Recently I e-mailed a friend that beginning chemotherapy treatments on Pearl Harbor Day felt like going to one’s doom. She wrote back, “No, no, no. Pearl Harbor Day was the beginning of our fight against the enemy. Look at it that way.”

I can’t help it. When the treatment prescribed for a condition spawns whole books on likely side effects and how to manage them, I still say it feels like doom. The National Cancer Institute (NCI) has produced one such publication. It’s called Chemotherapy and You. This little book lists nineteen potential side effects. Here they are:

• Anemia
• Appetite changes
• Bleeding
• Constipation
• Diarrhea
• Fatigue
• Flu-like symptoms
• Fluid retention
• Hair loss
• Infection
• Infertility
• Mouth and throat changes
• Nausea and vomiting
• Nervous system changes
• Pain
• Sexual changes
• Skin and nail changes
• Eye changes
• Urinary, kidney, and bladder changes

According to the booklet, some types of chemotherapy cause anemia because they make it harder for bone marrow to produce new red blood cells. The red blood cells carry oxygen throughout the body.

As my regimen calls for shots to be administered to boost the white blood cells, I think the white cell count is more of a worry. White cells are part of the immune system and fight infection. Apparently, about seven to fourteen days after treatment, the white cell count will be at its lowest. Fatigue and depression are common around this time. After this drop in the white cells, their numbers improve until the count is nearly back to normal. Then it’s time for the next treatment. This is, according to my oncologist, part of the reason why taking chemotherapy puts people on an emotional roller coaster.

Appetite changes can occur due to nausea, because the chemotherapy can make the mouth and throat feel sore, or because the recipient is depressed or tired. Ways to manage this include: Eating smaller meals or snacks instead of three big meals a day; drinking milkshakes, smoothies, juice, or soup; and using plastic forks and spoons. This last one surprised me. Some kinds of chemo leave a metal taste in the patient’s mouth, according to the NCI. Eating with plastic can help decrease the metal taste. Cooking in glass pots and pans is also said to help.

I’ve dealt only briefly with the first two side effects, and already I’m scaring myself. I’ll write about the other side effects another time.