was BCLACTAC; which means Breast Cancer Locally Advanced Carboplantin TAXOL ADRIAMYCIN Cycloephosphamide. Yes, this label fits me perfectly…it is wordy, just like the person it is attached to! What you really need to know about this very LONG designation is that everything after BCLA is actually the drugs that will be given through the course of chemo.

So now that I have been officially labelled, please allow me to introduce my drugs buddies for the next 12 weeks – Carboplantin and Paclitaxel (also known as TAXOL). As impressive as they sound, their possible side effects are even more awe inspiring….diarrhea, constipation, hair loss, nausea, nerve pain, mouth sores, infections, fatigue….oohh these are drugs that know how to PARTY! Jacine stressed that the side effects are possible, not guaranteed, except the hair loss, that is basically an absolute certainty and will start within the next 2 weeks or so. These meds will be with me for the first 4 cycles of chemo. Each cycle is 3 sessions one week apart. This will all add up to 16 chemo sessions with these specific drugs. On the first week, I will receive both drugs, and on the second and third weeks, it is just me and Paclitaxel (you will learn why I have a few mixed feelings on this relationship in the next post). From there, rinse and repeat until we hit the magic 16 and then on to the next drugs.

Once I have completed the 16 sessions with good ole C & P, it is on to the new meds ADRIAMYCIN and Cycloephosphamide. Again, some pretty interesting side effects but relatively in line with the ones covered with the first meds. The chemo cycle will change with these new medications. My chemo treatments will move to once every 3 weeks for 4 cycles; which will mean a total of 4 chemo sessions with these bad boys!

So the goal is July 11th to complete the chemo stage if my journey. Again, it is a goal, things can happen along the way that could result in a treatment being moved, such as infection, illness, etc. However, I will be posting July 11th all over my house as a constant reminder that the goal is now in sight!

Lesson Three – Establishing Health Baseline – With the treatment protocol thoroughly reviewed, it was on to establishing my health baseline. This is simply a page of questions all about how you are feeling. This is done on your first session, as you have yet to start the treatment plan, so how you are feeling at that moment is considered setting the bar. As I am an overachiever, I was feeling great, did not want to be there…but feeling great. My blood pressure was also checked (and again indicated I REALLY didn’t want to be there).

The very last step was the temperature check. This is where you actually have a bit of a test, however there was no need to study! When you come for chemo on your first day you are required to bring a little baggy of goodies along. For me, my bag included the meds I have been prescribed for treatment days that will control of nausea and a steroid to help with the impacts of the drugs. In addition, on the first day I also had to bring an oral thermometer that I will be using at home in the event I need to check for a fever. This is where the test starts. First up was Jacine who took my temperature with the clinic thermometer, 36.0 (NAILED IT!). The next step was to compare the home thermometer to see if it talked the same “temperature” talk! I had to take my temperature again with my thermometer. My trusty $21 Vick’s thermometer with the quick 8 second readout (sounding like a sales pitch doesn’t it) showed a read out of 36.6 (this would be Celsius for those who may be thinking I am a popsicle). This difference was then logged in my file so in the event I am reaching out regarding a fever, the clinician helping me will see that my thermometer reads higher.

Lesson Four: Pre-Med Warm Up – With everything now covered, it was time to pop into my little goodie bag and take the two pills that would get me ready to get the show on the road.

I will not lie when sharing that anxiety was a third chemo buddy for me on this day. However, there was also an odd sense of relief associated with what was happening. The fight to kill this unwanted invader was actually starting and my body was about to turn into a battleground where there can only be one outcome …I will win the fight. I walked through the doors (that are NOT an exit) having no clue what this first step on the path through chemo would look like. Now, I knew the plan, who would be there when I need them, and my surroundings. I was well informed to take the next steps, which would be the first poke of the IV needle, the first step to winning the battle…..and the day still had a bit of excitement planned for me.