Certainly this round of chemo has been the toughest yet. Other than the my consistent side-effects: fatigue; low energy; lack of appetite; disrupted sleep patterns; persistent numbness in my thumb and forefinger (and to a lesser degree - my feet and toes) and general achiness, the cumulative affects of these poisons have amplified some of these side effects and manifested into 'new' ones.
Fatigue
This has been a constant, but this round (so far) it hasn't let up. During 1-3, by day 10 if not sooner, I 'felt' an improvement. There could be many factors why this is not the case right now. The atmosphere (weather) has been very 'heavy'. Between the humidity and the rain storms, the air is super saturated and not conducive to one feeling energized. Allegedly, Wednesday will be the break in the current weather pattern. [Hurricane Danny may change that.] Although it's been humid, sitting in front of a fan seemed to work and I have not turned on the air conditioner. [My electric bill should reflect this.]
Low energy
I'm sure this is directly related to the fatigue and my lack of appetite. In addition, my standing causes dizziness to the point of a near black-out to various degrees with no particular pattern. This makes me immediately stand and wait (making sure I'm near a chair or something to hold on to). Once my 'blindness' passes, I able to move cautiously. Once up, I'm OK unless I forget and bend over to pick up a dropped spoon or whatever (not feeling things picked up with my left hand causes many small things to drop). Once erect, the dizziness returns. [It should be noted that dizziness is a side effect of the blood pressure medicine I'm taking, so this is not foreign to me. However, the degree of dizziness has been much greater while undergoing chemotherapy.]
Lack of appetite
Throughout this ordeal, I have been fortunate not to have nausea. However, there have been many foods that I used to eat daily (salads, oranges, fresh fruits, coffee) that I have little tolerance for. Certain vegetables when cooked are 'passable', but others and some fruits, I can't eat. Not that they make me nauseous, but I get 'the burps' and lately, spells of hiccups and gas pains. My online research has made me understand that the chemo does affect the entire digestive track and many of these foods are too much at this time (hopefully). Prior rounds, I relied on my cravings, but this round even my cravings can cause problems.
Taste changes
Most likely related to my lack of appetite and the effects of chemo on my digestive tract, I've been most affected by taste changes for round 4. During previous rounds, I had cravings for foods not as healthy for me, like steak and cheese subs, pizza, burgers and fries. But I was able to tolerate these and did get some nutrition. However, this week all of my cravings have seemed flat tasting and basically tasteless. Even fish (salmon, haddock, scallops) has not been satisfying. My old stand-by of bland foods: cottage cheese; yogurt; cheese; oatmeal and crackers are soon becoming a turn off. I'm now resorting to soup, nuts and chocolate. Possibly for their salt content. But even salt taste is diminished. I am forcing my self to eat something, but choices are getting smaller. I've lost almost 10 pounds since my last weigh-in. [I'm usually bloated from all the fluids, so the last weigh-in indicated a higher weight than normal. In reality I'm probably 5 pounds from my 'normal' weight.]
Having been a coffee drinker for 30 years, giving up coffee seemed to make my brain foggier than 'normal'. Today, I broke down and had a cup of instant (Starbucks). So far so good.
Disrupted sleep patterns
In previous rounds, the first few days/nights I experienced intermittent sleep. Generally waking up every hour or two and during one round not being able to fall back asleep for hours [Law and Order marathon reference here]. Round 4 had similar patterns, but most recently, I've been waking up with back pains, leg and arm pains. There could be various reasons why this is more prevalent now since I haven't had the energy to take walks, thus causing muscles to atrophy and be painful. It's a two sided sword, but I'll try to 'ease' into a regimen of light exercise and walking as soon as this round 'breaks'.
Neuropathy
Listed as possible side effect of Adriamycin, I have had 'slight' numbness to my feet and a few toes. Nothing debilitation, but noticeable when standing in one spot for too long (4-5 minutes). The most aggravating neuropathy has been to my left thumb and forefinger. Dr. Mehta had mentioned that neuropathy is generally symmetric and since I haven't experienced this on my right hand, it's probably not chemo related. I don't want to be charged with practicing medicine without a license, but I do believe this is related. As the rounds of chemotherapy wind down, the numbness begins to dissipate. It's at this time that I'm able to play the guitar again. While this numbness is heightened (first two weeks of a chemo), the 'fine' sense of touch is gone. In addition, pressing my finger against the string actually hurts. Other normal functions, like picking up a small object, turning a newspaper page, opening an envelop, or separating paper are quite difficult. I can still button and unbutton clothing (which would be impossible if this was Charcot Marie Tooth (CMT) which runs in my family). I'm hopeful that by next week, I'll begin (again) to get my guitar chops up.
General achiness
Much like a neglected house, my body is in need of repairs. Most of these should be done by the body's recuperative powers which will need my attention in ensuring that I have the right sustenance and exercise regimen in place. Until this happens, I'm really feeling old. Chemo has done a number on me. My veins ache, my mouth seems on the verge of being sore, my muscles need basic toning, my stamina needs rebuilding, and I have many other aches and pains.
Some things will bounce back, while others will take some time. I'm fearful of the things that will never return or the 'things' I will need to live with the rest of my life. But I'll face those when they are identified. Until then, I have more to go with chemo # 4.
On Monday, I have a follow-up with Dr. Mehta. In the words of Roseanne Roseannadanna, "It's always something."
More to come.
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