Cycle 1

August 23, 2012

Our decision was made to do chemo first then possibly doing surgery at a later time. However, the main purpose of surgery is containment. Since Carmen’s cancer had already spread, it would defeat this primary purpose. The other reason to do surgery is to alleviate any symptoms she may have. She had no symptoms, so all surgery would do is cause more hardship with little to no long term benefits. This was the view of her oncologist and it made sense to us as well. It took us time to understand this, but now we do.

This day was going to be a long one. Carmen’s regimen was a 2 drug cocktail. One is called Oxaliplatin and other Xeloda. Oxaliplatin is an infusion drug which was administered through her vein. In order to facilitate the infusion, a PICC line was surgically inserted into Carmen’s left arm. The end of the line protruded from her arm to connect to the infusion drip bag. The other end followed up her arm as it traveled through her vein and ended directly into her heart. This was done in the morning and between the prep time and insertion, it took a few hours. The good thing about a PICC line was that she would not be poked each time she received the infusion. Carmen has a terrible phobia of needles. I would’ve thought that she would have overcome her fear by now. Delivering 3 kids and having dislocated her right shoulder twice, she’s seen her share of needles. The 2nd drug, Xeloda, was in pill form. She would take 3 in the morning and 3 at night for 14 days. The infusion was once every 3 weeks. So each cycle essentially lasted 3 weeks with the 3rd week being a “free” (of chemo) week.

Let’s talk about side effects. Neither of these drugs caused hair loss. So Carmen was able to keep her hair throughout her treatments. The main side effects of Oxali were extreme sensitivity to anything cold which was immediate, and a longer term effect of something called Neuropathy. Neuropathy is basically nerve damage to her finger tips. This wasn’t noticeable right away, but the effects we’re told would linger for quite some time, perhaps a full year after the final Oxali treatment. The first side effect was a bit scary. Her oncologist warned her to avoid anything “cold”. This meant no metal door knobs at room temperature. Opening the fridge door would be painful, and opening the freezer would be dangerous. Of course she had the obligatory nausea with Oxali and extreme fatigue. Her body had never experienced anything like this, so for her to get the Oxali that afternoon followed up by 3 Xeloda pills that evening, I can safely say that her body was revolting and saying “what in the world did you just do???”

The infusion took about 4 hours which basically meant we spent the entire day at the hospital. When we got home that night all she wanted to do was lay down and rest. No appetite, no energy, extreme nausea, and was freezing. This was on a Thursday. The next day she seemed to be doing better, but as our oncologist friend warned us, the effects may show up much stronger after the 2nd day. Sure enough Carmen had a horrible Saturday. Keep in mind she’s now on 6 Xeloda pills a day for the next 14 days. She didn’t eat much or do anything except lay in bed. For someone so active and constantly on the move to be in bed all day was a new experience for her, but also for me as well. The scariest part of this was that this wasn’t the most toxic regimen. The Epirubicen was supposed to be the most toxic one so I couldn’t imagine her being on 3 drugs.

The Oxali effects were strong. After a few days Carmen began to recover from the infusion and became a bit cocky thinking the worst had passed and neglected her oncologist’s warning to avoid anything remotely cold. So one day she went outside to walk her mom back to the car. There was a slight breeze that afternoon. Her mistake was going outside without covering up her neck. When she came back inside she picked up a grape (room temperature) and took a bite. This is the part of the story where she realized maybe she should take warnings a bit more seriously. Her face froze as she bit into the grape. Her throat began to constrict and she felt like she couldn’t breathe. The “coldness” from the outside breeze and the grape were too much for her. For a few seconds I too froze as I began to prepare for immediate action in case she choked. Luckily she spit it out quickly and the effect subsided. From then on, we heated everything before she ate or drank. After about 7 days, this effect subsided. We just needed to be careful for the first week, especially the first few days.

Another ugly side effect happened at nights when her calves would cramp up. This usually happened in the middle of the night and was timed perfectly to when I entered REM sleep. So between getting up to feed Audrey and stretching Carmen’s calves, I became a zombie. Oh yes, our little Audrey. She was such a good baby. Within the first few months she was able to sleep about 5 straight hours giving me the rest I desperately wanted. As for Olivia and Ella, they were shuttled around like orphaned children to various places by various friends and family. We needed the help and we were grateful to receive it.

Not much fun during these 3 weeks. But I believe the prayers from so many people helped us get through it. During this time when things calmed down a bit we had time to reflect and ask why and how this could happen. Carmen never smoked, wasn’t a drinker, and ate fairly well, hardly any junk food. There had to be a reason for all of this. As Christians we need reasons for why things happen because we believe that things do not happen in a vacuum. As there is purpose in our lives and our existence, we felt there should be a purpose for our current situation. The conclusion we came up with is illustrated in the Bible. In John 9, Jesus heals a blind man. The question posed to Jesus was “who sinned, this man or his parents, that he was born blind?” The answer Jesus gave was “Neither… this happened so that the works of God might be displayed in him.” He then healed the blind man. I began to view Carmen as the blind man in the story. Her life would be a testament to the healing power of God and His grace in her (and our family’s) life.

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