One Woman's Diary Documenting A Week Of Chemotherapy

Photo: Courtesy of Jessica Sliwerski.
I was diagnosed with malignant breast cancer four months after the birth of my daughter and 59 days after my 33rd birthday. I had a double mastectomy to remove the lump in my left breast, but because my tumor was aggressive and because I am young, chemotherapy was recommended to decrease the chance of the cancer recurring. I spent three months doing chemotherapy, with a cocktail called Taxotere and Cytoxan, or TC. I had a total of four infusions, each so laden with poison it necessitated three weeks of recovery before the next dose. What follows is a series of diary entries written over the course of my treatment.

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Photo: Courtesy of Jessica Sliwerski.
Day 1: Day Of Infusion

I arrive at Mt. Sinai's Dubin Breast Center and am checked in, an admittance bracelet wrapped tightly around my wrist so I can't escape (or at least it feels that way). I am given a private room, where I climb into a sort-of-comfy chair as my nurse preps my veins and inserts a needle. I cover my legs with a cozy blanket I brought from home, and my head with a beanie my grandmother knit me. I'm hooked up to an IV and given two bags (each 1 liter) of saline fluids, to preempt the dehydration that inevitably accompanies chemo, followed by an intravenous steroid to help with the chemo-induced nausea and an antacid to prevent acid reflux and indigestion.

Each of these IV bags drips slowly. A massage therapist comes into the room and gently rubs my feet, helping me to further relax before the nurse returns with the real good shit — Benadryl, to prevent an allergic reaction to the chemo drug Taxotere. When it’s time for the chemo drugs (because the other two hours of fluids were merely foreplay), I am sound asleep. I feel the nurse playing with the IV, I hear the beep of her gun as she scans my bracelet, and then I feel the cool rush of the Taxotere pulsing through my right arm, climbing up my shoulder, around my breast, and then I don't know where because I am in the midst of a damn good nap. I am still dozing when the final IV bag, the chemo drug Cytoxan, is administered. I feel nothing.

After almost five hours, my husband gently nudges me awake. I am finished with the infusion but have to see my oncologist before we can go home. As my onc examines me, I pull my beanie back, showing her my patchy head. "My hair is going," I say, touching my tingling scalp. I need to prove that the chemo is working.

She gently rubs my head. “You look beautiful,” she says, smiling.

"I can't stop thinking about the cancer coming back," I whisper. Cancer cells are microscopic. Despite everything I was doing to decrease the chance of recurrence, it could still come back, and it wouldn’t be in my breasts, because the mastectomy removed the tumor and all of my breast tissue; it could be in my bones, my liver, my lungs, my brain…

"Did you know many breast cancer patients have PTSD?"

"I have PTSD," I tell her, wiping away tears. "I am so scared it's going to come back. I can't stop worrying," I say, fishing in my purse for my Ativan. It calms me down and helps with the chemo nausea.

She leans down and hugs me hard. "You are going to live to see your daughter do many things." I sob into her shoulder, wanting nothing more than to believe her, but finding it so hard because after this experience, how can I ever trust that my life will be good and normal again?
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Photo: Courtesy of Jessica Sliwerski.
Day 2: The Day After Chemo

I’ve figured out how to make chemo recovery more tolerable — hydration. The problem is, I can’t possibly drink enough water; the chemo drugs are drying, and they’re vehemently coursing through my body. So I return to hospital first thing this morning and get another large bag of saline fluids that measures approximately four bottles of water; that takes about two hours to administer intravenously.

I once saw a show on the Food Network where a mixologist of some renown went to all these swank bars in Vegas and got totally fucked up on fancy cocktails. The next day, he went to a trendy lounge where hot nurses hooked him up to an IV of fluids. He pulled his shades over his eyes, passed the fuck out, and woke up feeling like a rock star, ready to get his party back on. That's kind of like what I do: I get good and fucked-up on designer chemo drugs, and then I return for intravenous hydration at least three times within the next six days.

Exactly 24 hours after the chemo infusion, my husband gives me my Neulasta shot in my thigh. I sit on the toilet, and he kneels in front of me. One, two three, pow! Right in the muscle. "Shit!" I yell, biting my lip and holding back tears. Neulasta puts my bones into overdrive making white blood cells to replenish the ones chemo obliterated.

My hair is falling out everywhere. I take a shower, and there are chunks of hair on my hands. I decide it is time to be bald. I am ready. I spend a good half hour beneath the water, massaging my sore scalp and pulling hair out by the fistful. It’s all over the shower curtain, the tiles on the wall, the sides of the tub, the shampoo bottle. I watch it spiral down the drain. I emerge from the shower with only a smattering of random stragglers. Looking in the mirror, I feel a hot lump in my throat. I cannot believe this is my life, I think, not for the first time.

I ask my mother-in-law, who is visiting, to shave the remaining hair. I want all of it gone. I can no longer bear the agony of watching it slowly fall away. As she trims, she says, "You have a husband who loves you no matter what. You have a daughter who loves you no matter what. That is all that matters in this world."

Tears stream down my face, but they are not sad tears. They are tears of pride because I did it. For the first time since the day I was diagnosed, I finally feel free. All of the worry, all of my fear, all of my angst, all of my sadness floats away. Gone is the woman who was so worried about what she may look like bald, and in her place is one fierce bitch.
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Photo: Courtesy of Jessica Sliwerski.
Day 3: The Day After The Day After Chemo

I have chemo sores on the inside of my lip, all over my tongue, and in my throat. It hurts like hell to swallow. I am swigging Magic Mouthwash on the reg. It makes my mouth completely numb. The numbing sensation triggers my mouth into saliva-production overdrive. As I then try to go about my daily activities — emptying the dishwasher, riding the subway, carrying on a conversation — spittle dribbles uncontrollably from my lips, which are also numb, so I don’t know that I am slobbering all over myself until it drips onto my clavicle.

My tastebuds are shot. I guzzle pineapple juice and taste nothing. I sip green tea, anticipating the bitter tinge I’m accustomed to. Nothing. I sautée vegetables with garlic, chili flakes, and salt, take a bite, and taste a tiny spark of chili heat. I eat cherries. Nothing. I drink cinnamon tea. Something. I eat salmon. Nothing. I eat hummus. I taste lemons, sort of. Frustrated and desperate to taste, I tear into my chocolate stash. I bite into a piece of milk-chocolate-covered toffee and, closing my eyes, let it melt on my tongue. I taste it. I taste it hard. I rip open a chocolate bar with coconut. I don’t even like coconut, but this chocolate is sheer heaven — velvety smooth, with a slight crunch.

"Are you licking the wrapper?" my husband asks, interrupting my reverie.

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Photo: Courtesy of Jessica Sliwerski.
Day 4: When Shit Hits The Fan

The full effects of the chemo have kicked in, and so has the Neulasta shot. My bones ache with excruciating pain — shoulders, neck, jaw, lower back, left foot, right calf, tailbone, right index finger, left knee. I try not to move, and when I do, I gingerly hobble. I am too tired to play with my daughter, too weak to hold her. I am nauseous, low-energy, dizzy, and faint. I have chills. I check my temperature — 102 degrees. Any fever above 100.4 degrees necessitates an immediate visit to the emergency room. Once there, you are supposed to say, "I had chemo. I have a fever." When I show up, I announce, "I'm back!" since this is my third trip to the ER in less than seven weeks.

Chemo fevers are treated with the utmost seriousness because of the fear of infection. Given that chemo annihilated my white blood cells, I am at risk of an infection; should I contract one, it could be deadly because my immune system is compromised. They give me a mask and whisk me away to the VIP "sterile" neutropenia, or isolation, room. Everyone I pass along the way looks at me like, Oh, shit. I don't want what she has. Once I am stowed away in my special chemo-freak room, they check my vitals and ask me super-important questions like, "Have you been to this hospital before?"

"Three weeks ago. Don't you remember me?!"

Knowing exactly what happens next (a battery of blood tests and yet another round of hydration), I hold out my arm to the nurse. It is covered in tracks of broken, bruised veins — trashed from chemotherapy, blood draws, and intravenous fluids.
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Photo: Courtesy of Jessica Sliwerski.
Day 5: Chemo Hell

The nausea is so awful, I awoke three times last night, drenched in sweat and feeling like my insides were going to explode all over the floor next to my bed. I am in hell. The bone pain is excruciating. Today is muscle aches and chills and nausea and no taste and head pain and extreme fatigue and dehydration, despite drinking so much water. I spend the entire day in bed, willing sleep to heal me.
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Photo: Courtesy of Jessica Sliwerski.
Day 6: Still In Hell

I no longer menstruate. For days, I’ve been checking for blood. I check every time I pee, but there is nothing. I have only ever missed my period because of pregnancy. Missing it now is a nasty reminder of everything I’ve lost. I am so, so sad. I realize the night sweats I’ve been having for the past several weeks are hot flashes.

"I'm trying so hard, but I feel like shit," I whimper to my therapist. “I can’t win,” I sob, recounting my recent trip to the ER, my fevers, the multiple hydration sessions, and the latest chemo gift — losing my period.

“You must remember that everything that is happening is evidence that the chemotherapy is working. It is killing every last particle of cancer,” she says in her soft voice.

On the train, I see my bald head in the window reflection and think, The chemo is working. As I eat another tasteless meal and gurgle more Magic Mouthwash, I say, It’s just temporary. The chemo has to kill everything. I endure the muscle spasms and the screaming bone pain, and I give myself over because I know this is what I have to do to live for my baby and my husband and myself. I realize nothing else matters — not my breasts, not my nipples, not my hair, not my taste buds, not my fertility.
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Photo: Courtesy of Jessica Sliwerski.
Day 7: Crawling Out Of The Hole

There is lingering bone pain, muscle aches, and nausea. I am low-energy, but officially on the upswing. Each day between now and the next infusion, I will continue to feel better.

On the subway today, I notice, out of the corner of my eye, the man next to me surreptitiously staring. I turn my music up and stare straight ahead, ignoring him. My hat is in my bag, and I reason that I could take it out and put it on my head, but the cool air on the train feels good on my naked scalp. At 59th Street, he taps my shoulder. Oh god, I think, anticipating some kind of crazy. I turn and look at him, surprised to see tears in his soulful eyes. With his fist against his chest, he says, "I know; I was there. You got this." He smiles and exits the train. I ride home to Brooklyn, thinking about the unexpected gift this man has given me.

When I get home, all I want is to be with my daughter. I read to her, I make her laugh, and I run my finger on her bottom gum and feel her first tooth poking through. I feed her a bottle, holding her long after she’s fallen asleep, nuzzling against her warm neck. I kiss her soft head, breathing in her delicious baby scent. I think about how her strength inspires me to be stronger, how grateful I am that I had cancer and she didn't, and how she makes my life so wonderful and perfect and good. She makes me brave. She makes me fight harder.

Today is a good day.
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