with elimination. She could expect to stop menstruating immediately, but she told her that it was not impossible that she would menstruate again after chemotherapy. The eventual sterility rate was fifty percent, but that gave her an even chance of still having a baby, if she still had a husband, Alex thought to herself, as she forced herself to listen to the doctor. And Dr. Webber went on to reassure her that there was no evidence of birth defects afterwards.
There were potential, but remote, problems with bone marrow, though, and her white count getting too low, but these were less than likely. And bladder irritations were not uncommon. Only the weight gain surprised Alex, it would have seemed that with the nausea and vomiting she would lose weight and not gain it, but the doctor explained it just seemed to be an unavoidable factor, like the hair loss. She suggested that Alex go out and select a wig she liked immediately, even several of them. Given the drugs she would be taking, it was almost certain she would lose all or most of her luxurious red hair. But it would grow back afterwards, the doctor reassured her.
The doctor was as informative and as reassuring as she could be, and Alex tried to pretend to herself that she was listening to a new client, and had to hear all the evidence before reacting. It was a good system for her and it worked for a while, but as she continued to listen, what she began to hear couldn't help but overwhelm her. The nausea, the vomiting, the loss of hair, the relentlessness of it made her feel breathless.
The doctor explained that she would have a physical exam each time she came, a blood test, and regular scans and X rays, all of which could be performed in her office. They had the latest state-of-the-art equipment. She told her that she would be taking an oral drug, Cytoxan, for the first fourteen days of every four-week month, and then she would be coming in for methotrexate and fluorouracil intravenously on the first and eighth days of that same four-week month. After the intravenous drugs were administered, she could go back to her office. She wanted Alex to be careful to rest more than usual on the day before they were given to make sure that she minimized the problems and didn't lower her white count.
“I know it all sounds very confusing at first, but you'll get used to it,” she smiled. Alex was startled to realize they had been talking for almost an hour when the doctor led her into the next room for the examination.
Alex undressed carefully, folding her clothes on a chair, as though each moment, each gesture mattered, and she found she couldn't control her shaking. Her hands were shaking like leaves, while the doctor looked at the surgical site and nodded approval.
“Have you picked out your plastic surgeon yet?” she asked, but Alex only shook her head. She hadn't made that decision. She didn't know if she even wanted reconstructive surgery. The way things were going she wasn't sure she cared. And thinking about that brought tears to her eyes, as the doctor pricked her finger for her blood count. Suddenly, there was a catch in her throat for everything, and as the doctor set up the IV, Alex suddenly found herself sobbing and apologizing for it.
“It's all right,” the doctor said quietly, “go ahead and cry. I know how frightening this is. It won't ever be as scary as the first time. We are very, very careful with these drugs.” Alex knew that that was why it was so important to have selected an excellent and board-certified oncologist. She had heard horror stories of people who had been killed by improperly administered chemo. And she couldn't help thinking about that now. What if she had a reaction? What if she died? What if she never saw Annabelle again? Or Sam? …even after the awful fight they'd had the night before. It didn't bear thinking.
Dr. Webber began an IV infusion of dextrose and water first, and then she added the drug to it, but the IV kept backing up, and her vein collapsed just after they started. It was painful, and Dr. Webber immediately took the IV out, and looked at Alex's other arm, and then her hands, which were still shaking.
“I generally prefer the dextrose and water first but your veins aren't looking so great today. I'm