Chemo side effects: “everybody is different”

January 2022

My mom and I are sitting in an exam room with the oncology nurse practitioner, Karen, a member of my oncology team. (You get a whole team when you’re diagnosed with cancer.) Mama has a paper and pen at the ready as the nurse talks about the first phase of my treatment, iv chemo. 

“Do you have any questions so far?” Karen asks.

My mama ALWAYS has questions. She’s not one to wait for someone to get through how they want to present info. And Karen just put her in the driver’s seat. “What can she expect for side effects?”

Karen nods vigorously. Takes an audible breath. “She could have fatigue, nausea, diarrhea, constipation, mouth sores, adverseness to cold things, and her hair might thin out.” She turns to look at me, “But good news! You won’t have to shave your legs as often.”

It’s January 2022 in New Hampshire. The height of Covid wave 2. Who the F is shaving their legs now? Karen pauses and leans over on her clipboard, maintaining eye contact with me, “Everybody reacts to chemo differently. Because you’re young and healthy...”

Mama interrupts, “She. Has. Cancer.” Fair point. I’m 48, with stage 3 rectal cancer. Young AND healthy.

Karen forces a laugh, “Well yes, besides that. The doctor recommends treating your cancer aggressively.”

In retrospect, Karen neglected to mention some possible chemo side effects in her list that day. I think they do that intentionally, so you don’t wig out too much. I’ll add mine here, but please remember I’m young and healthy, aggressive treatment, and everybody’s experience is different. 

* Your hands and feet may feel tingly-burny particularly when cold, but sometimes, just because. And they may peel painfully--this is the chemo actually coming out the pores on your skin, burning you. 

* Sometimes your hands may cramp up in a useless claw.

* Water might taste like ass.

* Your throat may snap shut when you try to drink--it’s like the back of your tongue and throat saying, “Nope. Screw you. The way is shut!” even when you’re really thirsty. (Before you start chemo, I highly recommend chugging a few big old glasses of ice-cold water, lemonade, whatever really satisfies your thirst, cuz that ain’t happening for a while.)

* Food and drinks won’t taste the same; sometimes they’ll taste like nothing, sometimes they’ll taste metallic. And this will change from day to day.

* You may get dizzy, especially when going from lying down to standing up. (This would’ve been particularly nice to know before I did that 2 am chin plant on my bedroom floor while on the way to the bathroom, relocating a tooth and slicing a prolifically bloody gash in my tongue.) 

* You may be really gassy, like you just shot-gunned a beer, walking around thumping your chest, hoping for relief.

* You might find yourself saying something you think makes absolute sense--”Dad, she buried the body under the spring set.”--only to hear it a second or two later and realize you actually sound ridiculous. “Dammit. Swing set. Under the swing set.” It’s called “chemo brain.” At least chemo brain bemuses me and my family and friends.

I don’t why they call them side effects. I guess it’s cuz the main objective is to kill the tumor, but these other things might come with it. Kind of like side dishes. You ordered the fried chicken. It might come with fries, onion rings, green beans, or coleslaw. But everybody’s different. We don’t know what you’re going get.