This Might Be the Week I Develop an Eating Disorder

I had treatment number three last Friday.  It was slightly unusual in that they had problems with my port.  The first nurse who tried to insert the I.V. tried and failed twice and apparently saw enough blood to inspire her to give up up and call in reinforcements.  I guess some nurses are just better at it than others.  Thank God I always opt for the lidocaine before they start working the big needle.  (I can't believe I just said always like this is the new norm already.)  Once they got the needle in, they couldn't draw blood from the port.  It's essential that they be able to put things in the port as well as get a blood return from the port.  Something about the circulation and adriamycin not sitting around destroying all of my tissues and what not.  They concluded the port was clogged.  The solution was to inject my port with some enzyme that they compared to Draino (which would not actually surprise me at this point).  Then I sat and marinated for an hour and waited for the clog to dissolve.  I guess the point is don't be in any hurry when you're scheduled for an infusion.  The rest went as expected.

Sometime recently, I saw my physical therapist.  I'm making some good progress with my range of motion in my left arm.  The thing I love best about my PT is that she does not ask me about my mood.  I don't know how many doctors have asked me to rate my mood on a scale from one to ten or indicate my level of distress on a questionnaire according to smiley face, flat face, frowny face, etc.  I recognize there is a reason to ask, but I just find it so exasperating.  I want to ask, "am I in the right place?".  "You do know I have cancer right?"  It makes me want to scream, scratch out the faces, draw a picture of my middle finger, tear the paper to shreds, burn it, and stomp up and down on the ashes until I collapse into a pile of hysterical laughter.  Instead, I reply, "my mood is stable".

I was at church Sunday when a woman asked me if I'm pregnant.  If that doesn't take the cake.  Can't a girl have a little post chemo bloating without her family planning coming into question?  At least we know I'm heeding my oncologist's orders to keep my weight up during treatment.  I continue to eat despite the fact I have no appetite.  I'm also taking twice the recommended daily allowance of both Prilosec and laxatives per my oncologist.  (Sounds like the right foundation for that eating disorder I mentioned.)  In case anyone is wondering, I am under strict orders to not get pregnant.  The radiation oncologist (different from the medical oncologist previously referred to as "oncologist") told me that it makes everyone look bad if I have a baby with two heads.  Then there is the fact that chemo has sent me into menopause.  Assuming I were to come out of menopause after treatment, which is a big maybe, I have to take Tamoxifen for five years after my treatment which is also not compatible with pregnancy.  By then I should be around 46.  So for the record, there should be no reason to EVER ask me if I am pregnant.  For that matter, there should be no reason to ask any woman if she is pregnant unless there is incontrovertible evidence such as the baby is crowning.  On the bright side my mother-in-law put a hex on the woman involving the fleas of a thousand camels, nether regions, and short arms.  That made me feel considerably better, elevating my mood to a double smiley face.  

Chemo Brain, What's in a Name, and Other Random Thoughts

I was warned about "chemo brain", but so far it's not what I had expected. I was thinking perhaps I would misplace my keys or not be able to recall someone's name.  Since these are things I do already, my plan was to live happily in denial and simply not notice any cognitive impairment.  My keys are in my purse, my name is Paula, and I find myself forgetting things I would not have thought possible to forget.  For example, last night I had to check three different cupboards to find my drinking glasses (which have been in the same place since we bought this house last October).  One of my friends suggested the next time this happens, I forget the glass and go straight for the bottle.  I think this is sound advice.

I was thinking about the names Adriamycin and Cytoxan.  Adriamycin, Adria for short, sounds like a pretty name for an interesting woman you might meet somewhere like hot yoga.  It doesn't sound like something that causes you to cry red tears or that may cause heart failure and/or leukemia.  Cytoxan sounds like something out of a season of 24. Former CTU agent, Jack Bauer, is closing in on a terrorist plot to release a lethal dose of the biologic agent Cytoxan in the NY subway system.  I wonder how it is they come up with these drug names.

I went to see my Psycho-oncologist yesterday.  He's probably an Onco-psychiatrist actually, but I think the other has a nicer ring.  Basically, he's a guy with multiple advanced degrees who is supposed to help me manage my fatigue.  He has instructed me to do moderate exercise each day and apart from that to employ energy conserving strategies such as organizing the things I need on one floor of my home or sitting to do things if possible.  He recommends doing the same exercise for the same amount of time at the same time each day (even if it requires scraping myself off the floor to do so). Because he has multiple advanced degrees, he says things such as "stimulating a biochemical pathway to create a vector."  Yesterday he told me that there is a subset of patients who after treatment continue to experience fatigue permenantly.  He said it's because they continue to "push themselves beyond their biologic capacity".  He said because of the downward spiral of fatigue they get in, they may push themselves beyond their biologic capacity simply by resuming their daily activities.  INSERT SCREECHING TIRE SOUND HERE.  What??!  Resuming their daily activities?  Oh my gosh, I forgot to set aside some of my daily activities.  I immediately thought, so far no one has given me permission to set aside any of my daily activities.  I also immediately realized that no one is going to.  I need to give myself that permission and figure out how to better orchestrate the setting aside where possible.  The goal is that I will recover from treatment more quickly.  My hope is that I will spend less time on the floor during treatment. 

Round Two

My hair started falling out in droves June 1, twelve days after my first treatment.  Kevin shaved my head June 2.  It's better to just shave it.  There's just something very disturbing about watching it fall out.  We did it with Midori there in the hopes that she would see the transition and be more understanding of the change.  She asked me for a couple of days, "is mama a boy now?".  "Is mama pretending to be a boy now?".  Other than some gender assignment questions she seems unphased.  I've received a lot of compliments on both my bald head and my wig.  I feel like I'm gradually turning into a plastic person.  Fake breast.  Fake hair.  My lashes are getting patchy.  Perhaps, I'll go for false lashes as a tribute to my silicon self. 

The Tuesday after my second treatment, I spent the morning on the bathroom floor in the fetal position.  I called the oncologist's service (from the floor).  When he called me back, I explained that my stomach was cramping/burning.  It literally felt like a five alarm fire in my stomach.  He told me to take some Prilosec which helped tremendously.  I spent most of the day laying in bed or partially propped up in bed.  Other than Tuesday, I've spent a good portion of each day up and about. 

I spent most of last night awake.  One of the anti-nausea meds that I take at bedtime for several days following the infusion is also a sleeping pill.  It wasn't in the regimen for last night.  I wonder if I'm developing a dependency.  I could call the oncologist, and I'm sure he would tell me about some more pills I can take to combat the side effects of the pills that combat the side effects.  I have become a walking pharmacy.  The worst of round two seems to be over although the very thought of another treatment makes me queasy.

In other news, I've lost my taste for chocolate and coffee.  Talk about adding insult to injury.  I find myself craving raw fruits and vegetables.  I have never craved a carrot stick in my life.  Let's revisit.  Fake hair, fake breast, fake lashes, subsisting on carrots.  Sounds more like a model than a cancer patient.  Ha!