In the spirit of sharing my experiences and educating whoever visits this site, I wanted to describe what a standard day of chemo looks like. Before all this started, I had no idea what the process was to undergo chemotherapy, and had the predisposition that it was just a bunch of sitting and doctors giving you medicine, but now that I've been through it 4 times, I thought I could clarify for others again to educate on this interesting process.
A Standard Chemo Day at Seattle Cancer Care Alliance
Lab Tests: At 7:40am I check in at the first floor lab where they utilize a sterile procedure to access my port by first poking a large gauge needle into my now numb port location, taping it up, then covering it with a see-through bandage. They then flush the port with saline, and draw 3 vials of blood for various blood tests. They then inject Heparin into the port to prevent coagulation as standard procedure.
Physician's Assistant Appointment: At 8:30am I meet with one of the physician's assistants on the 4th floor who takes my weight, blood pressure, heart rate, and performs a basic examination. We then discuss the side effects, and how I've been faring the past two weeks. We also go over the blood test results drawn less than an hour ago to see if any particular areas need attention (white blood count for instance). Based on the blood test results, they recommend various changes ranging from additions of medicine prior to my chemo, after chemo, changes in diet, etc. Usually the CEA number is not available at this time, because it takes longer to process.
Check In for Chemo: By 9:30am I head to the 5th floor to check-in for chemo. They usually give me a restaurant style pager which will let me know when they are ready for me. Once the buzzer goes off, I am given a bracelet and am told which bay I will be in and who my nurse will be. I then head to the bay (see picture below), meet my nurse, who prepares the port line and connects me to the pumps.
Chemo Prep Medicine: At 10am-ish, before the chemo is delivered, there are a number of antimetics and steroids given to me to prepare for the side effects of chemo. This process takes up to 4 hours because many of the drugs require a slower rate to be given to monitor possible reactions. The medications are delivered by a pharmacy assistant who requires me to state my name and date of birth. The medications are then connected to the pump by the nurse and the drip rate is set in mL/hour.
The medications usually administered to prepare me for the chemo include:
Chemotherapy (time for the good stuff): Around 12pm, the pharmacy assistants deliver the chemotherapy in bags with big yellow warning signs on them. At this point, the the nurse then puts on an apron, special gloves, then calls a fellow nurse to check the medication. With both nurses looking at the one medication that is to be administered, I am required to state my name and date of birth. The first nurse then reads off my bracelet my name, DOB, and patient ID number, and the second one repeats it, reading off the doctor's orders. They then perform the same check, reconciling the chemo bag, stating the medication, the mL, and the drip rate. At this point, my primary nurse connects the chemo bag and starts the drip. This continues for 4 hours, as the medicines are not all compatible and can't be administered concurrently. Each medication requires a second nurse to check. The following chemo medications are administered:
- Avastin (not chemo per se, but prevents the cancer from developing new sources of blood)
- Irinotecan (what makes this regime intense)
Pump Connect: My regime also requires a 48 hour drip of another chemo medication called 5-FU, so around 4pm, a third party nursing company called Coram comes to my room to connect me to a mobile pump. They connect me, to the pump which I am to carry for the next two days, then I leave.
Leaving SCCA: Around 4:15pm, I am nauseated, drowsy, shaky, sensitive to light, sensitive to cold, so clearly I am in no state to drive. I usually have Sam pick me up and take me home to start my 96 hour recovery/sleep session (with small breaks for eating).
Pump Disconnect: 48 hours after being connected to the mobile pump, Coram comes to my house to disconnect the pump, and inject the port with Heparin to prevent coagulation.
And that's it! Rinse and repeat 12 times, and I'm done with this regime.