By Matt Cohen
In September 2007, Matt Cohen’s wife Andrea was diagnosed with breast cancer. Over the next months, Matt used his blog to share with friends, family, and even interested strangers the family’s experiences with cancer treatment.
In this excerpt, re-edited for NCCN.com, Matt describes the day of Andrea’s first chemotherapy treatment.
Wednesday, November 28, 2007
This is my therapy. I appreciate feeling that I can get everything off my chest, writing whatever comes into my mind and knowing that someone out there is reading this. As you read, please remember that I write everything not because I want to be graphic or upset anyone but because I feel the need to communicate what’s going on in my head and in Andrea's. Going through treatment for cancer is scary stuff, but it’s doable. My hope is that the folks who read this will be better prepared and less scared for the road ahead.
For the past 2 months I feel like Andrea has been like a beat up car that keeps heading back to the shop for some more parts and tune ups. She is truly a hero; if you saw what she’s had to go through, you’d probably agree.
11:22 p.m., EST
I'll start at the end, with a "Cliff’s Notes" version of today. Andrea's day went as planned; she had a port inserted into her upper chest area this morning followed by her first dose of chemotherapy in the afternoon. We came home around 4:30 p.m. after spending from 7:00 a.m. on at the hospital. Andrea hasn't been feeling great since she got home. She’s had bouts of nausea, but at 10:45 p.m., she finally was able to fall asleep. What follows are some random thoughts from this difficult day.
2:14 p.m.
“Chemo Room 7” is where you find us today for treatment number one (of eight).
Andrea finished her first medication, an anti-nausea medicine, and the nurse returned to administer the first cancer medication, Adriamycin. She administered this with a large syringe that is connected to the tube going into Andrea’s port, and it took only about 5 minutes to enter her body. Andrea complained of itching in her ear and said it feels like a “hot flash.” The nurse comforted her and told her it is normal to feel this way.
The nurse then began the next medication, Cytoxin. Unlike the first cancer drug, this one is administered with a drip bag through the IV. This part of chemotherapy takes approximately 30 minutes to complete.
Now Andrea sits somewhat uncomfortably in the large lounge chair nibbling at some chicken salad and fruit while playing our “alternative” playlist on her iPod. The IV bag hangs to her left and a tube enters her port just below her left shoulder. The room is dimly lit—I tell her it’s mood lighting. Of course, yours truly gets the cheap upright chair in the corner. Where’s the respect?
The chemotherapy wing at the cancer center is made up of a number of chemo rooms, each with nice lounge chairs, TVs, and the normal sterile-looking stuff you see when visiting a doctor. Today’s treatment and the next 3 after it will take about an hour or two each.
As in a hospital, we can hear beeps coming every so often from other chemo rooms, indicating that one medication is complete and the bags need to be changed to the next medication. Her cancer care team told Andrea that the treatments themselves are pretty benign and that patients normally do not have symptoms until a day or two later.
This first day of chemo is a life check for both of us: you enter the center and all around you are women just like Andrea waiting to see an oncologist or checking in for chemo treatment. The staff here is wonderful and seems to truly understand what these women need.
The nurse enters the room regularly to check on Andrea, make some notes and press a few buttons on the IV box. Andrea has her head resting on her right hand as she tries to relax while Harry Chapin sings to her on her iPod. I could tell she was just trying to take her mind to another place.
A Series of Noteworthy Events
Getting a Port
We woke up at 5:45 a.m. this morning and prepared to head out for the hospital. Before starting chemotherapy, Andrea had to go to the interventional radiology department to have a port inserted below her left shoulder. Although this is not considered a major procedure, it was still invasive and she was still given anesthesia. The procedure included another IV, two more incisions in the chest, and needing to now have a rubber tube running from her upper chest into a vein near her neck. She says it’s uncomfortable, but the doctors assure us that the discomfort will subside in the next 3 to 7 days. The good news going forward is that she won’t need an IV each time she receives chemo, but it was a rough morning for Andrea.
Blood Work
After leaving radiology but before going to the breast center, Andrea had to get blood work done. At this point, another breast cancer patient overheard Andrea telling the nurse that this is her first chemo treatment. Since the door was open, the woman just came into the room, looked at Andrea and asked how she was doing.
“It’s been just about one year now since my first chemo treatment,” she added. “I was really scared too, and I’ve got to tell you it’s worse in your mind than the actual event itself.” This woman spent the next several minutes with Andrea and me, telling her story and showing us how her hair had grown back and that she’s doing fine.
I was meeting this woman for the first time, but I found something very noticeable about her and how she approached Andrea, the nurses, and others who passed her way. She seemed to have a glimmer in her eye and a palpable positive attitude, as if nothing bothered her and she felt that every breath she took meant something. I could sense her confidence, her strength, and her love for life. Andrea and I found it difficult to hold back a few tears as we realized how truly amazing meeting this woman was.
Chemotherapy
Just before the start of chemotherapy, Andrea asked for some food, so I went to the coffee shop. During the elevator ride, I found myself between a breast cancer patient and a nurse from the breast cancer center. The patient started telling the nurse how appreciative she was for all the care she received and how wonderful all the nurses and others she’s dealt with have been. The elevator stopped, and the patient leaned over to the nurse, gave her a hug, and said, “thanks.” The nurse humbly replied “I thank you on behalf of all of us."
For me, the fellow patient in radiology and the women on that elevator ride showed me how strong the kinship is among those fighting breast cancer.
The rest of the treatment went uneventfully. As Andrea nodded off to sleep, I continued to write and listen to the sounds of almost complete silence in the chemo wing. All I heard then was the rhythmic sound of the IV pump by her side, is softly playing what sounded like a slow electronic beat.
After the treatment was finished, the nurse came in and turned the lights back on, and we both squinted as our pupils reacted to the sudden light. The nurse then flushed the tube with saline and unhooked it. I can think of a lot of other things I’d rather be doing today, but we’re on the road to recovery and now down to only seven more chemo treatments.
Later That Evening
Interestingly, my life took a turn for the better tonight when my kids saw me cry. Our bedroom ritual involves me spending time with each of my three daughters for a few minutes before they go to sleep. I started with Sari (then 7) and she broke down crying because she was upset at seeing her mom lying on the couch since 4:30 p.m. feeling nauseous. She kept crying, "I want Mommy" over and over. I felt helpless and just held her. I reassured her that although “Mommy's medicine makes her feel yucky for a few days,” and she'll be feeling better again soon. She then asked, "Why does Mommy have to feel so bad now just after she started to feel good again from her operation?" It amazed me that she had this sort of perspective at 7, and I felt good that she was able to express herself. I just hugged her and let out some tears of my own, making sure she didn't see me cry.
As I held her for a few more minutes, her twin sister Elissa and older sister Rebecca entered the room, also wanting to talk. I did my best to explain chemo in a simplified way I felt they could all understand. In actuality, there's no easy way to simplify any of it. I tried to reassure them that the medicine that their mother received today was going to make her feel better over time, but I understood that it was a strange concept to explain to healthy kids who think medicine is grape-flavored Motrin.
As I talked to them, I couldn't hold back anymore and just broke down. I tried my best to fight it but just couldn't stop the tears from flowing. I could tell Elissa felt a bit uncomfortable seeing her father cry and began to cry herself.
Then the most amazing thing happened: all three of my girls came over and reached out to hug me, unsolicited and on their own, as if to say "it's ok Dad." It was a remarkable moment in my life, almost surreal when I think back on it. My daughters' instincts kicked in at the moment when I needed someone.
It was that moment, driven by the ugliness of cancer, that made me happier than ever on that evening to be their father and know that we will all be alright.