Two weeks into my treatment schedule and it’s time for another chemotherapy session. Chemo session two, however, didn’t exactly go as expected.

My husband and I know the routine from our first session: check in with reception, swipe my hospital card at the kiosk in the chemo reception area, then head to the lab for blood work to make sure I’m well enough to withstand another chemical bombardment. We then take a seat, watch the chemo patient status board, and wait for them to call my hospital ID number.

Just like the first time, the nurse eventually calls my number and we proceed to her little triage office. She weighs me, takes my blood pressure, asks some health related questions, and aside from some minor side effects and fatigue, I feel OK.

She then reviews the blood work results. It’s not good:

• magnesium is too low. Mine was 0.58 but it should be  0.70 to 1.05
• hemoglobin is too low. Mine was 98 but it should be 115 to 165
• white blood count is too low. Mine was 2.0 but it should be 4 to 11
• red blood count is too low. Mine was 2.76 but it should be 3.50 to 5.50

I had not recovered sufficiently from the first chemo session and was not strong enough to withstand a second dose as scheduled.

The kicker is that if I didn’t get my second chemotherapy soon, they would not be able to do the third chemo session: there wouldn’t be enough time to administer this one and the third chemo within the remaining treatment schedule. They had to allow enough time to recover between sessions, and yet the chemo must still be administered while I was still receiving radiation. My chemo affected the cells that were made more active by radiation. No radiation, then no active cells for the chemo to target.

The possibility of not receiving my third treatment caused me a lot of angst. I was afraid that if I didn’t get the third chemotherapy treatment, then my cancer would not be properly treated.

The chemo session was rescheduled for a few days later with the hope that I would recover sufficiently by then. In the mean time though, they had to address the more urgent blood work issues.

For starters, my magnesium levels needed to be increased quickly. Low magnesium levels can cause problems with the heart and muscles, among other things. Supplements weren’t going to do the trick, so a magnesium infusion was ordered. Luckily we were already booked in for chemo so finding a bed or recliner chair where I could be hooked up to an IV wasn’t going to be an issue. It takes about four hours, start to finish, to get the infusion done, including a hydration through IV as well.

The low white blood count was also a concern, and there wasn’t anything that they could do for it. Even if there a food that would boost it I wouldn’t be able to eat it — I was fully reliant on my feeding tube by now and couldn’t put anything other than the prescribed feeding supplement thought it. This meant that I was much more susceptible to infection and therefore had to avoid being around anyone who might have been exposed to a sick person. Some family members just couldn’t visit because of their proximity to contagious people as a part of their jobs. It also meant that I had to be diligent about taking my temperature every day at least once and to proceed to the hospital if it gets to 101°F, and to advise them that I am a chemo patient.

So now the day of the rescheduled chemo appointment arrives, and off we go to the hospital again. We check in, followed by another round of blood tests. The magnesium levels and white blood cell counts have improved but they’re still just outside of the normal range. The nurse calls the Chemo Oncologist to confer with him, and he gives the OK to proceed anyways.

The second time around, I’m a lot more nauseous after the treatment but it’s made more bearable by the anti-emetics (anti-nauseants). How wonderful it is to be nauseous, and then have to endure the radiation treatment after the chemo treatment hoping that you’re not going to be sick while strapped down,  followed by a one-and-a-half hour long car ride home. Yup, just grand.

I was relieved that I’ve managed to get my second chemo session, and I hoped that I would be strong enough to get the third. Apparently not everyone is.

—Sandi

Next time: more side effects are popping up

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