Sunday, July 26, 2009

I have my next chemo infusion on Tuesday, so I thought I'd write a nice little update about what chemo has been like. I feel like chemo is one of those things that sounds super scary, and thus, I'll scratch your morbid itch with some tales from the dark side. Since these updates tend to get a little epic, and I'd hate to offend the tl;dr crowd (that's "too long, didn't read" for those of you who haven't been spending a lot of time reading the internet lately), I'll discuss a different week of chemo during each of the next few updates.

First off, let me describe my chemo schedule a bit. I get an infusion every three weeks, and my side effects seem to change with every week between infusions. When I get my infusion, I get a shot of sweet, sweet Ativan to calm me, (which I don't really need, but I get this weird smug thrill anytime I'm prescribed drugs that have street value, like I won a prescription lottery or something) and a nausea suppressant and then I get two chemo drugs. The first is docetaxel (brand name taxotere), which is standard treatment for non-metastatic (yay!!) breast cancer. The second is a drug I can't spell (brand name avastin), which is part of the clinical trial. I also get another drug I can't spell (brand name xoloda) in pill form that I take for 14 days as part of the clinical trial. Avastin and xoloda are used in patients with metastatic breast cancer, and the clinical trial is looking at whether patients who get these drugs as part of standard chemo have better outcomes than patients who only get docetaxel. I will get this regimen of drugs for two more cycles (i.e., Tuesday and then three weeks from Tuesday) before my drugs change to what's known in cancer circles (you know, among us elite cancer patients) as AC. I'm sure I'll write another long post about that when it happens.

In this update, I'll describe Week 1:
So, the actual infusion process has a tendency to be pretty great. I start off with the ativan and revel in the smugness that only comes from knowing that kids are illicitly trading their hard earned allowance for this drug in dingy high school bathrooms. Then, I lie around and watch trashy TV (full disclosure: I adore terrible TV, movies, and amateur fiction, the trashier the better) for a couple of hours while the rest of the chemo drips straight into my heart (!!) and then make Cassie or Don or whoever drive home.

Immediately afterwards, I mostly feel tired (thanks ativan!), but I also feel the effects of the chemo pretty quickly. My biggest side effect during week 1 is an overwhelming sense of malaise. I feel tired and gross and mentally foggy and just generally mildly unwell. I have a little bit of nausea and a little bit of indigestion, but mostly my stomach feels somehow off. I get a touch of peripheral neuropathy which makes my skin and extremities feel like they are stuck in a low temperature fire. It doesn't really hurt, but again, it feels mildly uncomfortable. Finally, I get this kind of profound fatigue. I'll be out doing something, like complaining about how mildly unwell I feel (one of my favorite pastimes), and suddenly feel this overwhelming need to take a nap. Then, like a heroin addict looking for his next fix (I'm trying to add a lot of drug references since I'm writing about chemo), I become singularly consumed with a search for a bed. Once the bed is found, I cook it up and shoot it. Or maybe lie in it and sleep for 2 to 3 hours. This can happen up to 4 times per day on a particularly fatiguing day and usually goes away by Day 4 or 5 after chemo. Week 1 is the least fun of all of the weeks.

I also have a lot of taste changes during Week 1. Taste changes are easily the weirdest part of chemo because they come and go, so you never know when you're going to get a surprise bite of disgusting. Even water will taste strange during Week 1. Taste changes are also the saddest part of chemo, because inevitably, I'll get an intense craving for something, like a delicious refreshing Coca Cola, only to have it taste terrible. The craving won't go away, so I'm just stuck longing for something that no longer exists for me. I told you it was sad! One of the weirdest taste changes, which only seems to happen during Week 1, is that carbonated beverages, such as the aforementioned soda, all seem flat and too sweet. Gummi bears, on the other hand, taste bitter. (To those of you that gave me tons of gummi bears during my chemo shower, please don't fret. They start tasting great again during Week 2.)

During Week 1, I also have to get daily neupogen shots. You may remember from past updates that neupogen is a drug that boosts my white blood cell counts. They make another drug like this, neulasta, which you only get once, but apparently it's contraindicated during this chemo regime. So, everyday, I traipse off to the hospital to get the injection.

It is during these trips to the hospital that I sometimes pause and reflect on the cancer experience and think, "This kind of sucks." My inner monologue usually goes more like, "I can see how someone who wasn't as optimistic would really get bummed out by this. It's inconvenient and kind of hurts and I feel mildly unwell anyway and my hat looks kind of dumb. You know, (aside: I never really think 'you know' to myself, but for the sake of written transitions, let's pretend I do), they say that optimists are the least realistic people and that depressed people have a much more realistic view of the world. Maybe I should be depressed. That doesn't sound like much fun," and then I start wondering about what kind of douchey thing Jon Gosselin got up to that afternoon and if acid washed jeans will ever come back in (as an optimist, I think not). Usually, after the shots, I get some bone pain (that's how I know it's working) and take some percocet and feel smug.

Also, during these trips, I get blood work done, and I think about how blood is made up of different kinds of blood and how I can have too much of some blood and not enough of other blood. Think about this sometime and it will BLOW YOUR MIND!

Weeks 2 and 3 to follow when I get around to writing them.

Not related to chemo, but Cassie just told me that in the Philippines, they have Orange Julius, but it's called Orange Brutus. The more I think about that, the funnier it gets.


  1. I was in Urban Outfitters in Tyson's corner, and I saw acid wash EVERYWHERE. So clearly it is coming back amoung the yuppy / Tysons crowd. Although I didn't actually see it on anyone walking around.

    On an unrelated note, I learned a new word from our interns, "jhorts", which is short for Jean Shorts. Crazy kids....

  2. I bet Jon Gosselin would wear acid washed jeans with his endless supply of ed Hardy tshirts, just wait and see.