Days 1-4 after chemo

The first few days after chemo where always going to be scary for me. I was no longer in control of my body. I had no idea how I would react to the chemotherapy. Would I get some or all of the side effects? How bad would they be? When would they kick in? How long would they last? Being out of control is something I do NOT enjoy!

I had done a bit of reading, and had somehow got it in to my head that most people had a bad week, and then a really bad week, and then a week to recover. Could I cope with that? Was I right in what I had read? Why didn’t I just ask the oncologist and the oncology specialist nurse how long I would feel unwell for?

All these questions that never entered my head at the time of the outpatient appointment – things were happening so quickly, and I hadn’t had time to make a list. In hindsight, it is always more accurate to find out from someone who has actually been through the treatment, or a doctor / nurse who prescribes the treatment and sees people of through it on a regular basis.

Despite spending my life telling patients not to google randomly, because they’ll find things that might scare them, or that aren’t true, or they don’t need to know, here was I doing the same. I didn’t want to bother anyone. I’m a doctor, a breast surgeon, I should know this stuff, shouldn’t I…?

This breastcancercare.org.uk site was the most useful to both of us for general information about the side effects of chemotherapy

Day 1 (Friday) – day of Docetaxel infusion
Macmillan – Docetaxel side effects
BreastCancerCare – Docetaxel side effects
CancerResearch – Docetaxel side effects

The only change I noticed that night was a metallic taste in my mouth, and food tasted different. A cup of tea was now revolting, and I had no idea what I wanted to eat. It was quite daunting opening up the chemo bag with the masses of tablets and injections to take over the next couple of weeks.

I had steroids and anti-sickness tablets to take that night, and went to bed very early, only to be awake from 1-4am.

It was lovely to have my parents around for a couple of days, just to help look after me and my husband, and keep me company when he went off to work.

Day 2 (Saturday)
I still hadn’t had much sleep (thank you steroids), and that metallic taste in my mouth was here to stay. My mouth felt a bit sore, and I didn’t really have much of an appetite, as well as feeling a little bit sick. Salty crackers tasted like cardboard, and tangy fruit (strawberries etc) was very painful on my taste buds. It was a case of trial and error (mostly error) to work out what I wanted to eat. I knew I had to eat breakfast before taking the steroids. I settled on Weetabix left to go soggy in milk, so it would be soft to eat. And used maple syrup instead of sugar, as the sugar crystals were painful to eat.

I managed to get out of the house to walk the dogs, and had promised myself that I would get out and walk every day – just for a bit of fresh air and to feel more human again. Several people I knew who had been through chemo said this was really important to them, and trying to stay fit and active might reduce the side effects of the chemo.

During the rest of the day, I felt flu-like – shivery, with aching arms and legs – a bit like I’d just cycled 100 miles. I knew I had to take my temperature every day, but had no idea how often (another thing I should have checked, or been told, in the oncology appointment), but was doing it before I swallowed down paracetamol (taken to try and ease the aches and pains), as paracetamol can mask a high temp.

We went with my parents to visit our best man and his wife, and it was a lovely evening, with a little bit of normality away from the strange cancer world I was now living in. They cooked a fab roast chicken for us all, and we could all just relax and let off some steam. I was tired at the end of it, but so glad that we had gone.

That evening I had to give myself an injection, which was very, very odd. I was given 6 daily injections of G-CSF to boost my blood count. All I knew was I had to take it out the fridge for 30 mins, and inject it into a padded bit of me, under the skin. I opted for my thigh, and although it didn’t hurt, I didn’t like doing it. The syringes were spring-loaded so the needle withdrew after use, and I couldn’t stab myself with it.

I had no idea what the side effects of these injections were. I presumed they must be good for me, and didn’t bother to read the leaflet in the box. I had no choice in taking them, anyway.

One hour later I felt shivery and cold again, with an awful headache, and just a little bit of heartburn, with another steroid-induced sleepless night ahead of me.

CancerResearch – G-CSF side effects
Macmillan – G-CSF side effects
Drugs.com – G-CSF side effects

Day 3 (Sunday)
More steroids for breakfast, and the fatigue was starting to kick in. I just felt exhausted with no energy to do anything. The day was spent dozing on the sofa. The pain in my leg muscles was getting worse (a bit like being hit with a hammer) and I was getting a deep bone pain in my hips. My gums, jaw and ears were starting to ache, and I was guzzling Paracetamol like there was no tomorrow

I still managed to get out for a walk, but was stopping to rest every 5-10 minutes – I wasn’t used to having no energy. I managed to crack lunch options – with soup – nice and sloppy, nothing to chew. I could tolerate bread, but no crusts, and definitely no salt in the butter.

More steroids and another injection at night, and an hour later I felt shivery, and flu-like with an awful headache. I was starting to get suspicious about those injections…

Eating at night was hard. I had no appetite (where were the supposed steroid munchies that everyone complains about…? Mind you, my natural response to stress is to stop eating, not to stuff my face, so I’m not surprised by this). I was just picking at whatever my parents and Dermot were eating, but it was hard for us all working out what to feed me.

Day 4 (Monday)
Another relatively sleepless night for me. But today I felt like I’d been hit with a chemical sledgehammer – just completely exhausted. A wonderful neighbour, Alex, had asked if I wanted to walk with her every morning at 6.30, and I’d agreed, although it was one hell of a struggle to get out of bed. But I did it, and was really glad of the fresh air and the company. Dermot walked the dogs separately as I didn’t think I’d have the strength to hold our labrador and spaniel.

The rest of the day was spent lying on the sofa, and everything ached – my scalp was sore and tingly (did this mean my hair was getting to ready to fall out?). The severe headache was back, together with the usual gum, jaw, ear and hip ache.

Water now tasted disgusting, but Robinson’s Barley water made it tolerable. I had a lot of lemon and ginger teabags but the hot drinks were painful. My tongue had a lovely white coating and everything was a bit slimy (lovely, isn’t it!). It felt like a chemo fog had descended on my brain, and I couldn’t concentrate on anything – not even trashy TV. I just stared into space or dozed. Rich Tea biscuits became a salvation (recommended by the wonderful ‘J’, or Julie to her friends), but I did miss enjoying a cup or tea to dunk them in. Dermot did suggest I make the cup to tea to dunk them in, but don’t drink it. He’s so sensible!

Another injection at night, followed by the usual shivery flu-like feelings, and the continual headache that wouldn’t shift.

Four days done – how bad could / would it get? How long would it last for? Could I cope? My parents were going back to Scotland, and it would just be me and Dermot. How would it be for him, having to leave me looking and feeling like crap on the sofa, whilst he goes to work? Could I be trusted to look after myself (i.e eat and drink during the day) if he wasn’t there to remind me? Only time would tell.