I thought it would be helpful to give what a day is like at a chemotherapy session; although this applies to Sunnybrook Health Science Centre’s Odette Cancer Centre, I suspect that all centres have similar protocols. This is what took place last Tuesday, April 23rd at my chemo session:
10:05 a.m.: I arrive at the reception desk to check in; the process takes a few minutes.
10:08 a.m: I go to get bloodworks, wait a few minutes and hear my name called.
10:12 a.m. Get my bloodworks done; the nurse removes the usual three vials from my left arm; she is exceptionally adept at it, and I feel very little pain when she inserts the needle. Of course, she does this all day.
10:14 a.m.: I walk across the hall and use another card to check in electronically at a kiosk to let the assessing nurse know that I have completed my bloodworks; it will take an hour for the tests to be ready and sent electronically to the nurse.
11:22 a.m: My number is called, and I see the nurse; she asks me the routine questions on how I am generally feeling, if I have lost weight; if I have an appetite; what my side effects are and whether these are manageable. I receive the go-ahead, and she gives me a pager to let me know when a bed or chair will be available for chemo treatment. The nurse then sends instructions to the on-site pharmacy dedicated to the cancer centre to prepare my chemo drugs. This process typically takes about one hour.
11:23 a.m. I take my anti-nausea medication (Ondansetron, or Zofran®) in preparation for my chemo; I then go downstairs to the cafeteria to get some lunch. I order a delicious and healthy salad, filled with greens, fruit, olives, mushrooms, beets, sunflower seeds and a Asian sesame dressing. I sit down with a book I brought, in this case, Richard Dawkins’ The Selfish Gene, and eat and read.
12:11 p.m.: I finish eating and reading, and go upstairs and go outside yo get a breath of fresh air, I call my wife and briefly speak to her about what is happening.
12:22 p.m.: I return inside in anticipation of being called inside to one of the many chemo-treatment suites. i don't have to wait long; the chemo nurse calls my name 15 minutes later.
12:37 p.m.: I am called inside and am situated on a comfortable chair, where I receive a pillow and a heated blanket. I am then given three steroid pills and a glass of orange juice in preparation of my chemo treatment. There are four of us in all in this treatment suite; this time two men and two women.
12:42 p.m.: The chemo nurse attaches the needle to my port-a-cath, a poke through the skin; the pain is minor.
12:55 p.m. The chemo drugs arrive and she attaches three bags, two if which are the powerful drugs oxaliplatin and fluorouracil, and one a bag of dextrose. The bags are attached to a double-infusion pump set at 158 mL/min, which means that I will be sitting in the chair for approx. two hours-a typical treatment time.
12:55 p.m. to 2: 45 p.m.: I spend the next two hours talking to other patients and reading my book, and writing a few notes for upcoming blog posts.
2:55 p.m: This chemo session is over; the nurse removes the tubes from my port, does a heparin flush and then connects another bottle of chemo drugs ( 230 mL of fluorouracil), that provides a slow infusion over a period of 46 hours. I will have this bottle, the size of a baby bottle, with me for two days, until Thursday. I carry it in my left pants pocket.
3:05 p.m.: I go to the pharmacy to pick up my two take-home medications: 1) 4 pills of Ondansetron, or Zofran®) and 2) 6 pills of Dexamethasone (or Decadron®); I have to take the first for two days, every 12 hours; and he second for three days, also every 12 hours, with meals. I hand over $4; now that my deductible has been reached, Ontario’s Trillium Program pays the rest.
3:15 p.m.: A little more than five hours after arriving at the cancer centre, I step outside through the main doors to the parking lot to retrieve my car. I was feeling good until I stepped outside into the chilled wind (about 4°C). In my short walk to the parking lot, no more than a few hundred metres, my throat constricted and I had trouble breathing. I still have to pay for my parking ($23) at the parking kiosk, which I do.
For what Dr. Chan, my oncologist, had told me this was one of the side effects; cold air is bad for me. I make it to the car, turn on the heat, and within a few minutes I am feeling better, but exhausted. Now I know how asthma patients and others with respiratory diseases feel, gasping for air. It's unpleasing to say the least. I am OK, but tired.
3:45 p.m.: I arrive home, tired and but happy to see my bed to take a nap before supper; I don't yet have much of an appetite, but I eat to ensure my weight doesn’t dip. It is now ranges between 65 kg (143 lbs) and 67 kg (147 lbs); my baseline weight is 71 kg (156 lbs), I sense that I will not recover that lost four to six kilograms until after my chemo sessions are completed.
5:00 p.m.: I decide to wear a scarf when I go outside to cover my neck, along with leather gloves a leather jacket and sunglasses to protect my eyes from the sun, the scarf and gloves a necessity at least until the temperature hits 20°C. I somehow feel like the great late Canadian pianist Glenn Gould, but without the musical talent.