Nfld. & Labrador·Blog

Dr. C: Chemotherapy is a bit like war

Dr. Nikhil Joshi has had several rounds of chemotherapy for Hodkgin's lymphoma, and he's feeling the effects.

You have no idea what chemo is like until you go through it, writes Dr. Nikhil Joshi

This is Dr. Nikhil Joshi's view as he gets chemotherapy at the Health Science Centre in St. John's. (CBC)

I don't want to do this anymore.

I don't want to be Dr. C., I don't want to write my blog, and I'm done with chemotherapy. 

I've just finished my third cycle of chemo, my sixth treatment, and I am unbelievably burnt out. 

One of the questions I'm often asked is: What's chemotherapy like? 

I think it's a bit like describing war. You can say whatever you like but until you experience it for yourself, you have no idea. 

Chemo is different for everyone

So I'll give it a shot.

Chemotherapy has several stages and it evolves as you go through it. 

There are are also many different regimens depending on the type of cancer — and they all have varying side-effects. So, chemo is different for everybody. 

The first thing that happens is you physically need to get the chemo. In my case, I get it from the ambulatory treatment clinics at the Health Sciences Centre in St. John's. 

I get into a chemo chair or bed, and over three hours, I get all my drugs. The drugs are a mix of oral and IV — this includes pretreatment with anti-nauseants and anti-anxiolytics. 

When I was going for my first treatment, I wondered why first they gave me Ativan — a drug sometimes used to treat anxiety disorders.

Then, halfway through the process, I realized that if I really stopped and thought about what was going on in my life, I'd freak out and run out of the clinic. 

More drugs

After the Ativan gets in my system, I chill out a fair bit and relax while I get my chemo. 

So I've gotten my chemo, now what? Well, I'm drugged up now, so the best idea is to have someone take me home and sleep.

I sleep. When I wake up, I'm nauseous. I take four or five pills of various anti-nauseants.  

These pills have varying degrees of effectiveness. Overall they are leaps and bounds above what we used to have, but I still find the nausea to be pretty difficult even with the drugs. So that's Day 1.  

Day 2 starts, and I wake up early. I don't do it on purpose. I just wake up at strange hours now. It's 5 in the morning and I'm starting to feel nauseous again. 

I take my first dose of the anti-nauseants as soon as I can and try to sleep some more. 

Chemo rounds accumulate

In the early rounds of chemo, you still have enough in you to smile and laugh, and think, "This won't be so bad, I can definitely get through this."    

But then the rounds accumulate. Over time, it's taking me longer and longer to recover from each chemo treatment, and my body had been building up toxicity. 

What was a few days under the weather are now turning into more than a week of abdominal pain, nausea and vomiting. I'm sleeping constantly, more hours than I'm awake.

I have no idea what the hell is happening in the outside world. 

I know somewhere out in the ether there are people who are wondering how I'm doing and they want updates. They care. But they're not real to me because of the misery I'm in. 

The only thing that's real is this heaviness in my body and mind, and a little voice inside of me that says, "Let's just stop this now. Please." 

Inside me there's this person who is so burnt out, so tired, and so scared and angry.

I have no choice

Realistically, I know I cannot stop chemotherapy. 

If I want to be cured of my cancer, I have no choice but to have more of it. 

I'm OK if that person inside of me is not OK today. I'm fine if he isn't happy with the way things are.

I just hope he doesn't let this experience limit or haunt him after it's over. 

Because I can go through chemo once, but I don't know if I can do it again.


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