Are you concerned about the side effects of Adriamycin (aka The Red Devil) and Cytoxan?
When my medical oncologist told me I was going to need aggressive chemotherapy to fight my breast cancer, I tried to absorb as much information as possible about the first two chemo drugs I would be taking: Adriamycin and Cytoxan.
I hope that sharing my experiences with AC chemo helps you in some way!
- Diagnosed with Breast Cancer
- Preparing for Aggressive Chemotherapy
- Chemo Bag Items
- What to Wear to Chemo
- Red Devil Round 1- What to Expect
- Side Effects
- Adriamycin and Cytoxan: Rounds 2-4
- Surviving the Red Devil Chemo
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Diagnosed with Breast Cancer
*Please note that I am in no way a medical professional and that the information you read in this post is based solely on my personal experiences. Always contact your doctor before making medical decisions.
I was diagnosed with breast cancer in September of 2018, just a few months after having my second baby.
My tumor was classified as Grade 3, estrogen receptor positive, progesterone receptor positive, and HER2 negative. It was small, but the cancer was growing rapidly.
I had a bilateral mastectomy a few weeks after my initial diagnosis, which is when my surgeon discovered the cancer had spread to my lymph nodes.
Ugh not what you want to hear after a massive surgery!
Preparing for Aggressive Chemotherapy
I first met my medical oncologist about a week after the bilateral mastectomy. He explained that I had a really aggressive cancer that wanted to both spread and come back.
So, we were going to have to fight it aggressively!
My chemo treatment plan consisted of four rounds of Adriamycin and Cytoxan chemo followed by twelve weeks of another drug called Taxol.
Since I was going to be receiving some heavy duty infusions, my oncologist wanted my breast surgeon to insert a chemo port into my chest.
Surgery for Chemo Port
About a week before my chemo was scheduled to start, I went in for an outpatient procedure to have my port placed.
This was a really easy surgery with basically no recovery time. The chemo port was supposed to make the process of getting the chemo into my body much easier.
As much as I feel it’s an eye sore, I’m grateful that the port made the chemo process run more smoothly.
I despise getting IV’s in my arm, and the chemo port completely prevented the need for that each time I went in for an infusion.
My port is located on my chest above my right breast. I also have a small scar on my neck where it ends.
Terrified of Chemo
My Adriamycin and Cytoxan chemo regimen consisted of an infusion once every 21 days. I would do this four times, and then switch to Taxol infusions once a week.
Adriamycin (also known as The Red Devil) is the tough chemo that people hear about. It causes complete hair loss, excessive nausea, fatigue….you name it.
I was not looking forward to it, and I knew I had a long winter ahead of me.
My medical oncology nurse came up with a plan that included a spreadsheet (which I loved her for) for taking the nausea medication.
I had two different types of nausea medication that I was supposed to rotate between every few hours. The nurse told me to do this for the first few days when nausea is at its worst.
She also prescribed a numbing cream to place on my port prior to infusion. This is used so that you don’t feel the needle poke your port.
I want to say that a majority of the people I talked to did not use the numbing cream because they said the poke just felt like a shot.
I, on the other hand, used the cream religiously and caked a ton of it on my port each time. My goal was to feel nothing, and it worked really well!
Chemo Bag Items
A really great friend of mine packed a chemo bag for me to take to my infusions. The bag included essentials like:
- hand sanitizing wipes
- water bottle
I carried these items in a backpack because it was easier to haul places.
The infusion center had snacks available, but I was really particular about what I could eat.
White Cheddar Ritz Crackers were my go-to snack at every infusion. They may not be the healthiest things to eat, but they were the only things that consistently seemed appetizing to me.
What to Wear to Chemo
Since the nurses needed to access my arm to place the Neulasta OnPro device, I had to also pay attention to what I wore to my infusions. I found that a cardigan over a sleeveless shirt worked best.
This way I could pull off the cardigan when I needed to; yet, stay covered and warm with the cardigan throughout the chemo process.
If your chemo port is on your chest, I also recommend wearing a shirt that has a relaxed neck or a v-neck so that it’s not in the way of the IV.
The photo above was taken at my very last chemo session when I got to ring the bell!
You can see my comfy cardigan that was easy to remove for the Neulasta device.
The hair in the photo isn’t my own, but it is that of my favorite wig. I bought a ridiculously priced wig that I literally wore twice.
The wig pictured above wasn’t expensive at all, and it was really comfortable to wear on my sensitive head.
It comes super long, but I cut it myself to better match the length of my pre-chemo hair.
The wig doesn’t have hair on the top, just on the sides and back. So, you obviously need to wear a hat with it.
This is the hat in my picture. (Amazon Affiliate link)
You can wear any hat that you own with the wig though.
Red Devil Round One- What to Expect
I felt pretty good going into my first chemo session. I was anxious about how I would react to the medications, but I was ready to get round 1 over with.
My two nurses were both young and bubbly. One of them had a baby who was the same age as my younger daughter so we bonded over that.
My infusion chair was comfortable enough, and it reclined. It also had a side table and a TV attached to it.
There was a curtain beside the chair that I could pull closed for privacy. I think I was one of the only patients who closed my curtain, but I liked feeling like I was in a room rather than out in the open.
How is it administered?
My AC chemo experience consisted of nurses hooking up an IV to the chemo port on my chest. They tape it on so the IV is secure enough for you to move freely.
What does it look like?
The nurses then change out the bags of fluid on the IV machine in order to put the pre-meds and chemo into your body. I had several different pre-meds at each chemo treatment including an antacid and steroid.
The actual bag of Adriamycin and Cytoxan is red in color and is the reason for the nickname: The Red Devil.
AC Chemo Experience
Shortly after the nurse hooked me up to the IV, I realized I was starving. I hadn’t been able to eat much that morning because of nerves.
The nurses told me to go ahead and eat because I probably wouldn’t feel like it afterward. This turned out to be great advice!
My husband went to the cafeteria to grab Subway. I was able to get up and walk around with the IV machine if I needed to use the restroom or anything.
(I remember wondering if that was allowed before going in for my first treatment.)
When it was time for the Adriamycin and Cytoxan, my nurse brought a cup of ice. I chewed on the ice because keeping your mouth cold is supposed to reduce mouth sores, which are a common chemo side effect.
Once I had finished with this infusion, the nurse attached the Neulasta On Pro device to my arm and went over all of my instructions for my medication.
Overall, I think I was there for about four hours. My husband was with me the whole time and drove us home when it was over. I could not have driven myself because the nausea meds made me loopy/drowsy.
I felt okay until about an hour after getting home. After that, I went to bed and slept until my husband woke me up to eat dinner later that night. I had zero appetite, and I felt like if I moved (even a tiny bit) I was going to vomit. So, I ended up not eating and just mostly sleeping that first day.
Worst Days for Nausea
Every few hours throughout the night, I would wake up to take my nausea medicine. I recommend either putting someone else in charge of this or keeping a notepad and pen beside your bed to document when you take your pills.
I was often confused about which pill I had swallowed and what time I had taken it. In the moment, I always felt like I would remember, but I never did!
The next day I still didn’t have an appetite, and I realized that I couldn’t keep any foods down. I was able to drink water, but even one bite of a banana came right back up.
I tried to eat a few more times throughout the second day, but I was so nauseous that I couldn’t stomach anything. So, I called my oncology nurse, and she prescribed a different nausea medicine to help.
It worked much better with the nausea, and I never got sick again after taking it. I was pretty much in my bed for a full 5 days; though, as these were the worst days for me with each round of AC chemo.
Even though the nausea went away, I had no energy and just wanted to sleep. I tried to get up and visit with my family as much as possible, but I could only stay up for about an hour before needing another nap.
Neulasta and Bone Pain
Neulasta is the medicine that helps your body fight infection since chemo causes your white blood cell count to plummet.
At the end of each AC chemo, the infusion nurse would attach the Neulasta OnPro injector onto my arm. The device would automatically give me an injection the day after chemo.
This way I didn’t have to drive back to the doctor, and I could get the medicine at home.
Neulasta can cause bone and joint pain, which some allergy medicines are supposed to help with. You can ask your doctor about recommendations if you suffer from joint pain. I did get flu-like body aches after the first round of AC chemo.
Chemo Hair Loss
After the first week, I was mostly back to normal. I noticed my hair started itching and hurting my head.
It felt similar to taking down your hair after wearing it in a tight ponytail.
It got so annoying that I ended up shaving my head about two weeks after my first infusion. This was really emotional for me, but I felt so much better after it was done!
Adriamycin and Cytoxan: Rounds 2-4
The first round of AC chemo was the worst for me. Once the nurse changed my nausea medicine, I didn’t get sick to my stomach any more.
I did get sleepier DURING the chemo sessions though and just kind of laid there with the TV on.
Looking at my phone or a magazine made me feel nauseous…kind of like reading in the car.
I also didn’t really want food while I was there. If I did eat, it had to be something bland like french fries or crackers, but that was about it.
After each session, I continued to mostly sleep for the first 5-7 days.
I also never really remembered this first week after an infusion.
I watched TV shows and had conversations with people that I would have absolutely no recollection of the next day.
A lot of that may have been due to the nausea medicine I was taking and not the actual chemo though.
Surviving The Red Devil Chemo
Overall, Adriamycin and Cytoxan were the hardest things I have ever been through. It was nice that I had 21 days between each round so that I could recover and then have a couple weeks of normalcy.
Once AC chemo is over, you feel so much better! You really realize that you are stronger than you think you are and that you can handle anything!
Do you have any tips for surviving the Red Devil chemo?
Share them with us below!
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