Note: This post goes into details about my first cycle of FOLFOX. I’m planning to include additional parts as I progress through my remaining thirteen cycles of treatment if there’s anything interesting to add.
Receiving chemotherapy for the first time is exhausting. The buildup to the day, with the associated tests, appointments, and procedures, leaves treatment day as the final boss in a weeklong gauntlet of physical and mental torment.
Taking that vinyl seat
The chemotherapy room comprises a large number of beds and chairs, each with their own IV pump and wall-mounted TV. There’s an option to lay down or to take a seat. I choose the chair.
The nurse, as is customary, verifies my identity through my name and DOB. I haven’t been in this cancer world long, but I’ve started to say them one after another when prompted for my name.
Once my vitals confirm that I am, in fact, still alive, a pill cup with anti-nausea medication and a pair of steroid is passed my way. Bottoms up! I’m told I can have a room temperature ginger ale to wash them down if I’d like. Who could turn that down?
Then, my PICC line is flushed to ensure that it’s ready to go for the chemotherapy drugs. Since this is the first time I’m receiving them, there’s a chance that I could have an immediate and severe reaction. My heart races as the Oxaliplatin and Leucovorin are hung from the IV stand.
“We’re starting now,” announces the nurse.
I anguish for a few minutes as I watch the drip of the drugs into the IV line. Nothing happens. A sigh of relief.
For the next two hours, the IVs drip themselves empty. As the bags run dry, the sensors on the IV pole go into alarm.
“It’s time for the next drug,” the nurse explains, disconnecting the bags from the pole.
This time it’s Fluorouracil—another new drug. This is the same one that I’ll be taking home with me in a portable pump.
I go through the anxiety again, wondering if I’ll react to this new medication. Luckily, nothing happens. After about 15 minutes, I’m disconnected and hooked up to the take-home pump. In 46 hours, I’ll have finished my first treatment.
I stand up from the vinyl chair. I’m soaked with sweat. I’m ready to go home.
There’s a long list of side effects that can go hand-in-hand with FOLFOX chemotherapy. It’s surreal.
The most impactful so far has been fatigue. It’s less like having the wind taken out of your sails and more like being consumed by a Kraken. I’m just so indescribably tired. I would compare it to being awake for 48 hours straight, but I think this is worse.
I have also had some neuropathy—tingling in my fingers and toes—over the last couple of days. I would liken this to the pins and needles you’d experience waking up with your hand asleep. It’s intermittent and annoying, more than anything. It also turns to numbness, which is great for typing. This one can be permanent, so I’ve been keeping a tingly journal so I can report back to my oncologist.
Neuropathy kind of goes hand-in-hand with cold sensitivity. Will it feel like burning when I grab a the milk from the fridge? Is my sip of 7-UP going to feel like a razorblade in my throat? Just one more fun game, courtesy of chemotherapy.
Lastly, there’s nausea. This one’s tricky because, if you’re like me, thinking about being nauseous actually makes me feel that way. So I’m left wondering how much of my nausea is psychosomatic versus real. Nonetheless, I’ve been taking medication for it when it comes on. The anti-nausea pills make me extra tired on top of the fatigue. I haven’t thrown up, so I guess I’ve got that going for me.
Now that the existential dread leading up to cycle number one has subsided, I can focus on feeling more like myself, but with added fatigue.
I’m supposed to do this another thirteen times. The effects can get worse after each cycle.
While I’m not entirely sure how I’m going to make it through, I know that I will. I have a new understanding of what it means to be resilient in the face of an obstacle, so all I can do now is keep going.
… oh, and chemotherapy feels like shit.