The surgery is done. The recovery begins…. Not quite. Let’s discuss post-surgery chemotherapy.
Part of my treatment includes more chemotherapy after surgery. Just as I had two months of chemotherapy prior to surgery, I also require another two months of chemotherapy after surgery to complete my treatment. The challenge with chemotherapy after surgery is that all of the side-effects of nausea, diarrhea and fatigue are amplified. Only 60% of patients are able to start chemotherapy after having their stomach removed, and 46% are able to complete it. Part of the challenge is not being able to eat enough to stay hydrated and to have enough calories ingested in a day. Many have asked me, “What does it feel like going through chemotherapy?” I will attempt to recreate what I went through during my recently completed cycle of chemotherapy (1 out of 4 cycles completed).
Chemotherapy – Play by Play
Day 1: This is the first day of chemotherapy. Five hours spent at Princess Margaret Hospital receiving 2 chemotherapy agents by IV. I then go home connected to a portable IV pump to receive my 3rd chemotherapy agent. At 9 PM, the nausea kicks in. I pop an olanzapine, which is an anti-psychotic drug with strong anti-nausea properties, commonly used during chemo.
Day 2: I wake up nauseated, with a very sensitive gag reflex. Everything makes me gag. Watching tv, moving around and talking too much makes me gag. I start a diet of ginger ale and crackers. Attempts to eat chicken makes me retch. Plain water makes me retch. The nice thing about not having a stomach is that I can’t physically vomit anything, which means my food stays down. I play with a combination of Maxeran, olanzapine, and ondansetron, but nothing seems to do the trick.
Day 3: More nausea and retching. I find out that potatoes don’t make me gag and add it to my list of foods to eat when having nausea (list includes ginger ale and crackers). I had a restless night. A lot of retching through the night. I try sucking on pieces of mint, with mixed results.
Day 4: Woke up retching. New symptom: watery diarrhea. Imodium to the rescue.
Day 5: Still nauseated. Sleeping 14 hours a day by now and still feeling lethargic. There doesn’t seem to be an end in sight, and my mood is way down.
Day 6: Starting to feel less nauseated, and more energetic. My mood is improving. Still having diarrhea. I’m becoming mildly dehydrated. Canned soup and diluted ginger ale seem to help (undiluted ginger ale contains too much sugar, which causes Dumping syndrome, which causes more diarrhea).
Day 7: More diarrhea. Nausea going away.
Day 8: More diarrhea. Starting to resume a “regular” diet (that involves more than crackers and potatoes). Eating 75% of the amount I used to eat before starting chemo.
Day 9: No diarrhea! I feel adventurous and try to add fatty foods in my diet to increase my calories (e.g. mac and cheese, avocado and sausage).
Day 10: More diarrhea. Back to a plain diet. Eating 90% of regular amount.
Day 11: No diarrhea, no nausea, and feeling quite energetic. Eating the full pre-chemo amount of food.
Day 12: Feeling like my normal self again.
Day 13: Still feeling good.
Day 14: Feeling as good as ever. I begin to write this blog.
Day 15/ Day 1: Restarting chemotherapy (and the cycle repeats).
My overall thoughts…. (tl;dr)
To summarize, each 14 day cycle includes: 5 days of really bad nausea, 1 week of diarrhea and lethargy, and 4 days of real recovery. I am starting my second cycle of chemotherapy. Having a detailed account of my side-effect profile helps me anticipate (and hopefully prevent) uncomfortable symptoms. While one can never truly prepare for chemotherapy, I hope that I can at least recalibrate my expectations in order to have a better experience this time around.