What To Expect When Expecting...Chemo

A few days ago I had my final check-up, the one before the long waiting period to be declared “cured,” and it occurred to me that we’ve never discussed exactly what happens when you go for chemo, step by step.  Going through it, I realize how valuable it would have been to have a “what to expect” guide, and some handy tips on how to get through it easier.  So, here it is, the definitive guide for what to expect when expecting chemo.

What actually happens at chemotherapy?

When you are first told you have to get chemo, it’s overwhelming.  The word carries more baggage than a Manhattan socialite going to the Hamptons for the weekend.  The things that go through your head – you just can’t help it.  It’s like Dr. Seuss’s “Oh the places you’ll go,” but everything is scary and nothing rhymes.  To help put your mind at ease, let’s take it one step at a time, and the first is getting there.

Find a friend to drive you

Probably, you’ll want to have a friend or loved one drive you.  If not always, at least the first few times until you get the routine down and know what you’re dealing with. If you don’t have anyone who can you can call the American Cancer Society and they can help you find a ride in your area.  Once you get there, the first thing you’ll do after you check in is get blood tests.  Most doctors like to have the most current numbers before they pump you full of poison, you know, just in case it makes you sick and you feel like crap… oh wait…

The scene in the chemo waiting room

After you get your blood tests, you get to go back to the lobby and wait.  The lobby of the “chemo mill,” as I like to call it, is much like the Star Wars Cantina from Mos Eisley – you know, the “wretched hive of scum and villainy.”  Instead of scum and villainy though, it’s filled with all the different cancer patients and their various infirmities – some are wearing masks, some are in wheelchairs, some are walking wounded like I was, and some are out and proud with their shaved heads and “f*ck cancer” attitudes.  It’s a real motley crew.  All are laid low in equal measure by the big C, though, and the waiting room of the chemo mill is a testament to that.  Eventually, you’ll be called in for a consult with your doctor.

Blood tests and vitals

On your way to the exam room, you’ll most likely be weighed to make sure you haven’t lost a significant amount of mass – it’s a sign of cancer as I’m sure you already know.  They’ll also take your vitals to make sure you don’t have a fever and make sure you do have a heartbeat.  After that, it’s just a quick 45-minute wait for the doctor to tell you the results of your blood tests.  Don’t worry if you don’t understand what the tests are the first time around – you’ll become well versed in hemoglobin, white count, platelets, and RBC count numbers.  Once you get the all-clear from the doc, he puts in the order for the chemo and then you go… yup, you guessed it, back to the cantina waiting room.

Back to the waiting room

By the time you get back to the waiting room, your seat will probably be taken as that place is always busier than the women’s room during intermission and you’ll have to do the seat search.  It’s best to split up for this if you are with someone, as finding two together is rarer than a Kardashian who isn’t awful.  Settle in, because it’s probably going to be another long wait for them to call you into the infusion area.  Bring a book or an iPad, and don’t be one of those jerks who uses their device without headphones, please.  Some of us have cancer!

Entering the chemo suite

Once you do eventually get called into the back, a number of things happen in succession.  You’ll be put into the comfy infusion recliner and you’ll be assigned a nurse.  They will insert an IV and if you have problem veins it’s best to tell them as soon as they seat you.  They can provide a hot pack and other things to help the veins come to the surface and make it easier to stick you.  Once the IV is in, they will probably ask if you want a ginger ale or some of the sandwiches they try to peddle.  I swear some of those sandwiches have been in the fridge since before bread came sliced, but you can take your chances if you like.  My advice – pack a snack!

And now... chemotherapy

After this, there is some waiting again.  The chemo drugs are strictly regulated, and there are guidelines that all institutions have to follow.  For me, it went like this.  Two nurses would come over carrying the chemo in front of them like the crown for my cancer coronation.  The nurse who was actually holding the drugs was so covered up that he or she looked like an overly cautious beekeeper, and then comes the verification.  They have to verify you are indeed the patient who is supposed to get that specific chemo and to do that they must double and triple-check that it’s your patient number on the bags.  By the time you finish your chemo, you’ll have memorized the number.  3340405 was mine.  Like Jean Valjean in Les Miserables – prisoner 24601, they gave me a number and forgot my name.  Once started, the infusion runs anywhere from under an hour to upwards of six hours, depending on what you get, so bring enough entertainment to keep you busy.

This experience will be different for everyone

Things may not be exactly the same for you, but in general it’s pretty much like I said.  When you get home the first time, you probably want to have some oncology mouthwash ready in case of sores, and for me the next most important thing was the anti-nausea pills.  Other than that, I promise you will figure it out after a session or two.  It seems, daunting, I know, but I wish someone had given me this guide before day one, so I hope it helps.  Talk soon.