And So It Begins

My Testicular Cancer Treatment is BEP Chemo, and Today is My First Day

One month and eighteen days since this journey had begun, the first day of BEP chemotherapy finally arrived. I was oddly excited. This was partially because it meant that an end was in sight and also because I get weirdly fascinated with new experiences.

My appointment was supposed to start at 9 AM. The first thing I had to do was to numb my port with a cream the oncologist gave me. A port is a medical device that was implanted in my chest about a week and a half ago. A thin membrane on the opening allows them to administer the chemo drugs or draw blood. (Think of a sport water bottle that doesn’t have a lid and you need to squeeze it to get the water.) A catheter runs from the opening of the port and into a vein.

The whole purpose of having it is so I don’t have to get stuck with a needle all 21 times I receive chemo. The port is on my upper right side of my chest and feels like a little bump. It’s not so much painful as it is just bothersome. Essentially, it is something that was surgically implanted and connected to my heart to help keep me alive.

That’s right – I am Iron Man.

I had to apply the cream an hour ahead of time so it would numb the skin before I arrived. Once I was all done with that, I had to cover it with plastic wrap to keep the area clear. I wore a polo and a zip up hoodie so the nurse who would be administering my treatment could get to the port easily. No Magic Mike show for the other patients, unfortunately.

Mallory and I arrived (Mom would take me tomorrow) to the office and were directed to my own personal pod with the world’s most comfortable chair. One of the nurses came by and removed the plastic wrap. She also drew blood to run labs by accessing my port (and apparently the numbing cream worked, as I felt nothing when she stabbed me). She also took my vitals, which was a pretty customary practice for me by this point.

The labs came back, and they were clear.

It was time to hook me up to begin my BEP chemotherapy.

First, Nurse Jen (who would be my primary chemo nurse for all 21 treatments) administered Dexamethasone. “Dex” is a steroid that helps reduce the risk of reaction, increase the effectiveness of anti nausea medications, and increase appetite. It also would increase my glucose levels and possibly cause slight insomnia, in which case they could prescribe sleeping medicines.

Next up was Aloxi, which was an anti-nausea drug that would last for 48 hours. We also briefly reviewed which medicines I should be taking at home. She stressed the importance of keeping up with nausea meds because if I started vomiting, oral medicines wouldn’t help. After that was complete, I was given Emend, which was an anti-nausea medicine that would last for 72 hours.

At one point during the morning, I went to use the restroom. This meant I had to bring my “medical tree” with me. The “tree” is where my drugs hang and pump into a machine. The machine pushes them through the lines and into my port. I made friends along the way to the restroom because I am determined to raise the level of holiday cheer while I’m here.

After the anti-nausea meds and steroids were complete, the BEP chemotherapy drugs were slowly started. My treatment started with the Bleomycin, which would only take about ten minutes. This was followed by clearing my lines, and then an hour long dose of Etoposide. After that was finished, a nurse cleared my lines yet again.

Chemo tree

Throughout all of this, we chatted with Nurse Jen and some of the other nurses.

Somehow, the concept of “making yourself throw up before your body chose to” was brought up, which led to us sharing college stories. What a great way to make a first impression.

The final chemo med, Cisplatin, would really drain my body of electrolytes so they had to prep me with a whole liter of Magnesium. (For those of you unfamiliar with the metric system, go buy a two-liter of Pepsi. Drink half of it in an hour. That’s how much liquid ran through my veins. Now buy another two-liter and drink the whole thing within four hours. That’s how much liquid was in me total.)

Throughout the day-long BEP chemotherapy infusion, I entertained myself in a number of ways.

In addition to reminiscing with the nurses about college, I read How Google Works, ate granola bars, wrote to my students on Google Classroom, and annoyed Mallory. Overall, the atmosphere of the chemo area was calm, with lots of beeping from the machines, gentle pop rock playing from the radio, and conversation between patients and families. My pod was a little more isolated than some of the other ones, so I didn’t have other patients to talk with during my treatment. Tomorrow, I would choose a different seat. I’d be spending 21 days receiving chemo; I wanted to make friends (and also spread holiday cheer!).

I did get a chance to talk to one older man as he passed by me with his “tree.”

He asked how many treatments I had and shared that he was on his second to last. He recommended taking some anti-nausea meds as soon as I got home because “that’s always worked for me.” A few moments later, a bell rang out. This signified an elderly woman had completed all of her treatments. Talk about duality – a young man begins his treatments as an older lady finishes hers.

Finally, they administered the Cisplatin, which took about an hour. Dr. Maurer stopped by during this time to just check in, review side effects (fatigue and nausea by the end of the week; hair loss by end of next week), and chat about my baseline tests (which all looked good). He reiterated to Mallory that cheesy Hallmark and Lifetime holiday movies would be just about the worst thing for my recovery. I added that I heard Christmas movies made prior to 1960 were bad too, and he did remember new research supporting this. When everything was all said and done, I had received 5 hours and 46 minutes of BEP chemotherapy today.

As I left the oncology office, I began feeling three separate but distinct side effects from the chemotherapy. 

Day 1 down… 20 to go

I felt very sluggish in my legs yet jittery in my upper body. All of this was underscored by a little bit of queasiness. As I arrived home, I took a round of Prochlorperazine to help quell the nausea. I then laid in bed for a while to try to regain some sense of normalcy. If this was just the beginning of nausea and fatigue, I couldn’t imagine what I would feel like at the end of the week, which was when Dr. Maurer had projected that those symptoms would be at their worst. As I recovered, I couldn’t help but drawing parallels between my situation and that of Cameron’s from Ferris Bueller’s Day Off.

I had skipped school and was now lying catatonic in bed.

Two hours after stopping chemo, my nausea had subsided, but it was replaced with a slight headache. My skin was starting to feel dry, so I applied lotion. Another unpleasant side effect that was already showing up. As dinner time approached, I realized that smells were starting to trigger my nausea. A food delivery from one of the kind people who was keeping us fed over the next few months arrived, which included roasted broccoli and cauliflower. Under normal circumstances, I would have enjoyed eating both vegetables, but the smell was overwhelming. Instead of enjoying those along with the baked ziti, I decided to stick with soup and some Gatorade. After eating, I felt marginally better.

As the evening of my first day of BEP chemotherapy drew to a close, I found myself acutely aware of how my body was responding to the treatment. Though the hours spent hooked up and having a myriad of substances pumping through my veins were mostly uneventful (unless you call swapping college drinking stories with your nurses eventful), the evening after (and the subsequent symptoms) was less than thrilling. But underneath all of the discomfort I was feeling was a small sense of triumph: I was one step closer to being cancer-free.

A self exam is how most cases of testicular cancer are detected early. Click the image for video directions or click here for a larger version



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