Alternatives and Anticipation

The third treatment approached quickly and I found myself hanging on to the final days of the second treatment in mere dread for what was to come. It was the first time that I found myself thinking about a coming treatment constantly--I began to dwell on the inevitable. I feared Friday, January 5th. All sorts of things were plaguing my mind. I hate being sick. I can't bear to go through that nausea again this weekend. I wonder if any more crazy things will happen to me this time? I became sick to my stomach just thinking about what I would have to go through over the weekend.

Thursday (the day before chemo) I went in to the cancer unit for my regular pre-chemotherapy check-up. This is when I get bloodwork to make sure my blood cell counts are high enough to receive chemo the following day and when I meet with a nurse and Dr. MacCormick to have questions answered and prescriptions added or changed, depending on the troubles the following chemo may have posed. I had the bloodwork done, which turned out to be fine, and proceeded to wait an hour, as usual, to see the doctor. After my hour's wait, I was surprised to see a female doctor (who so happens to be Mike's family doctor) come through the door of the examination room. Because I had seen Dr. MacCormick that same day buzzing around the cancer unit, I am assuming he was too busy to see me himself this time. The doctor went through her list of side-effects, asking what things I found troublesome. I told her about the "spell" I had experienced and explained to her that the ER doctor thought I was extremely dehydrated. She expressed her concerned about dehydration and said that the only way to really control it was to stop me from vomitting. Off she went to speak with Dr. MacCormick.

A few minutes later the 'fill-in' doctor returned with a prescription for Dexamethasone (aka Decadron) for me. This was the same steroid I was given through IV at the hospital a couple weeks earlier that helped me to feel better after I had been vomitting all weekend. I was a little concerned, however, because Dr. MacCormick had previously mentioned that he wasn't particularly fond of prescribing steroids for nausea, due to their negative side-effects (like weight-gain, fluid retention, insomnia, and, in the longer-term, osteoperosis). I told her I was skeptical about using steroids, but she reassured me that there would be few side-effects (especially longer-term ones) because they would only be prescribing the drug in a small dose and for the four days when I am the sickest. She told me that this was the last resort. Because of my pharmacological sensitivity to Stemetil and its large family of anti-nauseants, a whole list of other options became completely unavailable to me.

If Decadron did not work, the only other option for me would be Marijuana. A couple of weeks previous I had another discussion with Dr. MacCormick about using marijuana for nausea. This was, again, after I had been sick all weekend and he got a nurse to give me Decadron through IV. He said, "There is really not many more options for you. I could prescribe Marinol (marijuana in pill form), but it is known for its lack of effectiveness. Cannabis is really most effective when it is smoked and, unfortunately, I can't prescribe it in that form." He then went on to say that he would recommend smoking it if worse comes to worse and if I were to get caught with it, he could write me a note saying he recommended it for medical purposes.

Even though I was basically given a "get out of jail free card" for smoking marijuana, something in me suddenly told me that I shouldn't go this route. Too many pharmacological reactions seemed to be happening with me--all which seemed to stem from changing neurotransmitter levels in my body, which is what marijuana does to get people high. I didn't think it would be smart of me to mess around with my nervous system any further, even though my oncologist was more or less recommending it.

So, off I went with my usual prescription for Ondansetron and a new presecription for Decadron. I hoped that the Decadron would give me some relief from the torture I had experienced in the first 4 or 5 days of the previous 2 treatments. The nurses seemed to think that it was effective and that it would give me an added boost of energy and a stimulated appetite in addition to preventing vomiting.

Friday, January 5th appeared in what seemed to be the blink of an eye, and I found myself getting "cozy" in the chemo room once again. The same routine came and went. I stuck my hand in a bucket of hot water so that the veins would become more visible. The nurse poked around until she found a good vein with good blood return. I was then pumped with Benadryl, Dexamethasone (aka Decadron), Ondansetron (aka Zofran), Doxorubicin (aka Adriamycin or "The Red Devil"), and Cyclophsphamide (aka Cytoxin). About two hours later I was sent home feeling sleepy from the Benadryl, wanting to rest, and crossing my fingers in hopes that I could handle this treatment, both physically and mentally.