[Part One of a Series. I was writing to a friend of mine the other day talking about some of the side effects of chemo and all of the things I was doing to try to head them off. And then it occurred to me: I have been doing an absurd amount of work to keep myself healthy and to stave off any side effects from the treatment. And maybe some of you would like to know what a day in the life of a cancer patient might look like.
Note: This is no way intended to be a recommendation for other cancer patients - each person is given their own treatment plan specifically crafted for them by their medical team.]
Chemo treatment is talked about in “cycles” - with Day 1 being a day of chemo infusion and the days following counted as they grow toward the “off week” (when the chemicals are flushed out of the body and side effects are likely to subside.) I keep a special journal tracking how I’m feeling throughout the cycle (days 1-8), which is helping me make sure that I’m paying attention to my body and its signals.
The biggest thing people talk about when advising a young breast cancer patient is allowing the body to get the rest and attention it needs. So for the first time in my life, I am giving napping, sleeping and “taking a load off” as a high priority. Those of you who know me and my myriad of projects know how difficult this is for me!
I commit to having at least 8 hours of sleep per night. It’s gotten that I go to sleep so early (sometimes by midnight - for shame!) that some mornings I’ve able to get up without an alarm clock.
• Claritin (to manage bone pain from Neulasta white blood cell booster shot, plus my own allergies)
• Alpha Lipoic Acid (to combat neuropathy - loss of sensation in fingers & toes)
• Co-Enzyme Q10 (for heart health - chemo can damage the heart muscles)
• Vitamin D (many women are deficient and I was dangerously low)
• Prilosec (to combat the side effects of heartburn from the digestive tract being compromised)
• On the first 3 days after each chemo cycle I also take a steroid medication which helps counteract serious allergic reactions from the chemo as well as nausea and vomiting.
Midday medications & supplements include:
• Slippery Elm Lozenges (to combat throat irritation)
• L-Glutamine powder in orange juice (to help speed up cell renewal/growth)
• My favorite green smoothie from Whole Foods: Drink Your Greens (kale, spinach, green apple, ginger, lemon, almond milk, with added boosts of maca and spirulina.)
On hand to take, as needed:
• Zofran (#1 drug to take in case of nausea)
• Compazine (#2 drug to take in case of nausea)
• Imodium (in case of diarrhea)
• Colace (in case of constipation)
Combatting Infections & Fatigue
Chemo lowers the immune system and energy stores, because it is unable to distinguish between cancer cells (the ones we want to kill) and healthy ones (like white blood cells and red blood cells.) Low white blood cells leads to infection, and low red blood cells leads to anemia, so I spend a good amount of time trying to manage both.
So far I’ve been through two cycles, and I’m already starting to notice the energy patterns that my body is taking:
Day 1 - Chemo infusion.
Days 2, 3, 4 - Feel a little “hopped up” due to the steroids, which feel like I’m in Benadryl. I have mental clarity and energy, but the body feels a bit fuzzy - like it’s not really my own.
Day 5 - My energy starts to wane and I feel a loss of motivation.
Day 6, 7 - I feel like I have a cold. I’m achy, have a sore throat, and am completely fatigued. I’m also cranky, moody and depressed. Immunity is at its lowest. Crying for no reason is probable.
Day 8 - I start to pull out of the chemo zone, with a little more energy and less of the “blahs.” My immunity is still low but energy starts to return, so I now have 6 days left to build up my immunity for the next infusion.
I have to be very careful about infections. I wash my hands anytime I leave the house or return, every time I use the restroom, every time before and after I eat, etc. I am much more aware of when I’m touching public surfaces and then touching my face. If I use a razor in the shower it must be new or nearly new so that if I get a nick I don’t get days worth of shaving bacteria in the cut. Chemo eradicates mucous membranes and dry mouth can cause infections of the gums, cheeks and throat. So, I brush my teeth using a special soft toothbrush with a toothpaste made specifically for dry mouth symptoms, and then gargle with a special mouthwash.
As far as physical side effects, so far I have had minimal nausea, no vomiting, no mouth sores, no taste changes, no appetite changes, no skin changes. My body hair is starting to fall out in places, but due to the cold caps I have not lost the hair on my head (though I am seeing some thinning which is to be expected.) I have gained weight from the steroids (which I’m assured will come off immediately once chemo is done.)
I am counting myself VERY lucky that so far my side effects have been manageable. I don’t feel well and sometimes get a little cranky that I can’t do the things I want to do when I want to do them (blame that on Irish impetuousness!) But I am working very hard to see myself through this battle without a compromise - and I think this fortitude is making a world of difference.
Thank you so much for reading. As a reminder, I have a more personal blog here which talks about more than just medical updates. And if you're looking for ways to help, you can check out this blog post with my wish list.
Please leave a comment. It would be great to hear from you!
My treatment regimen:
4 bi-weekly cycles of dose-dense Adriamycin and Cyclophosphamide (AC), to be completed October 6, 2015.
12 weekly cycles of Taxol (T), to be completed in January 2016.
30 sessions of radiation over the course of 6 weeks - that’s 5 days a week for 6 weeks, to be completed by March 2016.