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.

Boring

The other day, at my latest visit to the Cancer Center, I was discussing side effects with my team: my oncologist and a couple of nurses. They had me define what I mean by terms like “indigestion”, “heartburn”, “constipation”, “migraine aura” so they can quantify the severity for their records and compare them to other patients. Since I’m in a clinical trial, my chart gets reviewed by a lot of people, and they need to maintain clarity and consistency in their record-keeping.

After a while, my doctor got up, hugged me, and told me she loves me because I’m boring. I’m fairly certain she wasn’t commenting on my personality, or the state my life has devolved to – at least I hope that’s not the case! Rather, she’s very pleased with the lack of turmoil in my health profile.

In fact, most of the time when I think about my cancer these days, I think about it in the past. It’s not gone, and I really must guard against getting too far ahead of myself; but the truth is, I feel great. My symptoms and side effects are manageable and under control, and my energy is quite good. One day last week, I even dashed for a commuter train!

I still have months of chemotherapy left. We need to put the whole of the disease behind me, which means taking every last step to a completely tumorless scan… and beyond. And once that’s done, I’ll need to maintain a lifelong vigilance with periodic follow-up scans.

The adventure goes on… but without quite so much high drama.

Stress is a side effect of cancer

I had my first migraine aura 27 years ago, in the month before I got married. My husband-to-be was a young doctor. He’d never run across a complaint of flashing lights taking over a person’s peripheral vision, so he ignored his own good medical advice (“When you hear hoof beats, don’t assume it’s a zebra.”) and secretly feared it was a brain tumor. He sent me to a neurologist to prove himself wrong.

And fortunately for me, he was wrong. Migraine auras are common, many times followed by a migraine headache. In my case, the auras are never followed by headaches, and in fact, I’ve been thankfully free of the migraine headaches I experienced as a young woman.

My auras tend to last about a half hour, gradually increasing in scope until they take over my entire field of vision. I reach a point where it’s hard to see anything through the flashing lights, and minutes later it’s over. These episodes are infrequent, typically showing up in times of stress.

Not surprisingly, I’ve had several in the past few weeks, most recently this morning. As far as I know, this is just another reaction to the stress that’s settled into every crack in my life. But I’ll report it to my doctor when I see her Monday. Headaches are also a known side effect of the anti-nausea drug I’m on, a generic form of Zofran, which means this form of migraine may qualify.

But in case the logic has escaped any in the medical community, stress is an undeniable side effect of cancer.