Finding Comfort and Connection in the Chemo Lounge

I’m sitting in a reclining chair in the chemo lounge of Christus St. Vincent Regional Cancer Center, in Santa Fe New Mexico waiting for the pharmacy to deliver the Tylenol and Benadryl I need before one of my four scheduled weekly infusions of Rituxan.

For years, my doctors and I assumed that my mild anemia was due to long-distance running. Maybe it was — but this is something new.

My new family doctor, who specializes in geriatrics, prescribed an antiviral medication used to treat shingles. The seven-day regimen left me nauseated and 10 pounds lighter, but the itching persisted. It wasn’t shingles, as confirmed by two dermatologists.

Eventually, an experienced chronic lymphocytic leukemia (CLL) oncologist diagnosed me with CLL — and with it, autoimmune hemolytic anemia (AIHA), a related condition in which the immune system mistakenly destroys red blood cells.

My wife, Judy, accompanies me to the cancer center. The visit begins with an orientation from Joyce, our oncology nurse and educator. Thankfully, Joyce is the parent of a friend of our daughter’s school’s running team, and Paula — another oncology nurse — has a son who played soccer with our son. It’s great comfort to be surrounded by familiar faces.

Still, I’m not well-suited to sitting in the chemo room all day. I struggle with hyperactivity and inattention, which means constant fidgeting, restlessness and difficulty concentrating. I also have degenerative disc disease; sitting too long causes my back to stiffen. So I pace the floor, trying to release pent-up energy without disturbing others. The nurses kindly allow me to wander.

Rituxan works by removing lymphocytes from circulation. It recruits the patient’s own immune cells to attack B-cells. Researchers suggest Rituxan may engage macrophages — a type of white blood cell — to "eat" B-cells through a process called antibody-dependent phagocytosis. It also appears to cause B-cell death through cell lysis.

About 10 minutes after the infusion began, I break into a full-body sweat. I signal Paula and another nurse, and they stop the infusion. I’m given dexamethasone, a steroid commonly paired with Rituxan. The nurses offer a warm towel and washcloth, and I return to normal.

My autoimmune hemolytic anemia may have been lurking for months. For the past weeks, I’ve had relentless nighttime itching that disrupts my sleep. A cold shower offers temporary relief, but it’s maddening. I’ve often been at my wit’s end.

AIHA is a disorder in which the immune system mistakenly targets red blood cells. Instead of protecting the body, the immune system breaks down these cells prematurely.

By late afternoon, everyone is tired. My infusion bag still has a way to go. Paula sits down across from me, rests her head on her hand, and gives me her full attention.

“I remember you were a fast runner,” she says. That simple sentence opens the door. Running has been my primary recreation since I started marathons in my late 50s. Time passes more easily as we talk. She shares plans for an upcoming trip to Big Bend with her husband. I told her how my brother-in-law loved that region and often took solo wilderness hikes there.

Talking with Paula felt like catching up with an old friend. Though we barely know each other, we share a neighborhood and a history through our children. That brief conversation lifted my spirits. It helped me relax — and prepare for the next visit. I will always be grateful for having such a thoughtful oncology nurse.

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