Chemo? WHAT?

Here's my best attempt at an explanation. Up until about an hour after I was diagnosed, I thought chemo and radiation were the same thing. So that just goes to show, we're not as sharp as we think we are.

My chemo "cocktail" is called ABVD and is very common for treating early stage (or any stage) Hodgkin's. I think it might also be used for Leukemia but I could be making that up entirely. You never know with me. Other common cocktails are Stanford V and MOPP. I don't know what those are but I know MOPP includes prednisone. I hate prednisone.

ABVD stands for Adriamycin, Bleomycin, Vinblastine and Dacarbazine. Four drugs that all do their own thing to kill cancer. Very successful with Hodgkin's. I am getting EIGHT cycles of this. I don't get bleomycin anymore becuase it caused lung damage so I just get the three others. A cycle is 4 weeks long. It consists of i) getting chemo on day 1 (all four drugs given by IV), ii)go home, feel sick for a bit iii)day 15 (2 weeks after the chemo) go in for another chemo, iv) go home, feel sick for a bit v)in 2 weeks, repeat cycle. So I will get a total of 16 chemos, once every two weeks. Two weeks is required between each session in a cycle to allow your body to build itself back up. Most importantly the blood levels which take about two weeks to get back to normal.

A typical cycle goes a little something like this...

My chemos are on Wednesday's (unless there's a problem/delay). I go in to the Cancer Centre (45 minutes away) and get some blood taken. It takes about an hour to get results back and my chemo is usually booked about 2 hours later. I get an appointment with my haematologist (cancers of the blood and lymphatic system doctor), he goes over any problems I had with the last chemo (2 weeks prior), any drug adjustments I need and pokes around to see if he can feel lumps. I have to see the doctor before I get chemo, it's "standard procedure". I hate "standard procedure". He gives me results of any tests I've had recently or tells me if any need to be done. He then writes a prescription for my chemo for that day.

Then I go to the Chemo Clinic. I check in and they mix my drugs (they don't mix them til they know you're there) and then wait. The chemo room is a big room with beds and chairs around the perimeter. I usually choose a bed since I'm there for 2 hours or more each time. Then a nurse starts my IV. This can be painful. I alternate arms. They usually put the needle in around my wrist but may go higher up the arm or use the back of my hand depending on how co-operative my veins are that day. Then I get a saline solution through IV (called a "flush"). My drugs arrive shortly after.

Then we take care of the anti-nausea drugs. I'm in charge of Zofran and get one included in my take-home prescription to bring to the next chemo. I get Decadron and Maxeran (with benadryl) once I'm there. These are all pills.

The adriamycin is red and comes in an IV bag. I get about 50 mL of it and it takes about 10 minutes or just under. It runs with the saline to dilute it.

The vinblastine is clear and comes in a syringe. I get about 9 mL of this I think. The nurse pushes it in and it takes about a minute.

The last bag is dacarbazine. It is clear and comes in an IV bag. I get about 600 mL of this so it takes about an hour. It can cause a burning feeling in your arm and may need to be slowed down. It is diluted to prevent this. I keep hot packs on my arm since this helps prevent any pain as well.

When I got bleomycin, I would first get an IV of hydrocortizone to prevent lung damage. About 50 mL again, taking about 10 minutes. The bleo was another small bag and would take about the same amount of time. I don't get either of these drugs now.

When the last drug finishes, the saline runs for a little bit to flush me. My IV is taken out and I go home.

I usually start feeling a little sick in the car and get pretty tired. I sometimes sleep immediately when I get home but I'm usually able to eat a meal that night. I feel wonkiest the day of chemo. I usually have nausea for the next three days but it starts to clear up on the fourth. I haven't thrown up at all yet and don't intend to.

On the fourth or fifth day I start feeling normal again and for about a week I feel perfectly normal. My energy levels (noticeable around 5th/6th cycle) have gone down a lot since I started but I still feel good enough to do most things. The only reason I would limit myself is to avoid getting sick (infection from crowds, etc...) or on the first few days after chemo becuase of nausea.

My hair started falling out after my 2nd chemo (end of one cycle). It started 3 days after chemo, slowly but started coming out faster. I had shaved most of my hair by the time my third chemo came around (2 weeks later, beginning of November) and it was starting to look thin. By Christmas it was really thin but I didn't shave it entirely until February. It continues to grow back after I shave it but it is still very thin. It also seems darker. Leg hair, arm hair, armpit hair and pubic hair all went too. My eyebrows have thinned but my eyelashes are hanging on so far. Right now, after 6 and a half cycles, some body hair is coming back.

Over all, this chemo thing has gone a LOT better than I expected but I expected to be in bed puking for 6 months. It's been much better than that.