Part 9, Chemotherapy and Brain Surgery

Part 9 of my Cancer Journal may reveal all you’ve wanted to know – and more – about chemotherapy and brain surgery. Although I started and finished chemo in the fall of 2017, I didn’t have the energy to write about it until now. I hope my story will encourage you.

Chemotherapy Preparation
On 9/6/17 I met an oncologist in Everett and gave him a copy of the SCCA specialist’s protocol for treating lung cancer like mine (see Getting a Second Opinion.) His face lit up as he read it. He said he’d studied under the specialist and would follow his recommendations. I was pleased.

On 9/15, Lee took me for a brain MRI, given routinely to patients before chemo. From there we drove to another part of town for a baseline hearing test. (Nice to find out my hearing is normal for my age.) Then I went to the surgical unit to have a port placed near my collar bone, allowing the chemo drugs to be infused into a large vein. The staff started an IV, took me to the OR, and put me in “conscious sedation” using drugs to minimize pain and make me forget. Must’ve worked as I don’t remember a thing.

On Thursday, 9/21/17, I met with an Advanced Registered Nurse Practitioner (ARNP), who explained all the anti-nausea meds I’d take at home during chemo. I asked if she’d seen any results from my Brain MRI. She left the room to check, came back, and told me in hushed tones that a 7 mm nodule had shown up on my MRI. I was stunned.

The ARNP said my oncologist would answer any questions I had about the MRI at my next appointment. As Lee and I talked it over, neither of us wanted to tell anyone yet because we didn’t know the next step in treatment, or whether my chemo would stay on schedule. And we needed time to pray.

For two days before Chemo #1, I took dexamethasone at breakfast and lunch to prevent nausea. At the clinic I saw my oncologist, who discussed the results of the brain MRI and referred me to a neurosurgeon. He said chemo doesn’t cross the blood-brain barrier but would continue to attack the cancer in the rest of my body, so I would get chemo as planned. He didn’t say anything about my prognosis, and I didn’t ask. Knowing it was in God’s hands was enough.

First Chemotherapy Treatment
On Thursday, 9/28/17, at 7:30 a.m., I put Lidocaine cream on my port, covered it with plastic wrap, and put on a button-down shirt for easy access. After breakfast, Lee drove me to the clinic, where I was shown to a recliner with a view of the Cascade Mountains. A nurse accessed my port and started a bag of saline. She also gave me a Vitamin B12 shot. After the saline finished, she hung a bag of cisplantin, a chemo drug. Lee and I played Scrabble on his Kindle. I ate celery and watermelon and a small burrito for lunch. No nausea. We played Quiddler in the afternoon while I got the second drug, pemetrexed (Alimta.) When it was finished, the nurse flushed the port, removed the needle, and told me to take ondansetron at 7:30 p.m. and every 8 hours while awake through the weekend. She said if I woke up during the night, and felt nauseous, I should take it again. We left the clinic at 3 p.m. and were home by 3:30.

Chemotherapy Up Close

Other than fatigue, I felt fine. My younger daughter called to check on me, and I told her I was planning to have the soup she’d made for us at supper. We watched a Dr. Blake Mysteries episode. Then, I slept. Watched Jeopardy! while eating the soup, which tasted great. Despite the brief nap, I headed straight to bed, read a chapter of a novel, The Visitation, and slept.

Aftermath of Chemotherapy – Journal Entries
Fri, 9/29/17: In the night, I felt a wave of nausea so took ondansetron at 3:30 a.m. Was up again an hour later. Slept until 9 a.m. The only food that looked tempting for breakfast was watermelon, so I ate a little with my mint tea. (No caffeine allowed.) Read a few chapters from my Bible as usual and prayed. My Pennsylvania daughter called, asked how chemo went, and we talked about Thanksgiving plans. I took ondansetron on schedule. After eating a light lunch, I emptied the dishwasher, and napped for an hour and a half. Woke up hungry, ate half a banana. Took Compazine for nausea at 6:15 p.m. Still felt bad, took ondansetron at 7:35 p.m. Couldn’t stomach the thought of food.

9/30/2017 Sat: Rough night of nausea, but was thankful I didn’t throw up. Took ondansetron. Ate small breakfast with Rooibos tea, applesauce for lunch. Took ondansetron at noon, Compazine at supper, and ondansetron at bedtime.

10/1/2017 Sun: During the night, I woke up with nausea, took ondansetron, and was able to sleep again. Took Compazine in the morning. I longed to go to church with Lee but couldn’t imagine sitting up through the service or standing for the songs. I napped instead, and Lee came home after singing with the choir. I took more ondansetron. We met the family in Redmond for a birthday lunch, and I was surprised to have an appetite. Everything tasted wonderful. Went to our daughter’s place, played a game, and had ice cream and cake, which also tasted wonderful. My only symptom was fatigue.

10/2/2017 Mon: Took ondansetron in the night. Woke up in the morning with a swollen parotid gland. Checked email and rested while Lee did errands. For lunch I had one pancake, half a slice of bacon, a scrambled egg. In the afternoon, I ate a bite of chocolate, but it didn’t sit well. Had bread and watermelon for supper. Took ondansetron. So tired. Went to bed at 8:30 and read for a while. My stomach hurt big time, felt like churning acid, wouldn’t let me sleep. I finally downed three Tums at 2 a.m., then took an omeprazole to see if that would help. I was miserable, couldn’t find a comfortable position.

10/3/2017 Tues: Pain didn’t let up until this morning, and even then it didn’t completely disappear. I threw up shortly after getting up. (First time since chemo.) Took me a while to dress. Very tired. But I was hungry and ate cereal, a banana, and herbal tea. Felt like I was moving in slow-motion. Had the runs. Mid-morning, I called the nurse to ask if I could take a narcotic for stomach pain. She said she’d ask the oncologist and would call in a prescription for lorazepam. Had half a Spam Lite sandwich for lunch. Hit the spot, so I had another half in the afternoon. Read and rested. Lee heated up soup for supper, but I couldn’t eat. Slept fine. No pain. No meds. Nice.

10/4/2017 Weds: Dry heaves this morning. Got dressed, ate a leftover pancake with tea. Felt fine, just weak. Right parotid gland still swollen. Nauseous, took ondansetron with a sip of water. Couldn’t drink more because the water tasted like metal. Gag. Ate Chicken Yakisoba for lunch, gave my grandson a piano lesson, and felt fine the rest of the day.

10/5/2017 Thurs: Got an appointment with the neurosurgeon for Friday and prayed about it and for him. Listened to the radio when I couldn’t sleep. Cereal and a banana for breakfast. Glad Lee had the day off. Picked up lorazepam at the pharmacy, walked on the treadmill for 30 mins, and ate lunch at Ivars, very tasty. Despite my sleepiness, I played a game of Ticket to Ride with Lee.

10/6/17 Fri: Saw the neurosurgeon, who showed me the MRI of my brain, pointed out the pea-sized nodule, and talked to me about my options. Despite my misgivings, I felt I could trust him. The hard part would be telling our kids.

Here’s part of the email I sent them a week later.

10/13/2017
Dear Family,
I got unexpected test results recently. Remember when I had a brain MRI in preparation for chemo? Well, it came back showing I have a 7mm nodule on the left side of my brain. It was unexpected because I have no symptoms. I saw a neurosurgeon a week ago. He showed me the MRI and pointed out that except for the nodule, my brain is healthy and normal. The nodule is in a region of the brain that handles sensory input rather than motor function, which is also a good thing. He said there’s no way to know how long the nodule has been there or what caused it but that it’s most likely cancer (although it could be an infection.)

He offered two options to treat the nodule, that is, keep it from growing. One is to zap it with radiation, which has the advantage of being quick and easy. The drawbacks are it’s impossible to limit the radiation to the nodule, which means it would destroy healthy brain cells in the path of the x-rays; it’s impossible to know if it was effective; and we still wouldn’t know if it was cancer or not. The second option is to surgically remove the nodule with a computerized wand connected to an ultrasound machine that shows the precise location. The disadvantages are that brain surgery is invasive no matter how small the opening, it requires at least one night in the hospital, and it takes a week or more to recover from after-effects of the surgery, such as swelling, headache, and/or droopy facial muscles. The main advantage is the nodule would be out of my head and would be sent to the lab for analysis.

Scary business, isn’t it? But I felt a lot better after seeing the neurosurgeon He did a full neurological exam, which went well, and said if he were in my place, he’d choose surgery. He’s the kind of person who inspires confidence, which is a plus, too. We chose surgery. He wants to operate as soon as possible, between chemo treatments.

During my chemo, I’ve really appreciated your emails, calls, homemade soup, offers to help with rides, and your prayers. We’re trusting God will give us all what we need to face this new challenge. We pray for you every day.

Love, Mom
p.s. from Psalm 139:13-14 – For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.”

10/19/17 Thurs: My oncologist said there was no reason to change the staging of the lung cancer as they don’t yet know what’s in the nodule. He said he’s still aiming for cure. Music to my ears. He and the neurosurgeon want to schedule the surgery between chemos when I’m in good shape. Got a call this afternoon – surgery is planned for Nov. 3. So much I want to do before then.

Chemo #2 took place on Friday, October 20, 2017, and went fine.

10/23/17 from an email to my cousin:

Two friends told me they know of people who had brain surgery while undergoing chemo and came through with flying colors, which encourages me. Yesterday, Lee asked for prayer in our Sunday School class, so it went on our prayer chain. My friend Donna says our church family provides “magnificent prayer support.” She’s so right.

20/26/17 Thurs: Have been struggling with nausea and headache. Got sick on Tuesday night, when I had pain, nausea, and dry heaves. On Weds morning, I had a pre-surgery appointment. Good thing Lee could drive me because I was totally wiped out. Was so weak, I had to use a wheelchair. Got an EKG. Saw a physician’s assistant (PA) who suggested I get my blood drawn but said they couldn’t use my port, which frustrated me because I was so dehydrated they’d have to stick me a dozen times trying to find a vein. I barely managed to be civil and felt bad about not being cheerful. The PA said the blood work could wait. I fought nausea all day despite meds. Took a double dose of lorazepam last night, slept better.

10/30/17 from an email to a cancer-survivor cousin:

Did you ever feel like you had chemo brain? I sure do. It’s like my brain just checks out. For example, last week when a telemarketer called and said, “Could I speak to Norma?” I intended to say something like, “Who’s calling?” But instead I said, “Who’s she?” An hour later, Lee and I were still chuckling.

Oct. 31, 2017, Tues: Had a nice weekend with our son here. The Sunday morning preaching (Paul’s conversion) and choir music was so uplifting. Yesterday was my first day of feeling wonderful again. I ate well and went to the gym. Last night I got a text from our younger daughter saying they landed at SeaTac (back from vacation) – PTL!

Brain Surgery
On Nov. 3, 2017, I had a craniotomy to remove the tiny nodule. The surgeon sealed the incision with staples, and I wanted to see them, so the nurse took a photo. I felt surprisingly good. None of the neurological problems I was warned about. Praise God!

Metal Staples from Brain Surgery

11/6/17 from an email to my cousin:

I’m doing okay. The surgery went well, and I came home on Saturday. Had no nausea on Friday because they gave me a scopolamine patch. The surgeon put in 24 staples in the shape of a C, on the top of my head. The pain comes and goes. I’m thankful he didn’t have to shave much hair.

11/9/17 Thurs: Lee had to work, so my son drove me to Everett for a blood draw and for an appointment with my oncologist. I was so tired that I fell asleep in the waiting room. Good thing I didn’t have to drive myself that day.

Chemo #3 was given on 11/10/2017. The nurse had to give me extra saline because I was dehydrated. We didn’t get out of the clinic until 4 p.m. Exhausted. More nausea and vomiting.

11/16/17 Thurs: My neurosurgeon said the path report confirmed the nodule in my brain was indeed cancer. At least it’s out of my head now. God has been so good to me!

11/28/17 Tues: My Pennsylvania daughter and her family came for Thanksgiving. We had fourteen people bumping elbows at the table for Thanksgiving dinner. I didn’t have to worry about any of the cooking because our three kids (two daughters and a son) made the entire dinner with all the trimmings, and Lee and the other men took care for the clean-up. What a blessing!

Hanging Out at the Zoo after Thanksgiving

Chemo #4 (the last one) took place on 12/1/17.

12/2/17 from an email to my cousin:

I’m doing my best to ignore the nausea from my last chemo, but it’s not easy as I have to eat to keep down the anti-nausea pills. I agree with you that no matter how much I lie down, I never feel rested – just worn out. My vision has changed and made reading hard, but I got some readers from the drug store that help a lot. May have to switch from wearing one contact (for distance) to glasses, which will help me see better and maybe camouflage the dark circles under my eyes.

Thank you very much, family and friends, for praying for me during chemotherapy and brain surgery. Because God answered your prayers, I came through in good spirits and more importantly, with clear follow-up scans.

Thanks for reading.

Posted on May 10, 2018
Previous: Part 8 Getting a Second Opinion
Next: Part 10 Radiation Treatments