Diagnoses
I was in a lot of physical pain when I was diagnosed with stage 4 Lymphoma. I was immediately admitted for chemotherapy. I didn't have time to adjust. My treatment plan involved high dose chemotherapy with aggressive treatment schedule. My husband did all the research while I was in the hospital.
Preparation
I had a PICC line inserted into my upper right arm for infusion access. PICC placement is instant and can be done at bedside. There are two types of infusion access, PICC or PORT. I have just described what a PICC and PORT is an access point implanted under your skin. Its usual placement, upper right or left chest area. It requires IR (Internal Radiology) to perform a small procedure to insert the PORT access point, so this requires hospital scheduling.
PORT requires a couple of incisions and it takes roughly 2 weeks for the incisions to heal properly. During those time, it is advised that you keep the area dry but once the incisions are healed, you won't know it is there.
Round 1
My first treatment, I was prescribed with 6 rounds of dose adjusted EPOCH, 5 days at every 21 days. After 1 round of EPOCH, I experienced vomiting and nausea almost all day and everyday. I didn't have any appetite for food and slept most of my days.
I went home with 3 types of nausea medications, medications for bowel movements, medications for pain, medications for sleeping and few tablets of steroid and blood pressure medications. My advise, be sure you have a medicine cabinet with a chart when to take the meds.
Round 2
Before I had my 2nd round, I received an immune booster shot, Neupogen, 10 days after I was released from the hospital. I was told chemo would induce neutropenia and to lower the risk of infection, I was given the booster. I had it scheduled after every round of chemotherapy I received.
Round 2, my hair began to shed at a drastic pace and to avoid leaving my hair everywhere, I had my nurse shaved my head. The side effects of chemo began to compound and I felt more fatigue. My bowel movement was every other day, because of all the medications I had taken. I took nausea medication every 4-6hours and I had little appetite to eat because everything started to taste metallic.
Round 3
At round 3, bed fatigue began to manifest and I felt an imaginary weigh on my chest, legs and arms. I was told the only remedy to bed fatigue was exercise. I had an infusion pump connected to my upper arm so I could only do small walk around the oncology ward. It helped but regardless of bed fatigue, a patient should exercise.
When I was home, I made sure I kept up with my small exercise. I took walks in the yard, did the laundry, washed some dishes. Performed mundane and mindless tasks with naps in between.
Round 4
Round 4, a routine was established. The physical side effects were : vomiting, nausea, lost of appetite (metallic taste), mouth soars and bed fatigue.
The dose adjust EPOCH chemotherapy compounded its toxicity and I had reached neutropenic. One morning I woke up with extreme bed fatigue and my temperature reached 100.4. Like all good patients, I had to be sure, so I took my temperature again in couple hours and resulted the same 100.4. Next step, the ER, I was admitted to ensure my fever was under control and I didn't contracted a viral infection. In one day, my fever subsided and I was released in 2 days time. Infections between treatment rounds could potentially delay the treatment schedule.
My advise to you, stay away from germs and crowds of people. Just think about the life you will have after treatment and don't focus on the 'now'.
Round 5
To combat mouth soar, patients has to be vigilant with rising mouth with salt or baking soda water. I brushed my teeth after every meal and rinse mouth every few hours when I remembered. I was lucky that mouth soars didn't stuck around however the metallic taste was an entirely different matter. It made food disgusting and I was not eating much.
Because I was given steroids, it made me hungry and food was means to an end. It was only when I discovered snacks and small bites helped. Instead of eating full meal, I stocked up my snack cabinet.
Round 6
Final round of EPOCH, I was excited but I knew it was not over yet. I had another treatment scheduled after EPOCH, high dose Methotrexate. 4 rounds of 24hours infusion for 3 days at every 15 days. I did have a break before I started with high dose Methotrexate.
Although I felt good after my last round of EPOCH but I knew my body took a big hit. I felt fatigue for a long time until I began to feel more like myself. My remedy to my fatigue was to build up my physical strength. I woke up early each day scheduled tasks for myself to complete and made each day a progress.