What get­ting chemothera­py is re­ally like

The Jerusalem Post - The Jerusalem Post Magazine - - OBSERVATIO­NS - BRIAN BLUM The writer’s book,

It was the hic­cups that scared me the most. When my fa­ther was go­ing through chemothera­py for lym­phoma nine years ago, he de­vel­oped a ter­ri­ble case of vi­o­lent, vir­u­lent hic­cups that per­sisted for days. In the story I told my­self, it was the hic­cups that ul­ti­mately killed him, mak­ing him too weak to bat­tle both the can­cer and the chemo.

So when I came home af­ter my first chemothera­py treat­ment and started to hic­cup, I im­me­di­ately pan­icked. It wasn’t that I was afraid I would die – my lym­phoma is a dif­fer­ent, less ag­gres­sive kind. But would I hic­cup for days, too? Would I bust or bruise my di­aphragm through the re­lent­less as­sault?

I called my doc­tor. She knew what the prob­lem was im­me­di­ately and pre­scribed a pill that paused the spasms and put my mind at ease. But it was the first sign that my treat­ment would be filled with sur­prises – not un­like my di­ag­no­sis just six weeks ear­lier for the can­cer it­self.

I’ve long har­bored a grim cu­rios­ity about chemothera­py. While I hoped I’d never have to find out per­son­ally, I won­dered: what’s it like to sit in an on­col­ogy or hema­tol­ogy day­care room with an IV in the arm? Does it hurt? Do you feel like vom­it­ing the whole time? What hap­pens when you get home?

I can’t speak for ev­ery pa­tient’s chemo ex­pe­ri­ence – there are so many dif­fer­ent types of can­cers and treat­ments and every­one re­sponds dif­fer­ently – but I can tell you about mine.

Let’s start with the hos­pi­tal. It’s ac­tu­ally kind of bor­ing.

Af­ter nee­dle finds vein, you pretty much sit around and wait while many milliliter­s of flu­ids in a pro­ces­sion of plas­tic bags hooked on a tall metal pole slowly make their way into your blood. There’s no feel­ing of pres­sure – the meds aren’t be­ing pro­pelled into your body by a pump. In­deed, the only time I re­ally knew any­thing was hap­pen­ing was the shiver of cold that would hit me when­ever the nurse changed the bag to blend up the per­fect cock­tail of cure.

Of course, it all starts with that prick. To para­phrase Har­ri­son Ford as In­di­ana Jones, “Nee­dles, why did it have to be nee­dles!”

Even in nor­mal cir­cum­stances, I’ve al­ways hated get­ting my blood taken. While get­ting an IV in­serted is not sub­stan­tially dif­fer­ent (it just stays in longer than for a blood test), I cal­cu­lated I will need a whop­ping 21 IVs be­fore my treat­ment is over.

Be­fore you even get started, the nurse takes some blood. If your count is off, then it’s no soup for you to­day.

My par­tic­u­lar treat­ment is nick­named G-CVP. Each “let­ter” gets its own bag, plus there are a va­ri­ety of “pre-meds” ad­min­is­tered be­fore the main course, mostly to pre­vent al­ler­gic re­ac­tions. Some of them make me drowsy. But I wake up when na­ture calls.

And it does – plenty dur­ing my usual six-to-eight-hour stay.

With all those flu­ids flow­ing into my arm, I need to pee a lot. No prob­lem: there’s a bath­room nearby. But for my par­tic­u­lar treat­ment, I also have an elec­tric-pow­ered box that reg­u­lates how fast the im­munother­apy meds can drip.

The prob­lem is, to walk to the toi­let with my IV pole in tow, I need to dis­con­nect the box from the power. But the elec­tric­ity strip is lo­cated high above the bed. I can’t reach it com­fort­ably with my IV arm.

One rule I learned quickly about get­ting chemo is: never come to the hos­pi­tal alone. The ac­com­pa­ny­ing per­son can quickly grab a doc­tor or nurse if there’s an is­sue or – most im­por­tant – un­plug you so you can go to the loo. If I had to wait for the nurse to dis­con­nect me each time, I’d burst.

Other times, you need help ma­neu­ver­ing around all the ac­tiv­ity go­ing on in the room. One thing’s for sure: get­ting chemo in an Is­raeli hos­pi­tal is rarely a soli­tary ac­tiv­ity.

There’s the morn­ing snack cart vol­un­teer who brings the sand­wich rolls with the su­per-sweet straw­berry jam, the choco­late Carlo pud­dings and a va­ri­ety of drinks (“I’ve got tea and Pepsi. Who wants?”); the af­ter­noon lunch lady with the end­less sup­ply of potato chips and rub­bery chicken schnitzel that makes a serv­ing in El Al coach seem like a Miche­lin-starred meal; the Aldo gourmet ice-cream truck (“I’ll take pis­ta­chio, please”); and the med­i­cal mu­si­cian from the Haverut or­ga­ni­za­tion who is happy to strum a sooth­ing song straight out of Psalms.

Jody and I have de­vel­oped a novel way of pass­ing the time sep­a­rately yet to­gether. We call it our “in-flight movie trick.” When we fly on an air­craft with in­di­vid­ual en­ter­tain­ment screens, we’ll pick out a movie we both want to watch, then press play at the same time.

We have two iPads at home, so for the hos­pi­tal, I cue up the same TV shows. We tap play and go – no need to crane our necks to­wards a sin­gle shared screen.

When the last bag has drained, the nurse re­moves the IV with a gen­tle tug and we’re free to go. There’s no for­mal dis­charge, no wait­ing for pa­pers to be signed – we all know the process will sim­ply start over again soon.

As “un­event­ful” as the ac­tual day­care ex­pe­ri­ence has been for me, all those chem­i­cals still wipe me out. Nor is that the end of the story. Once I get home, there will be a va­ri­ety of side ef­fects, both phys­i­cal and emo­tional.

But I’ll have to save that for an­other col­umn.

There’s no for­mal dis­charge, no wait­ing for pa­pers to be signed – we all know the process will sim­ply start over again soon

To­taled: The Bil­lion-Dol­lar Crash of the Startup that Took on Big Auto, Big Oil and the World, is avail­able on Ama­zon and other on­line book­sell­ers. bri­an­blum.com

(Olivier As­selin/Reuters)

CAN­CER PA­TIENTS sit in a chemothera­py ward while re­ceiv­ing treat­ment at the Korle Bu Teach­ing Hos­pi­tal in Ac­cra, Ghana, in 2012.

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