Way back in February, we had Radiation 101.  This is Chemo 101 - the details of what it's like in the early going.  As for the fork mentioned in the title, I also promised you the details of what it's like to have an ostomy, which will be offered in "fork-in-the-road" format, so you don't have to accidentally read the details.  Nope! The details require a deliberate click if you want the various ins and outs with no holds barred.
     But first the chemo; I was pleased at my first bi-weekly check-up with the doctor to find that while some effects are cumulative, some are not.  Nausea is one of those that doesn't seem to be cumulative.  In other words, what I felt the first time or two is generally what I'll feel from here on out.  I get a loading dose of anti-nausea meds with my IV and then I have pills I can take as needed afterwards.  I've found that I just want to preemptively take those pills starting a day after the infusion.  My infusions are on Monday with the pump worn through Wednesday.  I take the nausea pills starting Tuesday and continue them through Thursday and that seems to have it whooped.  I did NOT do this the first time, rather I waited until I felt nauseous.  Let me be clear on this should you ever be in this unfortunate position:

     Nausea is a tricky little devil.  I had a nurse at MD Anderson tell me very clearly that the feeling of "just not being hungry" is early nausea and that's the time to take action.  Not when the smell of your family heating up leftovers for dinner makes you want to run and call Ralph on the big white telephone.  That's too late, she said.  Well, she didn't say the part about Ralph, but the rest is true.  Take the pills, she said; do not try to tough it out, she said.  Here's a fun little quiz for those that know me.
When faced with no appetite, will Barb:

1. recognize the early signs of nausea and take her meds as advised by the medical profession, or
2. think she's pretty tough stuff and decide she doesn't need any extra meds in her system at this juncture?
   

Ding! Ding! Ding!  If you answered "1," you're obviously smarter than me.  I of course, answered "2" and got what I deserved.  To my credit, I learned my lesson and am now eating my pills like an appetizer before dinner.  And just like an appetizer, I find that I'm not exactly hungry for my subsequent dinner, but I eat the entree anyways because I ordered it, it tastes good, and I'm a Downey.  We eat.  Then I'm overly full until the next mealtime and we do it all over again.  "Yes, I think I'll start with the compazine, then for my entree, I'll have the reheated meatloaf and green beans."
     Did you catch the part above about compazine?  Yes, that's the name of the anti-nausea meds I can take as needed.  Being the "give me all the information you've got" type, I read up on it.  Here's a little snippet about what it's used for:
Nausea, Schizophrenia, Psychosis, Status Migrainosis, Dementia, Anxiety Disorder
Wowzer!  Sure the first one is applicable, but the rest of those on the list are some pretty major happenings.  Do you see why taking this little pill gave me pause???  So, if you see me on a Tuesday-Thursday of chemo week (That sounds like Shark Week.  All week long on the Barb Channel, it's Chemo Week!) and I seem a little, um, different, don't worry.  It's just that my schizophrenia and psychotic tendencies are temporarily under control.
     Well, now that we've covered nausea ad nauseum, we'll move on to the other chemo associated happenings.  While nausea is not cumulative, the rest of the effects are.  The big, bad wolf of these is neuropathy.  Recall your Latin & Greek Derivatives class and you'll realize this means nerve injury/death.  The cold sensitivity described in the great-chilled-meat-in-Wal-Mart-debacle (see previous post) was the early symptom.  That continued through the 2 week period between chemos, although it alleviated to occasional cold sensitivity if the contact with cold was prolonged.  In round 2, the cold sensitivity is back with a vengeance along with a new and interesting twist; if my hands get cold, they may refuse to follow instructions.  Me: "Open, hand, so I can set down this glass of ice water.  Hand?  Hand!"  Hand: "Sorry, did you say something?  I wasn't paying attention."  I tell, you, that is WIERD.  Oops, squiggly red line.  Try again.  ....that is WEIRD.  Red squiggle gone!  I always misspell "weird."  I have heard others say that this symptom manifested itself as just dropping whatever was being held because the hand went on strike.  My version seems a bit better.  But I can picture a cold meeting room and me shaking someone's hand and then not being able to let go of it.  Of course, they have to pry my hand loose, the cops get involved and it all goes downhill from there.  They jab a syringe full of comapzine in my thigh and I don't throw up on anyone and my dementia goes away, which makes my stint in jail a bit more bearable, if unfortunately more memorable.
     The good news is no numbness in the hands or feet yet.  That can be a deal breaker for the particular drug that causes that symptom (oxaliplatin) and I would rather not lose one of my weapons.  With my pathology report, I want all my guns a-blazing.  The final symptom thus far is some tiredness.  Well, sleeplessness followed by tiredness.  Before they start the chemo drugs IV, they preload me with the anti-nausea and steroids.  The first time, I'd had the surgical procedure and had pain pills, so sleeping was NOT a problem.  The 2nd round, I literally stayed up all Monday night.  I'm going to harness this next time.  Steroids make you feel like there's no limit to what you can accomplish.  Maybe I should finally tackle my disorganized and overstuffed closet.  Or maybe binge watch "Breaking Bad" on Netflix.  Yeah, I like that 2nd option.
     Now we've arrived at the promised fork in the road.  I'm going to tell those who're interested about ostomies.  The rest of you, I'll see you next time!