A/N: As the chapter title indicates, this chapter will deal with Donna's first chemotherapy treatment. I've done lots of research, and I hope this is accurate. I hope you enjoy, please read and review!

Chapter 10: Chemotherapy

Chemotherapy, Donna thought. Also known as poisonous drugs being used to rid her body of cancer.

She knew a little about it from research, but she was sure there would be a whole host of side effects that no one told her about beforehand. Not to mention that she was extremely worried about the fact that cancer had reached her lymph nodes. Dr. Phillips had said that there was a trace amount-not enough that it had completely taken over her body and metastasized, but enough that chemo was warranted to kill off every last cancer cell in her body. She would take nausea and fatigue over dying any day.

True to his word, the next morning, Dr. Phillips came in with a list of chemo drugs and sat down with her and Josh, explaining each course of treatment and its pros and cons.

"Now, with where you're at, and the fact that your particular cancer is HER-2 negative-"

"I'm-I'm sorry, what does that mean?" Donna asked, slightly perplexed by the addition of the new vocabulary.

"So, HER-2 refers to the protein hormone epidermal growth factor receptor 2. When this is present, then your body has a much harder time fighting off the cancer, and it's more likely to recur. But in your case, you tested negative for the protein. The good news for you is that it means a shorter length for your treatment."

"How short are we talking here?" Josh asked. He was sitting by Donna's chair, stroking her hand comfortingly.

"Well, that depends on what path you want to go for. You can do IV chemo or oral chemo, though I strongly recommend IV chemo."

"And how long would the IV chemo last?" Donna wanted to know.

"So, I am going to recommend this particular combination of drugs, Doxorubicin and cyclophosphamide, followed by paclitaxel." Dr. Phillips answered, handing them both a sheet of paper with a list of dosages and the two different timeframes of receiving them.

From what the paper said, Donna would receive the first two drugs on a cycle of once every three weeks for a total of four cycles, followed by the third drug once a week for 12 weeks.

"So, this is what, six months of treatment?"

"There is also dose-dense chemotherapy, where we would give you the medications once every two weeks, instead of every three weeks and then every week. The first would be about 16 rounds over six months, while the dose-dense would only be about 8 rounds and 4 months."

"I mean, four months is better than six months for sure," Donna said, mulling it over. "What exactly would be the difference between dose-dense and the regular chemo plan?"

"Shorter treatment time, plus it hits the tumor cells harder and faster. The only downside would be a decrease in white blood cells due to the decreased span of time in between treatments. But we would put you on a growth factor to increase your white cell count."

"That sounds reasonable. Would it affect my ability to do work more than if, say, I had treatment every three weeks?"

"Not necessarily. You would probably want to be working from home a little more on days where the side effects are harsher, but you would do that anyway, right?"

"Yeah, I would. What would you recommend?"

"It really is up to you and Josh. If I were you, though, I would do the dose-dense, because you'll be finished with treatment that much sooner. But that's just the timing-there are also real benefits. At your age, since you are in your early fifties and haven't started menopause yet, you would actually be benefitted by a dose-dense treatment. Studies have shown that pre-menopausal women who receive this treatment have a greater ten-year survival rate."

"Wow." Donna finally said. She turned to Josh. "I think I want to do the dose-dense treatment."

"You sure? I mean, yeah, standard treatment will be longer, but it probably has a better day-to-day outcome."

"Well, maybe we should talk about it some more, do our research."

"That's fine." Dr. Phillips assured them. "You don't need to make up your mind today. But we will need a decision in the next few days. Regardless of what treatment you pick, tomorrow, we'll be putting in a PICC line for your treatments. That'll be much easier to manage than being stuck every time you have chemo, and more temporary than a chest port. I'll let you guys talk this out now."

"Thank you, Doctor," Donna said gratefully. Josh nodded in acknowledgment.

The doctor smiled at them, then walked out.

"Wow." Donna breathed out as the door shut behind him. "Lots to talk about."

"Got that right," Josh replied.

"You think I should go for the standard treatment?"

"I just...what about side effects? Are they worse with the dose-dense treatment?"

"According to this, the side effects are no worse. The only difference would be 4 months instead of six months, and there would be an extra medication I would have to take."

"Right, the growth factor?"

"Yeah. And that'll actually help me be able to go back to work, because I'll be better protected. Whereas with the standard chemo, I might be more limited if my white cell count is low."

Josh appeared to consider this. "That's true. Is this really what you want?"

"I think it's what's best for me, my body, our family, and our lives."

Josh nodded. "Okay. Then let's do that."

…

After additional research and plenty of discussions, Donna and Josh had concluded that the dose-dense, 8-cycle chemo treatment would be best for her based on her type of cancer, her age, and the likelihood of continued remission. On Thursday, she underwent a procedure to put a PICC line catheter into her arm, which would allow her to receive her medications on a streamlined basis without being stuck for an IV multiple times. It was a small catheter that went into her arm and ran up her shoulder into her chest, towards her heart. On Thursday evening, the kids and Annabeth came up for another visit. CJ had had to get back to California for work that afternoon (a budget meeting she couldn't get out of) but had promised to return within the next several weeks.

"Is that the PICC line, Mom?" Abby said curiously.

"Yeah," Donna told her, pulling up her hospital gown to reveal an IV-like line taped down to her upper arm. "It's a way I can get my chemo without having to be stuck all the time." She turned to the rest of the kids. "So, you guys know how chemo works, right?"

The older three nodded. Leo shrugged.

"It's more systemic than radiation would be. Um, I'll probably be feeling sick to my stomach a lot, I'll be a lot more tired than usual, and I'll be more susceptible to infections."

"That means if your friends are sick, don't bring them home, and if something starts going around, you might have to stay home from school." Josh elaborated.

"And you'll lose your hair," Anna said. It was more of a statement than a question.

"That's definitely a possibility," Donna replied. "Another thing we'll need to talk about is scheduling. I'll need to go for chemo treatments once a week every two weeks. So, on those days, you'll need to get yourselves home from school and fix dinner for yourselves since I'll likely be out of it most of the day. And you guys will need to do more around the house if I'm not feeling my best. Do you understand?"

The four looked around at each other. Finally, Matty said, "You got it, Mom."

"Sure, Mom." All three of his siblings chimed in.

Donna smiled, tears welling up in her eyes. She didn't know what she did to deserve such an incredibly supportive family.

And the next morning, they drew blood in preparation for chemo, just to make sure she was healthy enough to receive treatment, while they mixed her combination of drugs. It was a procedure she would have to get used to.

Finally, around 11:00, her nurse Connie wheeled in her very first dose of treatment.

"Ready, Donna?" Connie said as she pulled the IV pole to a stop next to Donna's bed.

Donna took a deep breath. She smiled at Josh, who squeezed her hand comfortingly.

"Ready as I'll ever be, I guess." She replied.

With that, Connie disinfected Donna's IV tubing and hooked up the line with the chemo meds. Donna leaned back and closed her eyes as the drugs dripped into her bloodstream.

…

The next morning, after a brutal day and a half of treatment and its varying side effects, Dr. Phillips deemed Donna well enough to return home, so long as she took it easy for the day.

Donna was taken out of the hospital via wheelchair, which was probably just as well since she was so exhausted she could barely lift her head. Chemo fatigue had set in hard.

Josh helped her up and into the car. Nausea and fatigue had been the major side effects for this round, with the doctor warning them that other side effects were likely forthcoming.

Josh felt his own nausea rise every time Donna vomited into the emesis basins provided by the hospital. It was cruel, actually; she could almost never make it to the bathroom like she normally would because the fatigue wiped her out to the point of simply shuffling along the floor. It had taken nearly every ounce of her strength just to dress and brush her teeth that morning.

Josh eyed her sympathetically as he drove along the 15-minute route to their house. She sat in the front seat, head back on the headrest, her eyes closed.

Just then, he saw a text alert from Annabeth: Just arrived to help the kids get the house ready. See you soon!

"Annabeth just texted me. She and the kids will be waiting for us when we get home."

"Mm." was all he got in acknowledgment. He sighed, turning back to the road. Once he got Donna settled at home, he was going to run out and get the prescriptions meant to ease her side effects, as well as the prescription for her growth factor, filled.

In what seemed like no time at all, they were pulling into the driveway. Josh left the car in park and jumped out to help Donna out of the car.

Opening her door, he offered his hand as she stepped out. "Just take it easy, baby." He whispered as she walked alongside the car and towards the front of the house.

Annabeth walked outside. "Welcome home..." She started to say, then trailed off as she saw how weak Donna looked. Her entire demeanor changed.

"What do you need?" She asked immediately, seeing that Josh had his hands full.

"Um…can you get the bags from the car?"

"On it." She said, racing over to the trunk as Josh helped Donna inside.

The four kids were all in the foyer when they arrived. Like Annabeth had been, they were all smiles.

"Hey, Mom." They all greeted, before it hit all four of them how exhausted she was.

Anna started. "We, um, made a bed for you in the living room, so you don't have to manage the stairs."

"Thank you, baby." Donna said gratefully. She went into the living room, where sure enough, there were sheets, pillows, and a blanket on the couch. She eased down, and Josh helped her get comfortable. The kitchen trash can was nearby, in case she needed to throw up.

"Is there anything else we can do, Dad?" Matty said awkwardly.

"Nah," Josh replied. "You guys can go upstairs if you want."

Only Anna remained downstairs as the others disappeared upstairs. She sat down on one of the easy chairs while Annabeth sat on the other.

Josh stood. "Okay. I have to go get your prescriptions filled. You gonna be okay here with Annabeth?"

Donna nodded her assent. "Go on. I'll be asleep in a few minutes anyway."

"I've got her, Josh," Annabeth reassured him. Anna nodded in agreement.

Josh nodded, then kissed her forehead as she burrowed deeper into the covers. "I'll be back in a couple of hours."

An hour later, Annabeth was working on her computer, and Anna was reading. Just then, there was a knock on the door.

Anna jumped up to answer the door. "I'll get it."

She was stunned when she opened the door to find two or three Secret Service agents on the porch.

"Can I help you?"

"We need to do a quick sweep, ma'am." One said.

Anna nodded. The agents came in and did their thing.

She tried to wrack her brain. Had Uncle Sam or Aunt Ainsley said they were coming by for a visit? No, there would be more agents. This protocol seemed more for a former-

"Hi. Anna?"

Standing in the doorway was Helen Santos.

"Mrs. Santos." Anna stammered. "What are you doing here?"

"Well, when I heard through the grapevine about your mom's chemo, I thought I would come see if I could be of help."

"And you wanted to see Mom for yourself?"

"Well…yeah," Helen admitted. "You are Anna, right? I'm sorry, it's been so long that I-"

"Yep, that's me," Anna told her.

Helen's eyes traveled to her middle. "So...what I heard on the news is true. You're really-"

"Yeah. Almost 20 weeks. It's a boy."

"Oh, how exciting!" Helen exclaimed. Just then, their conversation was interrupted by a horrible retching noise. Helen rushed in ahead of Anna.

Annabeth was already at Donna's side, holding the trash can in front of her friend as she vomited.

Annabeth looked up, and she almost dropped the can. "Mrs. Santos?"

Helen nodded, rushing forward in a silent offer to take over. Annabeth hesitated, then nodded in thanks as they switched places. Helen began to rub soothing circles on Donna's back as her shoulders continued to heave.

"It's all right, you're all right, it'll be over soon," Helen said softly in a quiet litany.

Finally, after what was only a few minutes but seemed like an hour, Donna laid back down, falling asleep quickly as her energy was spent. Helen patted her shoulder as she stood up. She walked over to Anna, who had been frozen in the doorway the whole time.

"She'll be all right," Helen reassured her. "It's gonna be rough for a while, but she'll get through it. You all will. Now, do you need help with anything else?"

When Josh walked in with Donna's medicine, he had to do a double-take. Helen Santos was up to her elbows in soapy water, washing a pot that Josh hadn't gotten around to yet. Anna was wiping down the table with disinfectant wipes.

"Helen?" Josh asked in astonishment. "What are you doing here?"

"Just helping out," Helen answered. She wiped her hands on a towel and hugged Josh.

"Thanks for coming." He said sincerely. "Donna will be glad to see you."

"Helen?" said a confused voice from the doorway. They both turned to see Donna leaning against the doorframe.

"Hey, you." Helen greeted, crossing the room to hug Donna.

Donna smiled slightly as they pulled apart. "What are you doing here? Not that I'm not happy to see you, of course."

"I just wanted to come see you. I wanted to see if I could help and support you in any way."

Just then, a lightbulb went off in Donna's brain. "I wasn't seeing things? You were really there an hour ago when I was throwing up?"

Helen nodded. "Mm-hmm. And don't even think about trying to put me up. You're stressed enough I've made arrangements to stay with Peter in Virginia. It's only a couple-hour drive."

"Okay." Donna agreed. "I'm glad you came."

"Me, too," Helen replied, squeezing her shoulders.

Donna walked over to Josh. "Did you get my meds?"

"Yep." Josh spread them out. "Zofran for nausea and vomiting, mouthwash for mouth sores, and your growth factor. I also picked up some foods that'll be easier on your stomach."

"Thank you." She told him, kissing him on the cheek.

"Feeling better?" Josh asked her.

"A little, thank you." She picked up the bottle with the growth factor-labeled Neupogen-and said, "So how do I take this?"

"You put it through the PICC, so I have instructions for that," Josh explained.

Donna nodded. "Okay."

Annabeth came to join the three of them in the kitchen. "So, what can I do to help you through the rest of the day?"

Donna smiled at her, Helen and Josh. "For today and every day? Just be there, support me when I need you to, and we'll all get through this."

A/N: Hope you liked this chapter! The next chapter will start to explore some of the cracks for their kids and their emotions. Let me know what you thought!