Saturday, January 22, 2011

A Day in the Life of a Chemo Patient

8:30 a.m.: I arrive at NIH and go through my pre-chemo procedure: temperature, blood pressure, height, weight, physical examination, port access, blood draw, hydration at a half liter per hour, and a urine sample. I have received so much fluid that my piss is clearer than water.

12:00 p.m.: Patients get different anti-nausea medications depending on preference. I receive Zofran, Benadryl and occasionally Ativan. Zofran is the best with no side effects, except drowsiness when administered in large doses. Zofran blocks the brain receptors that receive nerve messages to vomit. Benadryl makes me sleepy, and Ativan causes an unpleasant, lingering drowsiness. This combination, which I call The Trifecta, will completely knock me out. I can hear Dick Vitale yelling, “It’s a Trifecta, baby!”

12:30 p.m.: I become sleepy and search for my chemo spot. There are a limited number of beds in the clinic, but several large blue chairs. I choose a bed depending on how sickly I allow myself to be perceived.

1:20 p.m.: My first chemo begins, etoposide, 365 milliliters, a clear liquid that has no sensation once reaching my artery. I’m fast asleep at this point and only wake up to urinate.

1:25 p.m.: I have to pee. If I’m in a bed, my mom closes the curtain, I slide my legs over the side of the bed, plant my feet, stand up, grab the plastic urinal, and let it flow. Lexi, just on the other side of the curtain, hears me peeing. She is grossed-out that the males can dispose of bodily fluids without any regard for others.

1:35 p.m.: I have to pee again.

1:45 p.m.: Again, I have to pee. With so much fluid in my body, I can’t stop going. If I increase resistance, I can probably have a continuous, two-hour stream.

2:20 p.m.: My second infusion, ifosfamide, 365 milliliters, another clear liquid. Together they combine for 730 milliliters, over five days 3,650 milliliters, over eight cycles 29,200 milliliters. That’s 29.2 liters, 7.7 gallons.

3:20 p.m.: Both chemos are completed and my first dose of mesna, the bladder protector, begins. The clinic is about to close, so my mom and I move to the hospital wing where I’ll stay for the next few days.

6:00 p.m.: I don’t feel well and want the day to end. I watch two episodes of The Simpsons, followed by Friends and Seinfeld.

8:00 p.m.: I watch obscure shows like Titus, Gideon’s Crossing, and Grounded for Life simply to pass the time. I would go to sleep right now if I could.

10:00 p.m.: I brush my teeth and get ready for bed.

1:30 a.m.: I can’t for the life of me fall asleep. My nurse barges her fat ass in here every few hours to check my vitals or change my IV hydration. I wish that damn IV pump would shut up. If my mom wasn’t zonked-out across the room, I would watch TV on one of the six channels this world-renowned research hospital offers on this TV that’s smaller than my dick. Has she always needed those sleeping pills, or just since my cancer?

I wonder what my friends are doing tonight. A few weeks ago, when they were eating a late-night snack at Taco Bell, Zeke decided to steal one of the chairs. How did he manage to steal a chair out of Taco Bell unnoticed? I wished I had been there that night, but, no, I had to get chemo.

I’m staring at the ceiling in this hellhole now. I wonder how many tiles are up there…one, two, three, four, five…what am I doing? Who gives a shit how many tiles are on the ceiling? But I bet there are other cancer patients doing exactly the same thing. A few weeks ago I overheard a boy talking with his physical therapist. He had his femur removed and replaced with a metal rod. Another kid has been stuck here for a year with a bone infection. Yesterday I saw a young girl with long black hair, but she had a small bald spot at the top where her chemo was injected. She got chemo through her skull.

Relax, just relax. Take deep breaths, slow, steady. Inhale, hold it…exhale. Wait…I hear some footsteps. Is that Godzilla stomping around? My thoughts get foggier. So, more chemo tomorrow, huh? How did I wind up here in the first place? Which chromosome mutated? Was it the twenty-second? Ah, what difference does it make?

My mind bounces back to Taco Bell. What was Zeke thinking? Once he dragged the chair out of the restaurant, he stuffed it in PepperoniNip's trunk. The plan was to set it in my driveway as a welcome-home gift. But the next day, PepperoniNip’s dad wanted to borrow his car, so he had to throw it into the woods. What was I supposed to do with a Taco Bell chair, anyway?

I sing myself a soothing song, a lullaby: “Go to sleep, go to sleep, go to sleep.” You know, cancer life isn’t so bad; it’s just a routine like everything else. I can handle it. I’m sure there are some people who can’t…the Redskins have a bye this week…what the hell am I going to do on Sunday? Oh yeah, I forgot—get more chemo. My mind starts rolling downhill into the vale of sleep.

7:30 a.m.: My breakfast tray arrives and I eat all of it. On my first day of chemo, six weeks earlier, I ate spaghetti and meatballs in record time. Dr. C came in during my meal and said, “Look at you eating hospital food. I’m impressed; most of the patients stay away from it.”

“Really? I don’t see why, this stuff is pretty good.” What was I thinking?

By this time I hate hospital food, but mornings are the easiest time for me to eat. This is different from Yorker who feels lousy every morning and often vomits. I fill out the menu for Saturday. For lunch and dinner, I mark what I think my dad will eat. My dad replaces my mom on the weekends. He loves hospital food.

8:00 a.m.: Several doctors visit me during their rounds. They stand in a semi-circle and stare. It creeps the hell out of me. “Good morning, Ben,” my attending doctor says. “I just checked your blood work for today and it looks good. How are you feeling?”

“Okay. I just finished eating breakfast.”

“Good. How did the chemo go yesterday? Any problems?”

“No, it was fine. I fell asleep.”

“All right. Well, you have four more days left and then you’re out of here. Pull up your shirt and let me listen to your chest. Take some deep breaths for me…now lean back and let me listen to your belly…okay, sounds great. Just let me know if there are any problems. Otherwise, we’ll get you ready for more chemo a little later.”

“Okay, see you later.”

10:00 a.m.: I walk down the long hallway several times to get my daily exercise. Chemo is draining and pushing this damn IV pole back and forth is enough for me.

10:20 a.m.: I watch a movie on the TV/VCR combo.

11:00 a.m.: I eat the red Jell-O off my lunch tray.

12:00 p.m.: The Trifecta begins.

1:00 p.m.: My nurse enters my room wearing a gown and rubber gloves. She carries my bag of chemo, as well as new IV tubing. The bag of chemo has a red biohazard sticker, as well as my name, my birthday, my hospital ID, the name of the drug, the amount in the bag, and the infusion time. The nurse double checks the information and then she asks me my name, birth date, IQ score, and pinky toe length in nanometers just to make certain this bag belongs to me.

1:05 p.m.: I count the drips and study their pace. Some stagger, clump together, and form one large drip. Some are smaller and follow one after the other, impatient, striving to reach their final destination. The drips become part of my blood, momentarily, and reach every vein, artery, and capillary. They are said not to pass the blood-brain barrier, but I have difficulty believing that—chemo brain and fogginess don’t come from nowhere. I will sweat the drips out, pee them out, poop them out, breathe them out, and puke them out.

1:25 p.m.: “I have to pee,” I say to my mom.

“Okay. I’ll wait right outside the door,” she says.

1:27 p.m.: “Okay, I’m done.”

My mom can’t understand what I just said, so she cracks the door and asks, “Are you done?”


2:00 p.m.: My first bag of chemo is done, so my nurse switches to the second drug, still wearing her gown and gloves as if I’m a leper. She discards the old chemo bag and tubing in a red receptacle labeled “biohazard.”

3:00 p.m.: My chemo is done and mesna begins.

4:00 p.m.: I eat a light snack consisting of cereal, pretzels, or a strawberry sundae from McDonald’s. Directly following chemo is the second easiest time for me to eat.

This sequence is repeated until I’m discharged.

Related story:
A Day in the Life of a Bone Marrow Transplant Patient