Another treatment

I’m on my way into the City for yet another infusion of Abraxane. This is the part of the cycle that feels most like real chemotherapy. I mean, it’s all chemotherapy of course, including the nightly Temodar pills, the symptom management, and the daily entries in my drug diary. But this involves bags of intravenous drugs and most of a day in the Cancer Center.

I have clear, definable reactions to the Abraxane, in fact to the whole treatment cocktail: Pepcid, Kytril, Decadron; I know what to expect for the next few days in terms of my sense of taste, my energy, my hair, and my digestive system. At other times in the cycle, I can’t differentiate what is “reaction” from what is simply another ache, pain, or bodily expression of living and aging.

I’ve written about this part of the cycle before. Maybe I choose the topic because it’s easy to identify, easy to define, and therefore, easy to live with.

In any case, I’m halfway through the fifth treatment cycle. There are two more weeks of Temodar pills to take and on April 21st I’ll have another scan that promises to be very telling. It will either resume improving from where the last scan stalled, or it will continue along in plateau mode. It could mean changing the course of treatment if there is no further improvement, a development I don’t like to think about, though I can’t seem to help it. Currently, this treatment juncture is always near the surface of my mind.

Still the side effects

Last week, about two weeks after an Abraxane infusion, I lost my hair for the third time. This business of growing and losing hair is one of the conditions I have to accept until the whole of the treatment is complete. I had another Abraxane infusion this morning, but I don’t have much hair left to lose. It grows back a bit between cycles, when I have an extra two Abraxane-free weeks. Just when it starts looking cute again, it’s time to lose it. I’m not fond of this process.

During the 42-day drug-taking phase that includes two Abraxane infusions and a nightly Temodar pill, I have a number of other side effects to manage. Temodar and Zofran, the anti-nausea pill I take with it, can cause headaches, constipation, heartburn, itchiness, hives, and who knows what-all else! In my case, headaches can take the form of migraine auras. My doctor agrees that they’re probably the same old stress-induced phenomena I’ve experienced for nearly thirty years, but next time it happens she may send me for an MRI.

Before my nurse starts administering Abraxane, I get intravenous doses of Benadryl, Pepcid, some steroid whose name I never remember (Dexamethasone), and another anti-nausea drug (Kytril). I get powerful doses of all of these to counteract the effects of the killer Abraxane. I leave the treatment room feeling groggy from the Benadryl. By tomorrow I’ll be speedy and energized from the steroid and that will last for two or three days. I'll also lose my sense of taste for three or four days between now and the weekend.

“Do you experience neuropathies?” my treatment nurse asked.

“What’s that?”

“When irritated nerves numb your fingers and toes and make them tingle.”

“Come to think of it, I do. My toes tend to feel that way when I wear anything more restrictive than Birkenstocks. I didn’t know that was a symptom too.”

I’m looking forward to the time when a headache is just a headache, and I can try out my spiky white (hopefully curly) hairdo on the world.