What’s the first round of chemotherapy like?

It’s October already – can you believe? On this day (2 October) last year I had my first chemo session. Many people remember the date of their operation but for me the 2 October is etched in my memory.

It was a day I’d been building up to since my diagnosis and there were so many unknowns and anxieties around what would be involved that I thought I should share what that first chemo session involved and hopefully it’ll help ease some of your apprehensions.

My first session was booked in for 10am and we were told to allow six hours for the appointment. This is so the nurses can monitor for any reactions to the chemo drugs.

We arrived early (as is always the case when my mum’s involved!) to be warmly greeted by the welcoming reception team (these guys have put endless smiles on our faces over the last 12 months). When we were called in, we settled ourselves into a bay where there was a large comfy chair, visitor chairs and drip holder.

The drugs

NB – these are the drugs I received but they may not be what you are prescribed. Your breast care nurse will go through your specific drugs and the side effects before your first chemo session.

First up was the herceptin, which is given as an injection in the thigh. It’s a slow injection (takes about 60-90 seconds), which is pretty painful as injections go but they inject it gradually to try to ease the tingle. They give you this first as this is the drug they monitor you for six hours for.

I’ve had 17 of these injections now – a year’s worth at three week intervals, which I think is pretty standard – and the first was definitely the worst. Once you know what to expect, it’s easier. I found these bruised my thighs (they alternate each time) but the bruising goes after a few days.

Next I was given some steroids via my PICC line – we’ll talk PICC in my next blog. This was the weirdest sensation – the steroids made my nether regions tingle, something I really hadn’t expected. At the same time I took some anti-sickness drugs. Both of these are to ease your reaction to the drugs.

Each chemo session you will be given anti-sickness drugs. You’ll also be given steroids to take in the days leading up to your next chemo but on the first session, you’ll be given these intravenously.

After the steroids, I had some saline (salted water) solution through the PICC to flush the line. Then it was on to the docetaxel, which was hung up to the drip machine, fed to the PICC and timed to drip over an hour. The vein around the PICC can feel cool, where the liquid, which has been refrigerated, enters but other than that, you don’t feel a thing. If you do feel any pain around the site, it’s important to tell the nurse as they can check the site and slow the drip to ease the pain.

Whilst you’re having the docetaxel, the nurses will monitor you for any reaction, including rash, itchiness, swelling, dizziness or sickness but the steroids are given to try to stop any reaction.

After the docetaxel, it was time for another round of saline (you’ll probably need to toilet multiple times throughout the day as you’re being given lots of liquid intravenously). The saline is also fed through a drip to the PICC so you just have to sit tight and relax. You can walk around with the drip so if you do need to pop to the loo, you can.

The third and final drug for me was the carboplatin, which is also given via a drip to the PICC line over the course of an hour or so. The drug comes in a liquid bag, like the docetaxel, but is covered by a black bag to protect it from the light. The drug is more effective if it’s protected from light.

Finally, before they let you go home, you’ll be given a huge bag full of drugs and directions of when to take them. This is pretty daunting, I won’t lie. There’s a combination of steroids, anti sickness tablets, sickness injections and tablets to help with constipation, should you need them.

You’re then free to go home.

How did I feel going home? 

I left feeling fine, nervous but fine. And the day after I felt fine too, just tired. The drugs really took effect two days after chemo, when I felt exhausted, nauseous and my mouth was full of ulcers. It’s a feeling I have never felt before so I can’t give you much insight but I could feel the drugs travelling to every part of  my body – to my ears, my gums, everywhere. Everyone’s reaction is different – some people continue as normal and others struggle. I struggled but you may cruise through it – I hope you do.

My tips for your first chemo session:

Take some snacks and something for lunch. You’ll be there all day so need sustenance – anything with ginger in is good for nausea – I went for ginger nut biscuits!

Take a good book, some sudoku or crossword games, your tablet or anything that will keep you occupied throughout the day. Mum and I used the iPad to shop online for Christmas pressies, which was a lovely distraction from what else was going on.

Try not to worry – it’s really not as bad as you imagine

Go through the list of drug timings with the nurse as many times as you need and make additional notes on the instruction page they give you. You need to get this right when you’re home it’s easy to forget what they told you several hours ago – especially with so many drugs.

When you get home, make a note of what drugs you’ve taken from the bag of delights and write a list of when you need to take the others. Tick each drug off when you’ve taken it. You won’t want to miss a dose and when you’re tired and have chemo brain, it’s easily done.

Be gentle with yourself in the days that follow. Listen to your body and rest.

Do you have any questions ahead of your first chemo session? I’ll happily answer any questions I can. 

Thanks
Becky xx

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