Chemotherapy and I...

February 12, 2015 was my last chemo...

Yaaaaay....

That was more than a month a go :)

What a journey!

Sebenernya udah lamaaa banget draft ini saya susun, sejak kemo masih awal dijalani. Tapi entah kenapa, baru selesai sekarang :). Well, lebih baik terlambat daripada tidak dishare sama sekali kaaaan...

After 4 rounds of AC and 12 rounds of Herceptin and Taxol, I can finally close one chapter of my #roadmaptowellness :). Many more to come but at least the hardest parts were done. Done...

Alhamdulillaaaaah...

Ngga kerasa lumayan lama juga saya menjalani pengobatan kemoterapi. 
Sejak pertama kali dimulai bulan Oktober 2014, 2 bulan setelah saya menjalani mastektomi, rasanya waktu berjalan cepat. 
Yah, cepat dalam arti satu demi satu prosedur pengobatan yang harus saya jalani selesai sesuai jadwal. Tidak ada yang mundur dari jadwal yang disusun sejak awal bersama onkologist saya :).
Benar-benar anugerah luar biasa dari Yang Kuasa.

Kemoterapi. ..

Apa yang ada di benar teman-teman saat mendengar kata ini?

Rambut rontok, kepala botak, badan tidak enak? 
Well, suka tidak suka, semuanya benar adanya...Paling tidak, inilah yang harus saya jalani selama 5 bulan terakhir...

Cheers....

Buat kami yang dideteksi terkena kanker, bisa jadi kemoterapi  adalah 'paket hemat' yang harus dijalani bersama dengan prosedur lainnya. Yah, walaupun tidak bisa dibilang hemat juga ya. Karena dari pengalaman tante saya, yang baru-baru ini terdeteksi kanker payudara juga, pengobatan kemoterapi di Indonesia sangat mahal :(. Saya beruntung karena masa pengobatan saya jalani di AS dan hampir semuanya ditanggung oleh asuransi, walaupun masih ada out-of-pocket expenses yang harus saya bayar dan jumlahnya tidak sedikit.

What is chemotherapy? 

Taken from my pocketbook provided by the NYU Clinical  Cancer Center, chemotherapy  is "a type of cancer treatment that uses drugs to destroy cancer cells." Drugs that will somehow stop or slow the growth of cancer cells.  The problem is it's not only destroying the cancer cells, but also some healthy cells. You know, cancer cells divide and grow very quickly and that's what the drugs are targeting. But, some healthy cells divide and grow quickly as well, so the drugs will hit them, too. At this point, the chemo drugs still can not distinguish them, because they only notice it from the speed of their growth. Well, that's why chemo has side effects and some of them are quite damaging.

Hal ini yang membuat kemo sangat terasa karena memang pada prinsipnya kemo adalah obat yang bersifat 'racun yang digunakan untuk membunuh sel-sel kanker. Salah satu ciri-ciri sel kanker adalah perkembangannya yang cepat. Sel kanker memang membelah diri dengan cepat dan obat kemo menargetkan sel-sel yang berkembang dengan cepat untuk dibasmi. Sayangnya, sel sehat pun ada yang berkembang dengan cepat dan biasanya ada di sistem tubuh yang selalu sibuk dan tumbuh, seperti misalnya rambut, kuku, dan sistem pencernaan. Itu sebabnya kemonya biasanya selalu membuat mereka yang menjalaninya mual, muntah, kehilangan rambut dan mengalami perubahan warna kuku.  

The notorius AC...

I still remember my first round of chemo.
It was the AC one. Or commonly known as Adryamicyn  and Cyroxan.
The notorious AC :(.

It was October 9th, 2014. 

Sitting nervously in my oncologist ' s room, I was once again prepared for my first chemo. I was also briefed, one more time, about the possible side effects and complications.

Before that, and before every chemo I have to go through, I need to have my blood checked to make sure I'm healthy enough. They're looking at my blood count, hemoglobin and some other indicators from my blood. Once everything is satisfactory,  I can proceed with my chemo.

Then I was bravely walk up to the next floor. The Infusion room.

This is where the chemo starts.

my infusion room at NYU Clinical Cancer Center

I'm lucky to be handled by Nina Bells, one of a senior registered nurse who is so kind and gentle. She got my vein, chatted with me so I could relaxed and also  explained  what I was going to go through. It started with pre medication, including ones that will help me with horrible nausea and vomiting as well as other possible allergies. Then she injected that notorius AC, slowly to my vein. She needed to make sure that my body could handle it. Then the rest of my first chemo went  smoothly. 

My dearest Nina...

Until I arrived at home. 
I had been warned that I would feel nausea, vomit, lack of energy, and many more uncomfortable feelings. and they hit me. 
Hard.

I still can't describe exactly the feeling I have after I had my chemo. It was like a mixture of discomfort when you have horrible morning sickness, feverish body, and total loss of energy. No wonder I spent 3 days just sleeping, (trying to) drink enough water, taking my medicine and sleeping again.

Rasanya seperti campuran mual ngg enak karena hamil muda, badan meriang karena tifus dan lemes ngga karuan ngga ada tenaga. Itulah rasanya kemo buat saya. Sepintas memang seperti tidak ada yang salah, tapi badan benar-benar ngga enak rasanya. Makanya selesai kemo, paling tidak saya butuh 3 hari istirahat total...hanya tidur, minum obat, minum air putih dan juice sambil mencoba makan apapun yang masuk (biasanya keluar lagi :( ) dan tidur lagi.

one of my pills...helping me with the nausea...

Although I was given the premedication and some extra medication to fight all these. And they are darn expensive. Again..I was lucky I had my insurance covering them. But USD 80 per pill for anti-nausea is indeed expensive. 

Rasanya tambah seperti kena tonjok ketika tahu harga-harga obat-obatan yang dipakai untuk melawan dampak kemoterapi ini. Salah satu obat anti mual saya kalau dihitung harganya sebutir kira-kira USD 80 ...dikalikan Rp13.000,00 udah berapa tuh. Untungnya, sekali lagi alhamdulillah, sebagian besar obat-obatan ini dicover oleh asuransi saya di sini. Saya hanya perlu membayar co-pay USD 60 untuk 4 box yang berisi 8 butir obat mujarab ini. Bener-bener rezeki dari Allah SWT :)

So, that's my first round of chemo with AC. 
I was scheduled to have 4 rounds of it and believe me, time flew so very slow at that time. I was trying to get back as normal as I can after the 4th day, going back to work, taking the subway....But I know exactly, I have to go easy on almost everything. 

Luckily, my bosses and the office are fully supportive. Although it was in the middle of crazy session of the the UN GA Third Committee, but I took things at my own pace and tried my best to manage all those stressful works and meetings amidst my chemo schedules. I also tried to stay healthy as I had to be fit enough to continue my treatment. If I had flu or infection or fever for example, I have to wait until my body is strong enough to receive another round of toxic that kills my cancer cells. That's why they had to check my blood cell counts before my chemo.


Alhamdulillah lagi, atasan saya dan teman-teman di kantor pun mendukung. Terus terang, saya sempat kepikiran bagaimana dengan tanggung jawab yang saya miliki di kantor selama masa pengobatan. Untungnya, setelah 3 - 4 hari istirahat pasca kemo, saya bisa kembali ke kantor meskipun agak keleyengan. Pelan-pelan saya menyesuaikan kondisi badan dengan beban pekerjaan yang ada. Di tengah masa sidang Komite 3 Majelis Umum PBB yang menggila, saya tetap berusaha memenuhi tanggung jawab saya walaupun harus berbagi dengan teman lainnya yang pekerjaannya juga sudah banyak. Rasanya tidak enak, tapi saya sadar memang saya belum sanggup untuk bekerja full seperti biasa, walaupun semangat tetap membara. Banyak yang terlewat, tapi sebisa mungkin saya penuhi. Again, not that easy, tapi Allah SWT memang adil dan saya diberi kekuatan ekstra untuk menjalani ini semua.



Well, yang pasti, saya harus extra jaga kesehatan karena selama kemo saya tidak boleh sakit. Dengan terpaan racun di tubuh, mau tidak mau tubuh pun mengalami penurunan daya tahan yang signifikan. Jadi, batuk dan pilek yang mungkin sepele bagi orang sehat, bisa menjadi masalah besar untuk saya yang tengah menjalani kemo. Karena itu, setiap menjelang kemo, saya harus melakukan tes darah untuk memastikan sel-sel di tubuh saya cukup untuk menerima pengobatan berikutnya. Untung, sekali lagi, saya bisa tetap sehat dan menjalani pengobatan sesuai jadwal.

Selesai dengan AC, saya juga menjalani 12 rounds of Taxol and Herceptin. Compared to AC, this is really a walk in the park. 

Well, no more nausea and vomiting, just a bit of fatigue, that I got so used to now, and tingling sensation at the tip of fingers and toes. If AC was given every 2 weeks, Taxol and Herceptin were given every week. After a while, everything feels like a routine and everyone in the clinic feels like family to me. I managed to come back to the office after just a day off. And my weekly trip to the clinic was much more colorful as well :)


What's annoying from Taxol and herceptin is the worsening tingling sensation on my toes and fingers. Rasanya seperti kesemutan, tapi permanen. Mengganggu banget kaaaan hehehe. Dan walaupun kemonya sudah lewat lebih dari 1 bulan, tapi masih kerasa dampaknya sampai sekarang :(.

My (not-so-new) hairstyle...

But the impacts of chemo are truly enormous. 
Dampak dari kemoterapi memang banyak. 
You wanna know some of them? At least, there are some that I myself have experienced during my treatment... 

I'll put them in my next posting, okay..this one is a bit too long already :)


Well, again...it's not an easy process, rather a long and winding road for me and my family...but stay positive and always feel grateful will help you get through it. 
As simple as that...
Because of course, I have to say it's a painful process and there's nothing I can do about it. Feeling those IV needles getting in to your skin on such a frequent time, managing nausea and other discomfort, coming to the the clinic every week, taking pills and more ...
Like it or not, as I wanted so bad to get rid of all these cancer cells, I have to go through these procedures and learn to dance with the storm :).

Aaah.. Alhamdulillah, sebagian besar dari prosedur ini sudah selesai dan sekarang, mari kita lanjutkan dengan tahap berikutnya :)...

Semangaaaaat...

References:

For Women Facing Breast Cancer, American Cancer Society, 2009
NYU Hospital Center on Chemotherapy, 2014 Chemotheraphy and You, National Cancer Institute, 2011