Dear Friends and Family,
With only two more days left in her multiple drug pre-transplant chemotherapy regimen, Nancy is poised to begin a new drug, Cytoxan. Our nurse, Erlene, described Nancy’s final “poison” as she hung the bag. As I listened, I couldn’t help but wonder, “Why would a drug company include ‘toxin’ in a drug’s name even though it ended with an ‘a’ not an ‘i’?”
“Nancy, this medicine will make you pretty nauseated. It’s noxious to the bladder, so we’ll give you lots of fluid to minimize its effects. You will need to get up and go to the bathroom at least every hour. And Cytoxan sometimes burns on its way into your vein. Don’t be afraid to ask for your pain meds. It’s also not uncommon to have jaw pain and flushing and other side effects.”
Nancy’s expression to this warning was stoic and full of resolve. So when Jayna arrived to cover my absence, I left for work at the clinic with somewhat guarded confidence. Unfortunately, I found a much different Nancy when I returned to the hospital in the early evening. She was no longer the sleepy, mildly uncomfortable, slightly nauseated patient I left earlier. Instead, Nancy was tossing and turning in her bed. She struggled to say hello when she finally noticed me. As I looked at her face, I saw dry and peeling lips. Tense muscles furrowed her brow. After the hello and a noble attempt to smile, Nancy vomited.
Cytoxan.
Two doses.
One tomorrow.
I cleaned up the floor next to Nancy’s bed and went to the ice machine in the hall in anticipation of Nancy needing cold fluid. When I returned, I stroked her forehead and massaged her feet. Erlene brought Nancy a parade of drugs for nausea and pain. “Would you like a movie as a distraction?” I asked. Nancy didn’t have the strength to speak, and I could sense that every bone in her body was aching, but she did nod her head. She even attempted to grin as she tried to make me feel better.
Upon finishing Nancy’s foot massage, I heard the repetitive sound of restful breathing. It was followed by what has become one of my favorite sounds, Nancy’s telltale snort. Finally, she was asleep. Dances with Wolves stayed in its package. There would not be any dancing for Nancy on this particular night.
Jayna, who left when I arrived, returned three hours later. She brought hugs, kisses, and her upbeat presence. Erlene came and removed the empty Cytoxan bag. Round one was in the history books.
Jayna’s kiss, placed gently on her mom’s fuzzy head, triggered open eyes, both wide and bright. “I’m cold,” she said, after grabbing Jayna’s hand.
I jumped immediately from my chair, a soft hospital blanket in hand.
“What will I ever do at home?”
“What’s going to happen when I mention something and nobody responds?”
“Do you think I’m spoiled?”
Nancy giggled softly at her discomfort and went on to say, “The hospital stuff isn’t so bad, Jayna.”
“I sleep all day.”
“I wake up and get nausea pills.”
“I eat.”
“I go back to sleep.”
“I even had a funny dream while receiving this latest medicine.”
“What’s its name?”
“Oh, it doesn’t matter . . .”
“What happened in the dream, Mommer?”
“Do you see that giant IV bag?”
“Which one, Mommer?”
“The one that looks like a cow’s udder filled with milk?”
Since Nancy now battles constant nausea and her gastrointestinal lining is irritated as a result of her medicines, her oral intake has dropped to near zero. The “milk” bag she pointed to was actually filled with TPN, an abbreviation for total parenteral nutrition. We have been told Nancy won’t be eating much the next couple weeks, so this liquid food will run day and night. Each bag of TPN was at least five times as big as the four others hanging from Nancy’s IV pole. (Quite comically, it looks like milk going directly into Nancy’s vein instead of being clear like water as in the other IVs.)
“I dreamed I was lying right here in bed, looking up at that ridiculous IV pole. I tried to read the names of the medicines on each of the three IV bags and the two IV bottles hanging from the pole. I asked the male nurse, who looked like Seth Meyers, ‘Why are you giving me milk from a bag that is so much larger than the others?’ But guess what? The reason the nurse looked like Seth Meyers is that I was actually part of a skit for Saturday Night Live. So the Seth Meyer look-alike flipped a switch on the IV pole and the bags and bottles begin to spin like a teacup ride at the circus and then smash, that big one with the white liquid food fell onto my face and smothered me.”
“Pleasant dream, Mom. I like the South Sea Island one better.”
“But Jayna, don’t you realize the dream was good news? It meant I don’t have to receive tomorrow’s dose of that medicine. I remember its name now, too. Cytoxan.”
In actuality, none of the six different IVs hanging from Nancy’s pole fell onto her that night. She endured her last Cytoxan dose, still more than a bit stoic and resolved. She ached and she vomited and she made her hourly trips to the bathroom. And when the drugs were all finished—she went from feeling horrible to “not so bad.” As she began to feel better, her first thought was “Where is the remote for the blinds? I bet it will be a pretty sunset tonight.”
The sunset was certainly beautiful. As the Oquirrh Mountains on the horizon swallowed the bright-yellow orb, we watched red-and-orange cloud wisps fade slowly into gray as the darkness turned the city’s buildings into dark shadows only visible due to the lights in the streets and in the windows of homes far below us.
“Another day comes to an end,” I whispered to Jayna. With Nancy deciding to look outside for the first time of this hospitalization, the day held additional significance.
Nancy startled me when she raised her thumb to the air:
“And another treatment comes to an end.”
“I am done.”
“No more chemotherapy.”
“I get to rest tomorrow.”
“Then my transplant.”
“Come give me a hug.”
“Both of you.”
Summary: A momentous day. Nancy finished her last “poison” medicine today. Chemotherapy will soon be an unpleasant, distant memory. She didn’t experience any horrible, life-threatening side effects, though she did feel terribly sick with nausea and vomiting. After another day’s rest, she will receive her transplant. Finally.
So much love,
Winnie