Rituximab 1st Infusion. Check!

Yes, I was anxious. Yes, I got very little sleep.

But my first treatment wasn’t nearly as bad as my mind had imagined. I didn’t know what to expect, and I hadn’t found many firsthand accounts of the experience.

Overpacked?

I prefer to say I was prepared for anything an infusion might bring: starvation, frigid temperatures, extreme heat, dehydration, boredom or dry skin.

I fixed my hair, added a little glam and wore something cute but comfortable.

Why not?

We arrived at the cancer center at 7:45 a.m. and were immediately hit with an insurance and billing problem. It was unsettling at first, but the issue was resolved.

Then, just like that, the director waved us through as though we had paid admission for a roller-coaster ride.

We followed tight twists and turns through doors, flashing lights and a hallway leading to a door marked “Infusion Room.” Our imaginary coaster slowed almost to a stop. It hung there, and my heart skipped before the big drop.

The door opened into a large room filled with more than 30 vinyl recliners.

We waited for the financial counselor to arrive.

Trust us—we’re smiling!

Really, we are.

I met my nurse, Katie. I consider myself qualified to judge a good nurse by her needle work, and she was excellent.

She explained the infusion process and warned us that it would be a long day. We expected to be there for five and a half to eight and a half hours.

Before starting the rituximab, I received medications through my IV to help reduce the risk of an infusion reaction. I felt loopy and drugged, but I was ready.

The rituximab began with a very slow drip so my body could adjust. Nurse Katie checked my vital signs every 30 minutes—all day long.

Bobby left to get Starbucks, and my warrior sister in pink, Sarah, sat with me. She had an appointment of her own at the cancer center and knows this place all too well.

Her visit meant so much. Sarah received treatment during the pandemic, when visitors weren’t permitted. She is one of the strongest warriors I know.

She held my hand and tucked warm blankets around me.

About 45 minutes into the infusion, my throat began to itch. I could feel welts forming inside my mouth, and swallowing became difficult. Then my ears started itching, and my sinuses began to swell.

When Nurse Katie checked on me, I told her what was happening. She immediately stopped the infusion and checked my vital signs.

I was experiencing a serious infusion reaction.

She gave me another antihistamine, but the symptoms didn’t improve. I was terrified that my body might not tolerate the medication, but she reassured me that infusion reactions can happen and that the team knew how to respond.

The infusion remained paused for more than an hour. My doctor prescribed a steroid, and the reaction began to subside.

When treatment resumed, the drip was even slower.

And time began to tick.

I wasn’t in pain, but I was restless. I tried reading, working on a word puzzle and even folding origami, but the steroid made it difficult to concentrate.

Bobby returned and dozed.

I didn’t.

I watched the clock as patients came and went throughout the day. They smiled and then returned to their everyday lives, as though treatment were simply another item on a to-do list.

I may not know those people, but I can tell you this: They are amazing.

The remainder of the infusion continued without another problem. Nurse Katie kept checking on me and knew almost to the minute when we would finish.

She explained that next week they would begin with additional premedications and start the rituximab slowly. If my body tolerated it, they could gradually increase the rate. The second treatment might not take as long.

We arrived home around 4:15 p.m. I was hungry, tired and a little achy—almost as though I had the flu.

On Saturday, I felt fatigued and emotional. I couldn’t quite explain it beyond wondering, “Did yesterday really happen?”

It is still difficult to believe that I am facing a second cancer diagnosis. I also have an appointment with my breast cancer oncologist on Wednesday.

Oh, and did I mention that I was tired?

My stomach was unsettled, but so far I had no nausea. That alone could have completely changed my day.

It is now Sunday, and as I write this update, I feel pretty darn good!

I’m teaching a relaxing yoga flow today, and I’m looking forward to getting back on my mat.

The Science

Treatment for non-Hodgkin lymphoma varies depending on the specific type and individual patient. Some treatment plans include a combination called R-CHOP.

For my follicular lymphoma, my doctor chose to begin with rituximab alone.

Rituximab is a monoclonal antibody that targets a protein called CD20 on B cells. This helps the immune system identify and destroy certain cancerous B cells.

Coming out with Cancer: The C Word

I have breast cancer.

Saying it, writing it and even thinking it feels shocking, awkward and difficult. I know the person receiving this information often feels much the same.

The purpose of this story is not to explain whom I chose to tell. It is to acknowledge the simple fact that I had a hard time saying, “I have cancer.” I also want to share the reactions and responses that brought me peace—the ones that reminded me I wasn’t alone.

Telling my family was extremely difficult. It was Christmas, and our house was filled with people whose experience with cancer was still all too recent because of the loss of my brother. The holidays are a bittersweet reminder that he is no longer with us.

We chose not to share my diagnosis until after the holidays. It was difficult, and at times I had to leave the room with a lame excuse, but I can honestly say it was one of the best holidays we’ve had.

Somehow, peace and relaxation settled over all of us. What is usually a hectic time found us spending entire days together on the back porch—just being together.

Telling my closest friends was also hard. I overthought every detail, primarily because I wanted to make it more comfortable for the person receiving the news. I don’t know why.

In my mind, I rehearsed it. Should I say it by phone, by text or in person?

I couldn’t say the “C” word. I found myself using phrases like, “My biopsy wasn’t good,” or “I’m having a mastectomy.” Anything but that ugly word.

How would they react? How would I react?

I didn’t want to cry. I was tired of crying, but I always cried.

With each “cancer reveal,” I felt emotionally and physically drained. I needed a two- or three-day break between each conversation.

There was one friend I especially wanted to tell in person, but she was out of town with family. On Christmas Day, I accidentally sent her a text asking, “How was your cancer?” instead of, “How was your Christmas?”

Freudian slip?

Another friend simply knew instinctively.

It has been nearly three months since my diagnosis, and every day another friend is just finding out. It’s not as though I could send a mass mailing or make an announcement on the local news. Imagine telling a yoga friend just before savasana.

There is never a perfect time.

The good news is that each conversation became a little easier because of the loving responses. Yes, I received a few odd, dismissive or unexpected reactions, but I credit most of those to the shock and awkwardness of adding “cancer” to a conversation.

I hope cancer does not enter your conversations anytime soon. Unfortunately, it may someday. If it does, I want to share the responses that brought me the most peace:

Extra-long hugs.

A loving look.

Reminders of my strength.

Assurances that you will be by my side.

Someone holding my hand.

A joke that cancer has already met its match.

Continued encouragement and regular check-ins.

Most importantly, the “thoughts and prayers” offered hundreds of times. I felt loved each and every time.

There is tremendous power in thought and prayer.

It’s working, my friends.