Delay Day

A few days after chemo last week I was overcome by a series of extreme yawns that forced me to expand my lungs as far as possible and then exhale everything through my mouth, as you do after a yawn. This happened five or six times in a row, kind of like when you walk out into bright sunlight and suddenly have to sneeze.

It made me think that perhaps my body was using my breath to get rid of some cisplatin. We get rid of a surprising amount of toxins via the lungs and breath, so it’s not unreasonable to assume I was doing just that. 

Today is chemo day two. The picc line is proving it’s worth, as I’ve not been needled this week at all. Plus I’m getting used to it and much less worried about it, and I’ve been reminded by a nurse-who-should-know that it’s better to endure this now than to add thrombosed veins to my list of problems. 

The chemo was given after a bag of water spiked with pain meds, then an immediate dose of radiation at 1pm. Then the second bag of water. This was supposed to happen yesterday, but everyone screwed up. 

We arrived at 10am yesterday, as instructed. Well it might have been a bit later, but it’s hard to feel bad about a few minutes when we ended up waiting in the waiting area for about 2 hours after checking in. My appointment for radiation was at 1pm, and at around 12:30 they brought us to my new room. I prepared for radiation and went, assuming we’d be doing the cisplatin afterwards.

This is why you tell a patient like me the reasons for things. A doctor came in a little after 2pm and said, ‘So Mrs. Marks, when is your radiation appointment today?’ This is something the nurse had already learned from me when I checked in on the floor, but I said I had just completed it, proud of myself for being on time and ready for him. But his response was, ‘Oooh, that suc- is not good. Not good at all.’ 

Nobody told us that having radiation immediately after the cisplatin was important. I’m only getting it once a week, after all, and radiation happens each week day. However, because I had the radiation yesterday before chemo, they delayed chemo until the next day so I would have it immediately before my radiation treatment. Joshua and I would love to see the study that compares chemo given directly before and given 9 hours before radiation. I suggested that we give me radiation last thing before bed and then get me in for radiation first thing in the morning. ‘A nice suggestion, but it is not possible.’

They said I could go home if I wanted, but since I was already settled in a nice room with it's own bathroom I figured I'd just stay. The schlep to and from home wasn't that much fun. And Joshua stayed through the afternoon and we went out for a tiny dinner. My appetite is about the size of a large apple these days. I had no roommate and watched a movie before going to sleep. Today has been relaxed, I'm reading a book I found in the waiting area and it has me enthralled, thank goodness. I have a new roommate and she is relatively healthy. Her name is Ramona. She speaks no English, but we communicate in smiles and commiserate about the awfulness of the food. 

Around 5pm today I decided that I needed to get outside for a walk. Last week, the worst day was the day after cisplatin, so I knew that tomorrow wouldn’t be an option. I decided to go and walk along the canal that is visible from my window. 

Leaving the building I realize again that the air inside is not good. It’s not like it smells bad everywhere, but it doesn’t smell good either. Lots of whiffs of alcohol hand sanitizer. The entire bottom floor where there’s access to the outside smells like tobacco smoke because people are smoking right outside the doors. We once saw patients in hospital gowns smoking in the entry bufferways when it was very cold outside. Late last night I was sure I was smelling smoke, as if one of my hall mates is smoking in their room when the floor is quiet.

I hold my breath while I get through the ground floor and the cold air outside smells and tastes incredibly fresh by comparison. As I leave the hospital campus I feel like I’m escaping, which is nice. I cross to the canal side of the street and walk along the wide bike and ped-way. It’s pretty grim. Still depth of winter according to all the trees and bushes. Not a green thing in site, everything is grey. 

Across the canal is a metal disposal plant; I watch a giant scooping machine take large scoopfuls of metal fragments, place them in another bin, and then crush them with the weight of the scoop. I think about water quality and realize that it’s incredibly comforting to be walking by the water, anyway. 

I thought of something Dr. Marnitz said to me, the radiologist who I first met with and who is in charge around here, but who is on vacation last week and this week. 

She said, ‘The cisplatin attaches to the blood cells and goes throughout the body. Then it is released, we don’t know how, and then the body gets rid of it.’ 

I think, ‘maybe she meant that this happens right away.’ The chemo really only does damage for this brief period of time, and then I suffer the effects of it leaving my body. Wow. This is so logical and provides an explanation for why they are inflexible about when chemo happens in relation to radiation, so I happily grasp onto it.

The path veers away from the road, thank goodness, and what is probably a green zone in brighter seasons acts as a nice wide buffer. It’s almost like being in nature. As I walk, I’m taking big breaths, trying to inhale a lot through my nose and exhale it again through my mouth, as if I’m breathing out pure cisplatin. I imagine the hospital as a bit of a stale chemo-breath house and commit to opening my window more often. 

But the idea that all I need to do over the next few days is get the cisplatin out makes me feel better. I know how to detox. If it’s really just important for that one day of radiation, then I’m going to do what I can do make the detox as quick as possible. More fennel tea for me, then, even if it’s wretched (which it’s not, turns out). After tomorrow's radiation, maybe I will feel good enough to go home.

I sit for a few minutes on a barely wide enough bollard which is not comfortable, but there’s nothing else to sit on. I think I can taste cisplatin on my own breath. I’m convincing myself that this week’s recovery will be better than last week, which makes me feel pretty good. I sure do want to be in control. I consider talking to a plant about cisplatin and then decide I might fumigate it, and of course there are no green plants or flowers with sympathetic looks. Okay Spring, I give you permission to start right up.

I wait until I’m ready and then get up and walk back towards the hospital. As I walk through the street entrance I see a sign that says this is a no-smoking hospital. Very funny.