Monthly Archives: October 2010

The Morning After

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As Christine posted yesterday, I fell asleep during Chemo at about 4pm on the day of the first treatment (Wednesday). From that point forward Christine tells me that I was never really awake until for more than about 20-30 minutes at a time between then and when we went to bed at 10.

At 6am Nurse Stine woke me up to have me take my pills and have some food. The two medicines that I have been prescribed at this point are both antimetics  (used to treat and prevent nausea and vomiting). Twice a day for the first two days after chemo I’ll be taking dexamethasone. It’s a steroid used to treat a number of ailments, but it’s also pretty good at shutting down the vomiting center in the brain. On top that I have a prescription for Prochlorperazin, this is an additional “take as needed” for nausea. After a light breakfast in bed to go along with my “take with food” pills, I slept until about 11:30. So I think it’s pretty fair to say that I slept from 4pm – 11:30am. Good Game, Chemo! Good Game!

I’m writing this about 2:30 in the afternoon on Thursday and so far I have no problems or adverse reactions to the chemo. This is to be expected from what I understand, and that first day is generally a good day. The cancer cells are under attack and my symptoms are just about gone again. On top of that I haven’t experienced any nausea or discomfort yet, though we are by no means out of the woods yet.

The only side effects I do have right now are from the pills controlling the nausea and possibly from the chemo itself. A general cloudiness and slight emotional numbness. Just sort of that “I don’t feel like myself like of way.” But the feeling is minor, and if it is between this feeling or being nauseous all of the time, for now I’m picking this. Physically I feel little weak, but not to the point that I need help with anything (though its nice to have!). I notice that my hands are pretty shaky while I’m typing this, and I’m not really great at walking in a straight line from place to place when I’m walking. I’m not really walking slowly, but when I do, I don’t always wind up at the point that I was aiming for in the step in front of me. I sort amble like I were a little buzzed. But all in all, I really don’t have anything to complain about yet.

I haven’t really talked much about Chemotherapy  yet, mostly because I’m just learning myself. I’m on a cocktail of 4 drugs that are given intravenously every two weeks. Each drug does something different and goes about finding and attacking cells a little differently.  Once “cycle” of chemotherapy is 4 weeks. So Wednesday I was given dose 1A, then in two weeks I’ll be given (i think) an identical dose, dose 1B. Before the next cycle (cycle 2) starts we’ll be meeting the oncologist again, and she’s decide at that point whether to adjust the meds at all.

As for how chemotherapy works, I really only have a basic understanding   I have mentioned on several occasions that most of the cancer tests (like PET Scan) take advantage of the fact that cancer cells are highly metabolic and can multiply up to 20 times faster than normal cells in the body. Most of the chemotherapy drugs also take advantage of this and are designed to seek out and destroy quickly dividing cells. I could be wrong, but I think at its simplest level the drugs attack any cell that is dividing at that moment. And that by playing the odds, if it’s dividing, it is more likely to be a cancer cell than not. From what we were told on Wednesday, one of the drugs is actually some kind of “bio-marker” which tags certain cells and encourages the bodies natural immune systems to attack these cells.

The downside of this “scorched earth” style of chemical warfare is that the majority of the other systems your body take a hit as well, but its more devastating to the cancer cells and tumors. The systems within the body that are most notably effected are not surprisingly those systems which have higher rate of cellular turnover. Most parts of the digestive system: mouth, esophagus, stomach, intestines. The skin, and fingernails/toe nails. And of course the hair follicles. This leaves most cancer patients which rough, splotchy skin, no hair, miss-colored fingernails, and they are a little nauseous most of the time.

So the idea is hit you hard one day, then your body spends the next two weeks recovering. Then you hit you again. You take two steps forward, then one step back. And that hopefully which each step back, we’re killing more cancer cells than anything else, and that eventually the body will win this battle of attrition. But based on how I feel at the moment, for the sake of timing, I might just hang the “Mission Accomplished” flag above the couch now.

Now if you’ll excuse me, I need to wrap this up. Apparently Dr. Stine and I are still getting use to this whole “cancer patient and nurse” dynamic here, and after some miss-communication I may or may not have taken two of the pills that I was supposed to take one of. We called the pharmacist, and while it’s no big deal, I need to get this post all wrapped-up for tomorrow, because apparently I’m about take a little nap now!

Have a good weekend everyone! Check back on Monday to see if whether or not we were able stave off the nausea this weekend!

“Chemotherapy and You”

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I think we may have have survived our first chemotherapy treatment.  I’m a little worse for the wear, but the medications that we were given to control nausea have seemed to have done the trick for now. This is very encouraging as we have been told that the first treatment gives a really good baseline for how the body will react to future infusions, at least in the short run.

In the long run of course the repeat treatments will certainly start to take their toll on the various systems in my body. But at least think the nausea from the initial poisonings chemo treatments might be bearable. (I hope!)

Starting on Saturday however I did start to experience one of the side effects of chemo. Mouth sores! If you remember from Friday, I talked about the fact that chemo works by attacking rapidly dividing cells (good and bad) and in that sense the mouth is one of the most active places in the body. The mouth is constantly changing and replenishing itself, and is often known as one of the fastest healing places in the the body. (Think about how comparatively fast it heals when you bite your tongue, or burn the roof of your mouth).  Hopefully that will keep these sores from staying around for very long, but it’s the same thing that makes it a susceptible area in the first place.

We’ve been reading about mouth sores AND MORE in our new favorite pamphlet “Chemotherapy and You.” We’ve read and been given tons of reading material, but I kept waiting for something with such an awesome title! I also would have accepted: “So, you have Cancer,” “My first cancer,” “Cancer and Me,” or “Why does Billy have Two Mommies.” I even love  tranquil, meadow/forest scene on the cover. It’s Perfect!

I even asked if the Sound of Music field on the cover was where I could expect to be receiving the chemo treatments. It is not. Just when I thought I couldn’t be more excited for the “Chemotherapy and You” book, I opened it up and saw that it was illustrated in the fashion of an airline safety manual. I could hardly contain myself with laughter and excitement and by this time I think the nurse thought that we were both our of minds. Sometimes I just don’t think that they are always prepared for cancer to be this much fun!

Talk to your doctor if you have concerns.

But yeah, these mouth sores suck and are the biggest side effect that I have right now. It’s like have a dozen or so canker sores on the sides and under the tongue as well as on the floor of the mouth.  As well as just the general weakness. I’ve been taking it easy though, trying to not to get up and move around much. But we’ll see how it goes. Apparently this is how I’m supposed to check:

Thanks “Chemotherapy and Me!” Now I know: open your mouth, and close your eyes.

Here is hoping that they go away as fast as they showed up!

I may have spoken too soon

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I feel sort of guilty about yesterday’s blog post. Well, maybe not guilty, but I certainly feel like I’m not painting the whole picture. You see, yesterday’s post was written on Saturday, and when I wrote it on Saturday, I didn’t know that Sunday was coming.

I almost hate to use the phrase, but the only way to put it would be that Sunday was a “bad day.” At least I hope it was, because if wasn’t then that means that the worst from Wednesday’s treatment is not behind me.

The story of Sunday is still a story of the mouth sores. SO TERRIBLE! When they woke me up in early in the morning we knew that it was going to be a serious problem. Christine called the 24 nurse hot-line to see if there if there was anything that they suggested. Oddly enough there wasn’t much available in their database of knowledge. Whoever Christine spoke to even admitted that she was surprised that there wasn’t much info available, other than it’s an expected side-effect and isn’t something that should be of great concern. I get the feeling that while mouth sores are a common side-effect of chemo, the debilitating intensity with which I was experiencing them might just be my own trademark experience.

The nurse on the phone was able to offer us some help, and after a quick trip to the 24 hour Pharmacy at the hospital, Christine came home with a prescription mouth rinse. It was described to her as Maylox-Benadryl-Lidocane mixture. Shake-well, add some water, swish it up and you should be good to go within 20 minutes.  The taste wasn’t too bad, and it did do the job for a while. The key ingredient is the lidocane, which is the same numbing agent that dentists use orally to numb the injection site before administering novocaine. So yeah, it tastes like that.

It worked for a while throughout the day, but by mid-day even with the rinse I couldn’t eat or drink anything. Even water made my mouth burn so much that I couldn’t drink it anymore.

My family was over for the day on Sunday which was great! But I was generally unavailable to them as I was on the couch just trying to ignore the discomfort I was in. Later in the evening Christine and I went for a walk around the block to get out of the house and I broke down a bit. I was weak from the treatment and weak from not really being able to eat and it was just one of those little moments that I had “prophesied” about earlier in the week. I was living a vision of what the next 8 months of my life are possibly going to be like and I cried as we walked around the block together.

By mid-day on Monday I could eat and drink again but it still hurt, but as my mouth slowly got better I began to get a sore throat that even now (on Monday night) it still causing a good deal of discomfort, but at least I can eat now.  My mouth still hurts, but not as much in the burning sores kind of way. It’s still there, but now there is also a dull aching in my teeth and gums. Not really sure what to make of that yet, but now I feel that the worst is over (until next week when I go back to chemo, at least).

“But Everything Was Going So Well!”

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As I’ve stated, I write the day before and set them to post early in the morning. So as I write, I’m hyper aware that right now I am missing the first rehearsal for for the show in which I was cast before I got cancer, and which I subsequently had to drop out of.

Getting that gig marked a really important milestone for me, it was a full year of solid work in the theater. The show at the Children’s Theater started rehearsal last October and ran through the end of January. Two weeks later I started rehearsal for another show and then the day after that show closed I started into the summer shows… In short, I’d had a great last year and was already set to start the 2010-2011 Season off on a great foot!

It’s probably the one thing that we kept coming back to when we first got the news (a month ago today): “Everything was going so well.” We were both working jobs that we loved, Christine was about to start the her MBA Program, and we had started making some real plans for the future. And it was a future that we could both see taking shape. Again, everything was going so well.

I do believe that everything happens for a reason, and I know that when we emerge from this period of our lives we’ll see how we have changed for the better. But that doesn’t make the changes easier to stomach in the short term (not that  I would expect it to). But at the same time, I just finally felt like I was on the right path for once and that it was working out. It’s just frustrating.

I guess I just wish that I was at work right now. But then again, I would probably just be sitting in rehearsal wondering if I was going to have tomorrow off. =)

How Quickly I Forget

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Emily emailed me in response to yesterday’s blog post and reminded me of something that I had said to her last month. We had spoken a few weeks ago about how I was (at the time) actually enjoying the slow down in our lives. There had been a lot of noise and a great build-up of anticipation in our lives that was suddenly silenced when we got the news, and for a while it was really nice. Christine and I stopped and took a breath, we just sat together for a few days and began focusing back on what was important. It’s amazing how fast I lost sight of that and needed to be reminded that this diagnosis has brought the important things back into focus in our lives: our relationships with each other, and with our friends and family.

It’s a lesson that we will need to continue to learn. Old habits die hard and it will probably take this treatment course and the subsequent rest of our lives to learn to appreciate what we have and to not be impatient. It’s hard, the world moves pretty fast and when I wrote that yesterday I was feeling like it was passing by without us; I had forgotten to take a breath.

I’ll probably forget again soon.

Today was a good day. It was a beautiful sunny day and I took the dog for a walk. I was ambitious and set of for the long version of our walk but wound up turning back short of the halfway point when my legs started feeling the strain, so it wound up being about a mile and half walk rather than my intended 2 miles. Regardless of feeling my limitations it felt good to get out.

It’s been a week after my first dose of chemo and I’m dangerously close to maybe almost starting to feeling a tiny bit closer to normal again. I don’t expect to get to 100% by Wednesday when we go back in, but I should hopefully be at like 80%. And since I probably won’t feel like 100% until next spring or early summer, 80 is the new 100. And when this is over and I do get back to 100, I’ll have forgotten what it was like and I’ll pretty much be Superman.