Breast Cancer Chemotherapy: First Cycle, Almost

This morning, I was the first patient at the cancer clinic ready for my first round of chemotherapy. Despite my professional experience as a nurse, I was surprisingly nervous.
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This morning, I was the first patient at the cancer clinic ready for my first round of chemotherapy. Despite my professional experience as a nurse, I was surprisingly nervous.

At the reception desk, I was given a questionnaire asking me about any symptoms I am currently experiencing (uhhhhh, none -- yet). Apparently I will have to do this before every chemotherapy infusion.

Then I was escorted to the "Treatment Room" which was a beautiful, peaceful, open space. After sitting down in this chemotherapy administration room, I realized that I'm officially into the next phase of FBC (aka F-Bomb Breast Cancer). Wow. Maybe that explains the morning's nervousness.

Three nurses introduced themselves. All were very welcoming and kind. The nurses already knew that I'm a nurse. There is an inherent professional connection, communication and respect for one of your "own," especially when illness and treatment are involved.

We discussed accessing my port-a-cath. Let me explain briefly how a port-a-cath is accessed:

Accessing the port:

  1. Supplies Needed: Huber needle, Betadine swabs, 10cc syringe of Normal Saline, 5 cc syringe with 100 unit/ml Heparin, sterile gloves
  2. Locate the port septum by palpation (i.e., touch)
  3. Put on sterile gloves
  4. Prime needle tubing with saline and leave syringe attached
  5. Cleanse skin five inches out from center of the port using the antimicrobial swabs. Use a circular motion and work outward

Placing the needle

  • Relocate the port septum (center) between two fingers, pulling the skin taut.
  • Firmly (as in STAB!) the needle at a 90 degree angle through the skin into the port septum until it hits the bottom of the port chamber. Once the needle is in place it is connected to the needle tubing (the route through which chemotherapy will enter my body).

Establish Patency

  1. Establish that the needle is in the correct place by aspirating blood through the IV line, then irrigate (i.e., flush) with 10 cc of normal saline (fluid).
  2. Once blood is drawn and/or when medications are complete, flush with 10 cc of normal saline and Heprain (blood thinner to keep the line open).

Thanks to a very difficult recovery from my double mastectomy, I told them that I have an extremely low tolerance for pain, i.e., even the lightest touch hurts. I requested either EMLA cream or lidocaine to ease the process of accessing my port-a-cath.

EMLA Cream is a local anesthetic that numbs skin to pain from injections. It works by blocking nerves from transmitting painful impulses to the brain. Bad news: they didn't have any there. To get EMLA cream, you need a doctor's prescription and it takes and 45 minutes to work. F-Bomb.

OK, well, how about a little injectionable lidocaine to numb the area. Nope. They didn't have that either. WTF? I almost broke into tears, but instead, out came the F-bomb (outloud). How embarrassing. I usually am able to keep the F-Bombs in my head, but sometimes they fly out against my better judgment. I reiterated exactly how low my tolerance for pain is and they promised to do it as fast as possible.

All I can say is that accessing my port-a-cath was a disaster and hurt like F-Bomb. ALARM! ALARM! ALARM! OWIE! OWIE! OWIE!

Holy heavens. Tears instantly poured down my cheeks. I wanted to throw up. It was awful. Not only that, but the nurse didn't hit the bulls-eye and had to pull it out and do it again. The poor nurse was mortified and completely apologetic. It was awful all the way around. She finally hit the center of the port and was able to get fluids to go through. Yeah!

In the meantime, she also gave me (per my request) intravenous Benadryl (to offset side effects, with the added bonus of making me sleepy) as well as Ativan (an anti-anxiety and anti-nausea medication).

After I was given these two drugs, the steroid Dexamethasone was administered through my IV. "Dex" as it's commonly referred, helps prevent nausea and other side effects of chemotherapy. On the opposite end of the spectrum, it can produce sleepless nights and anger issues, commonly referred to as "'Roid Rage." I'm not kidding. Let's just say that the F-bomb has been dropped a lot today!

Then, my doctor came into the room to tell me that there had been a "snafu." HUH? ('Roid Rage was beginning to take effect). Yesterday, in preparation for today's chemotherapy, I was supposed to have taken Dexamethasone (orally). Again: Really? Really? Hmmm ... why didn't I, the patient, know this?

A long story short, they were not able to give chemotherapy today (because I had not had that dose of Dex the day before chemotherapy). I'm not kidding.

Well, I had to look long and hard for SL (Silver Linings) today (especially considering the ever mounting 'Roid Rage), but was able to find several:

  1. I was able to get out all of the initial worries and anxiety about going to the cancer center to receive chemotherapy.
  2. For the first time in my professional career (and now personal experience), an Oncologist apologized (and truthfully, it wasn't his fault, however, as final decision maker he took responsibility). This gave me even more respect for him.
  3. I now have EMLA cream to place on my port-a-cath before tomorrow's Huber needle stick.
  4. I took a long nap to offset the effects of the Benadryl and the Ativan.

While today was a bummer, the Silver Linings really helped.

So, tomorrow morning, I will go back to the cancer clinic to try it again. Get back on the horse, as they say (but this time I'll have EMLA and anti-emetics in my saddle)!

What I know for sure is that we are all given challenges in this life that, at times, seem insurmountable.

We have specific choices about how we can handle the inevitable adversity in life.

I choose positive. Where there is bad, I seek to find the good. I am finding that looking for life's Silver Linings helps immensely. No, more than that ... Finding SL's makes all the difference in the world.

We just have to put one foot in front of the other and keep on moving.

Our lives are not determined by what happens to us but by how we react to what happens, not by what life brings to us, but by the attitude we bring to life. A positive attitude causes a chain reaction of positive thoughts, events, and outcomes. It is a catalyst, a spark that creates extraordinary results.


Next week, I'll report on the official first round of chemotherapy (hopefully with fewer F-Bombs!).

To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, Brookside Buzz ( You may email her at

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