Chemotherapy 101 Part II: Managing Through Treatment

Patient Expert

In Part II, Jacki Donaldson guides you through the process of undergoing chemotherapy, describes typical side effects and offers tips for finding support.

Part II: Managing Through Treatment

Ready, Set, Go

Before each chemo session, a nurse will draw blood to check your blood counts. If they are not in a safe range, treatment may be delayed. A nurse will weigh you (drugs are mixed according to body weight), take your temperature (treatment may be delayed if it's high), and take your blood pressure (make sure to use the arm on the unaffected side of your body).

Once you're ready, the port is accessed or an IV is placed and pre-meds begin. These drugs combat side effects of chemo drugs. I received anti-nausea medication (Zofran) and a steroid (Decadron) for both nausea and allergic reaction. You'll also receive fluids.

Then the chemo drugs begin their journey through the body. This part was always painless for me and I tried to enjoy the few hours of peace and quiet while my husband entertained my busy little boys at home. At the end of treatment, a small bag of fluid is given to push the remaining drops of medication through the line.

Side Effects of Chemo

Standard side effects of chemotherapy can include hair loss, nausea, dips in blood counts, fatigue, and loss of appetite. Hair loss typically occurs about two weeks after the first dose of chemotherapy and begins with the thinning of hair. My hair started falling out slowly, small handfuls at a time. Within days, I could gather fistfuls of hair and lost clumps in the shower each day. I shaved my head to minimize the trauma of my inevitable hair loss, and promptly covered my head with wigs and hats - I never found the courage to flaunt my baldness. My wigs, made of human hair and matched exactly to my hair color, length, and style, came from

Each chemo patient is armed with a stock of medication for nausea and while my own stomach felt a bit "off" for two days after each treatment, I never did vomit and was never bedridden with sickness. One sister survivor told me to drink a gallon of water the day before chemo, the day of chemo, and the day after chemo to help flush the drugs through my body. A gallon is a lot of water - but I did it. I had nothing to lose and everything to gain. Perhaps this is what prevented me from becoming terribly nauseated from chemo. Ask your doctor if you should do the same.

Chemo affects blood counts and patients may receive shots of either Neulasta or Neupogen to keep counts at a normal level. When blood counts decrease, the body's immune system suffers and infection is likely. I was hospitalized twice because of low blood counts. White blood counts should fall between 4,000 and 10,000. Mine were 700 and 1,200 on my admission dates. It took IV antibiotics to prevent infection and a blood transfusion during my first stay for my anemia to recover.

Fatigue and loss of appetite are common, and it is critical that you let your loved ones help you. Allow friends to deliver meals, baby-sit, and stop for groceries. Give yourself time to rest - this is the perfect time to justify daily naps. Be sure to eat -- it's necessary so the body can remain strong during this debilitating treatment. Try small amounts of food several times per day.

Most important, call your doctor with any symptoms that signal a problem, such as fever. One night I was awakened with a sore throat, headache, fever, and sore gums. My body was suffering. I was admitted to the hospital that same night. Had I stayed home, the result could have been tragic. If a hospital getaway is necessary, take advantage of the down time and allow yourself to heal and recover. The hospital is the best place to be if the body is not responding well to treatment.

Finding Support

I have never attended a support group but I do attend counseling. I started with a weekly appointment, and I now go once per month. It helps me to talk to someone who knows me only because of my cancer. My counselor is objective and compassionate and I walk away from her each time feeling inspired. My spirits were also lifted during chemo by a program called Chemo Angels ( Two of their volunteers wrote to me each week. Their letters distracted and motivated me. Any chemo patient can sign up for an angel and volunteers are always needed.