Two years ago, I met John (pseudonym), a colorectal cancer survivor. He told me: “Dr. Lee, everyone thinks having cancer is the worst part of it all but let me assure you, undergoing chemotherapy is much much worse.” I had the unfortunate opportunity to experience what John had experienced.
My treatment plan consisted of chemotherapy given to me through the veins at the Princess Margaret Hospital Chemotherapy Day Centre, over 5 hours. If the side-effects were reasonably-tolerated, chemotherapy would be repeated 3 more times, spaced 2 weeks apart.
Prior to receiving chemotherapy, I received no shortage of warnings of the side-effects I was about to feel. Some side-effects were expected to occur within hours, others were expected after days, weeks, months and even years later. I was told that I should expect nausea, vomiting, constipation, diarrhea and fatigue, and was given a possible timeline for these symptoms. I remember being told that it is impossible to predict when and how the symptoms were going to hit me, but that we have medication for them. I was prescribed enough medication to counteract the side-effects, and was provided with emergency phone numbers to call should unexpected symptoms occur. Yet, despite my healthcare team’s best efforts at preparation, and despite my own insistence that I was ready, I still felt unprepared walking into battle.
In the first 2 days after chemotherapy, I was pleasantly surprised with the absence of nausea. The medication was doing the trick.
On day 3, I was unprepared for the sudden appearance of nausea. In fact, the nausea was so strong that it would stop me from swallowing my own saliva. I later learned that I was part of a minority of patients whose nausea joins the party late and lingers around longer.
On day 4, I was unprepared for the fact that making, answering, and returning calls to my healthcare team for updates is challenging when you’re too nauseated to talk.
On day 5, I was unprepared for the wave of sleepiness that came after I aggressively increased my anti-nausea medication. While the nausea was kept at bay, I was too sleepy to eat, and my malnutrition persisted. As my circadian rhythm no longer knew the difference between day and night, I set timers to wake up every few hours to drink and eat.
On day 6, I was unprepared for the fact that I had transitioned from a social, talkative individual, to a shell of my former self, desiring nothing more than to be left alone. The more I closed myself off, the more sour my thoughts turned, and the more likely I was to entertain the idea that chemotherapy was not worth the trouble.
On day 7, I was unprepared for the sudden departure of my nausea and fatigue. It was a welcomed surprise.
Nothing had prepared me for the nausea fog that was clouding all hope and determination. While my struggle was real, it was short-lived. Family and friends came to my rescue and helped keep my energy up with meal-deliveries, soda and crackers, and positive encouragement. It would have been much harder if I had to worry about meal preparation, doing the dishes, cleaning the house, filling prescriptions and answering phone calls.
With respect to chemotherapy side-effects, there is no better teacher than experience. I already feel better prepared for my next session. Stay tuned for more!