What is a chemo cycle really like?

So, I’m currently on my second round of chemo out of six - a third of the way done! I certainly don’t feel like a pro, and I’m terrified of what new things might crop up in the next four cycles, but I do now have firsthand experience with what chemo is like. Before starting this process, I knew absolutely nothing about chemo. I “knew” that people go bald, and they don’t look healthy or happy, and that chemo wasn’t pleasant, but that was pretty much it. There are a LOT of little things that happen that I never knew about. And more than that, I never knew how completely different everyone’s chemo journeys can be.

I have been placed on a chemo regimen of 4 drugs - TCHP (Taxotere, Carboplatin, Herceptin, and Perjeta) - that I get once every 21 days. In total, this process will be 18 long weeks (already done with 4 of them though). Common side effects for this regimen include: diarrhea, fatigue, hair loss, low white blood cells, anemia (or low red blood cells), and decreased heart function. So… all extremely fun! In addition to that, the side effects are cumulative - meaning they get a little more intense with each round. Even so, my doctor told me to keep a close eye on my day-by-day side effects during the first round, because even though it might get a little worse each time, that first round would be a good indicator for how I would handle it each round. So far, that seems to be correct for me!

The First Round

My amazing nurse Lolo, giving me the sweet toxic chemicals.

Overall, my first round wasn’t so bad. The first week was hard mostly because I had no idea how I might feel from one moment to the next. I was afraid to do pretty much anything for fear that it might trigger nausea (I have a pretty good pain tolerance, but my tolerance for nausea is… not). My main symptom was fatigue. I described it to my mom as feeling like my spirit left my body. It was kind of an intangible thing, but from the moment I woke up on day 5 of the chemo cycle, I knew it was back. My doctor said the only thing that helps with fatigue is exercise, and recommended 30 minute walks every single day. That first week, I did the walks - but I was MISERABLE the whole time. If my mom wanted to stop and look at the Bay or enjoy the sun for a even a minute, I would just groan. They were probably the least pleasant walks she’d ever been on (sorry Mom).

Then, in addition to that, I had a MAJOR breakout of acne on my chest. I actually thought it must be a rash or something, since about 30 pimples cropped up in one morning. It took a minute for my doctor to figure out it was just pimples, since I kept saying it had to be a rash. Apparently, my body excreted chemo through my pores (basically, my body just said, what the eff did you just put in here, get it out!) and the chemo just clogged them all up. I couldn’t shower for the first day after because of my Neulasta (a device they put on your belly to inject you a day after infusion to trigger your body to make more white blood cells), so I didn’t get a chance to clean my pores before a breakout happened. I made sure to use some body wipes and a prescription of topical Clindamycin for the second round, which did the trick.

Weirdly, it was the second week that was a bit harder for me. It was completely different from the first week. I didn’t have fatigue, really. I mean, I was definitely more tired than usual, but I was far from incapacitated. I even got a few light workouts in! What was difficult for me was the mouth symptoms. I’m talking 4-5 mouth sores, taste changes, bad taste in my mouth, dry lips, the whole enchilada. This especially sucked because I’m the type of person who lives to eat. Food is my favorite thing about living, and when food wasn’t fun, I felt pretty defeated. It might have been a wakeup call that I might want to find hobbies that don’t involve just eating food, but also, I did not want the wakeup call. I wanted to enjoy a freaking taco. I had tried very hard to avoid the mouth sores that I knew might come. I was oil pulling every morning, swishing my mouth with a baking soda/salt/water concoction 4 times a day - all the works. Unfortunately, none of that mattered. I contacted my doctor and they said they thought there was “herpetic involvement”, and put me on antivirals. I’ve never had a cold sore in my life, so I truly had no idea it could be a herpes virus that was flaring up, but my lack of any mouth sores since seems to mean it was.

In addition to that, there were taste changes. Not the most pleasant thing to experience when you’re in a pandemic where the most common symptom is loss of taste and smell! Luckily, I expected the change to come on, so I wasn’t too worried when it happened. Basically, everything just tasted dull and not as I knew they should. It’s hard to explain how sad it is to put a familiar food in your mouth and realize it just doesn’t taste the way it’s supposed to. Luckily, this went away after a couple of days, but for anyone curious about coping mechanisms for this, here are some helpful tips.

The last week (third week) of the first chemo cycle was the best it could possibly be. I don't even now remember how particularly bad I felt in those first days of the cycle - I only remember it was bad. It reminds me of how women who have given birth decide to do it again because they don't remember how painful it was the first time. Going into my second round, I felt refreshed and ready, and all it took was a week of distance from all the crappy feelings. Honestly, even though it's really just one week out of the cycle that I felt normal, I loved it and I needed it. And I ate a few tacos 😉.

The Second Round

As I’m writing this, I’m on Day 9 of my second chemo cycle. Not gonna lie, I’ve been decently miserable this round. I was far more exhausted this time, but I think that’s due to me being much better at persuading my mom that I couldn’t possibly go for a long walk. I’ve given her instructions that for the next round, I have to go on the walk no matter how much I complain. (Again, sorry Mom. I love you).

Made my mom take a picture so I would remember how bad I felt 🤣

For those that don’t mind if I get a little more TMI - the most common symptom of the TCHP chemo cocktail, by far, is diarrhea. I was lucky enough to not have this too much or for too long in my first cycle but - DAMN. If we’re talking GI symptoms in the second week of this cycle, it’s been a real nightmare for me. I’m about to start stepping out into the world again as a social human tomorrow to get dinner with a friend, and part of me is terrified. Not totally sure I can go a whole dinner (or eat a whole dinner) without feeling nauseous.

And the hair loss is getting very real. I decided to use cold caps, and just bought cold caps for my upcoming two sessions as well, but to be honest - the hair is really, really thinning out. I lose a whole fistfull of hair a day, sometimes more. Today, day 9, is the first time I’ve really started to see how thin it looks on my head. I’d be lying if I said it doesn’t make me feel stressed, sad, and scared. But I know it’s just part of the game, so I’m trying to stay positive! If I’m lucky, most of it will stay planted firmly in my scalp. We’ll see.

As always, you can follow my Instagram (@michybees) for more frequent updates! And, if you're feeling friendly, let me know if there's anything you'd like to know more about or want to see a blog post on!