Where the light enters

finding meaning in mortality

Tag: taxol

A case of cold feet (and hands): Taxol treatment number two

Today was my second Taxol chemo treatment.  I was apprehensive about it because of the side-effects I experienced at the first treatment when the Benadryl they gave me to reduce the risk of a reaction caused me to be absolutely loopy (and not in a good way).  It also caused my feet to have horrible creepy, tingly feelings, like electricity shooting through them.  It was seriously not a pleasant way to spend an afternoon.

But today’s treatment wasn’t nearly as bad.  Since I didn’t have a reaction to my first Taxol infusion, they (“they” being a lovely nurse named Diane who always has a smile on her face) gave me only half the dosage of Benadryl this time.  It still made me somewhat drowsy and strange-feeling (and as my brother would say, I am strange), but I felt as though I could still function.   And I didn’t fall asleep.  I also (thank heavens!) didn’t notice much creepiness going on in my feet.  Yea!  A small victory, but important considering I have ten more of these treatments ahead of me.

The after-effects of the Taxol drug itself seem to be much less severe than those of the Adriamycin/Cytoxan regimen that I was initially on.  The only real side effect I noticed last week was that my nail beds were sore.  Evidently Taxol can do a number on your nails and digits, causing the nails to split or fall off, and causing numbness and tingling in your fingers and toes.

I did a little research online and found a product designed to counter these effects in a chemo patient’s hands and feet.  It’s called Elasto-Gel and it’s available in both hypothermia mitts and slippers that you wear during your treatment and for 15 minutes before and after.  These mitts and slippers are frozen beforehand and keep your extremities cold so that they (in theory, anyway) don’t absorb as much of the chemo drug you’re receiving.

These mitts and slippers aren’t cheap, but my boyfriend convinced me that I should get them, so he ordered me two of each from Amazon.  I needed two of each because they only stay cold for 45 minutes, and then you swap them out for a fresh pair from your cooler.  So at roughly $100 apiece, we spent $400 on this experiment.  But, as my boyfriend says, it’s money well spent if it works.

They arrived yesterday, just in time to pop them in the freezer for a good overnight cooling.  This morning, we packed them in my new cooler and placed ice around them before heading off to the hospital where my infusion center is.

So yes, I had a cooler on wheels today to go along with all my other bags, so I really looked like I was heading to the beach instead of a medical appointment.  Or maybe I looked like I was wheeling organs through the hospital.

At the appointment, my friend Joy helped me get into my new apparatus.  First you place a liner on your hand or foot; these are thin papery liners that are supposed to protect your skin from direct contact with the frozen parts.  The foot liners look like those blue surgical booties that doctors slip over their shoes.  The mitt liners are white paper “oven mitts.”  Both are large, and since my feet are small (5 1/2), the liners are huge on me.  But then the Elasto-Gel slipper goes on, and it doesn’t matter that the liner is huge.  The slippers are adjustable and once tightened around the back of my foot, they fit pretty snug.  The mitts are also adjustable, but don’t feel as snug on my hands as the slippers do on my feet.  They kinda looked like boxing gloves; I was ready to step into the ring.

They weren’t as uncomfortable as you would imagine.  I thought having frozen hands and feet might be unbearable, but the sensation of cold was different than I’ve experienced before.  Normally when my hands and feet are cold, my whole body feels cold, and I’m miserable until I can get them warmed up.  But I didn’t notice much discomfort today.  I did have a heated throw over the rest of my body, so I’m sure that helped.  But even though I could feel the cold on my hands and feet, it didn’t make me feel cold.  I was thankful.  Being cold is one of the things I really dislike.

The only thing I don’t like about wearing the mitts and slippers during treatment is that they hinder you from doing other things such as eating, drinking, and reading.  I also didn’t feel comfortable going to the restroom while wearing them, so I desperately needed to pee when it was all over.

But if they work, I think these inconveniences can be withstood for another ten weeks.  I think I can deny myself snacking for an hour or so a week.  And as long as I drink before and after, I think I’ll be getting enough liquids.  I guess I won’t know if they work for at least a few days.  I’m hoping that they’ll at least help keep the side effects to a minimum.

Whether or not the mitts and slippers work, it does appear that my chemo treatments are working.  I saw my surgeon Monday at Georgia Breast Care.  She did an ultrasound of my tumor, and seems to think that it’s breaking apart and dying off.  She said she doesn’t see a “mass” as she once could; it’s quite possible that all that remains is scar tissue and dead tumor.  Of course, an MRI will be needed to confirm this at the end of my treatments in ten weeks.  If this is shown to be the case on the MRI, I’ll likely be a candidate for lumpectomy.  This is the best news I’ve had in quite a while.

To celebrate, I made one of our favorite recipes for dinner tonight: Onion Gravy Cubed Steak and mashed potatoes. This is one of my go-to comfort dishes for fall and winter. It takes an hour and a half to cook in the oven, but as long as you’re not pressed for time, it’s simple and rewarding. As far as I’m concerned, this is the perfect warm-me-up dinner after a day of cold hands and feet, and a much-needed moment of celebration.

Fighting cancer with the yew tree

Today I received my first infusion of the chemotherapy drug, Taxol.  Taxol is a plant alkaloid made from the bark of the Pacific yew tree or Taxus brevifolia.  I find this interesting in light of the magical associations that Druids had for the yew trees that grew in their region (most likely the English yew, or Taxus baccata).  The Druids worshiped the yew, and if this treatment cures me, I may start doing the same.

In order to get the Taxol infusion, you first get an infusion of Benadryl.  This helps prevent a severe allergic reaction to the chemo.  It’s evidently quite a large dose because its side-effects for me were excruciating.  First I felt very woozy, my head bobbling from side to side.  My speech sounded as though it were coming from somewhere far away, my thoughts were all scattered.  I tried to take a sip of hot chocolate from my styrofoam cup, but couldn’t.  But then it got worse.  My legs started crawling with what I can only describe as electrical “jitters.”  It was like “restless leg syndrome” on steroids.  I squirmed and twisted and whined like a spoiled Pomeranian.  I found that if I flexed my leg muscles, it helped.  But how long can you sit with your muscles flexed?  Sooner or later I had to relax, and immediately the feeling was back.  Thankfully, the woozy feeling eventually overwhelmed my senses and I was out.  I slept for over an hour, and when I awakened, the jittery legs had improved enough for me to relax for the rest of the treatment, although I still felt too groggy to read or carry on a decent conversation with Joy, my friend who accompanied me today.

The nurse said that as long as I didn’t have a reaction to the Taxol, she could decrease the amount of Benadryl for my next treatment.  Thank heavens.  If I had this to look forward to for another eleven weeks, I think I might have to consider learning to live with a tumor in my body.

I came home from the treatment center and went straight to bed.  After a nice long nap, I was able to get up and be fairly functional again, puttering around the kitchen and figuring out what to make for dinner.

I haven’t noticed any side-effects from the Taxol yet.  The nurse said that most likely in two days, I will feel flu-like symptoms, such as pain in the joints and muscles.  Also, there can be neuropathy (numbness and tingling of the hands and feet), nausea and vomiting, diarrhea, mouth sores, hair loss, and low blood counts.  All very similar to the possible side-effects of the two chemo drugs that I just finished, except for the addition of the aches and pains.

The main side effect that concerns me is neuropathy.  I got a taste of that from my last treatment.  I’ve already lost most of my hair, but I do still have my eyelashes and eyebrows, so I suppose it could get worse.  My blood counts have all rebounded in time for my next treatment except for my hemoglobin levels.

Hemoglobin is a protein in red blood cells that carries oxygen through the body.  Because of my low levels, I’m anemic, but not iron-deficient anemic, so taking supplements doesn’t help.  There’s really nothing to do to improve it without a blood transfusion, and my doctor says my levels haven’t dropped that far yet.  But they are low enough to explain my racing, pounding heart and palpitations last week.  She told me to not perform any strenuous activities until my hemoglobin levels go back up.  And since I have another eleven weeks of treatment, my levels may not rebound for another three months or so.  Great.

When my mother was undergoing chemo, she had to have multiple blood transfusions.  She had a reaction to one of them, causing tachycardia, and had to be admitted to the hospital to slow her heart rate down.  Needless to say, I’m not excited at the prospect of getting an infusion.

Something I am excited about is a class that I took last Saturday called Film is for Everybody Workshop: Screenwriting 101 and Filmmaking Basics.  Taught by Najaa Young, President and CEO of NaRa Films and a professor of digital filmmaking, this class was a fun introduction to screenwriting for me.  I’ve always thought it would be a great project to take a book that I really enjoyed and write the screenplay for it.  Even if it was only a creative exercise that I did just for writing practice, I think it would be worthwhile.

Another thing that I’m excited about is the discovery of YogaAnytime.com.  For a monthly fee, I can take unlimited yoga classes online.  They have many teachers and yoga traditions to choose from.  They also have classes in meditation, the Bhagavad-Gita, and Ayurveda.  I’m hooked.  For the moment, I’ll try to take classes that aren’t too strenuous.  At least until my hemoglobin is back to normal.

So two things to be excited about this week.   That might be a record, at least for these recent weeks.  Now if I could only be certain that these chemo treatments were working…. That would be really exciting.

Last dance with the red devil

Today was my fourth and final Adriamycin and Cytoxan chemo infusion.  Two weeks from now, I’ll begin twelve weeks of a different chemo drug called Taxol, but these first four treatments are supposedly the stronger of the two.

Adriamycin is probably the worst of these. Its nickname, the Red Devil, might give you a clue to its ill effects which can include nausea and vomiting, diarrhea, loss of appetite, darkening of skin or nails, mouth sores, weakness, fatigue, eye redness or puffy eyelids, and, of course, hair loss.  These are only the common side effects.  More serious side effects can evidently also occur.

The major side effect that I’ve experienced while dancing with the Red Devil is fatigue.  By this, I don’t mean the normal “I’m pooped and I’m going to go curl up on the sofa with a good book” kind of fatigue.  I mean the “I can no longer stand up or sit up or pay attention to anything and I have to go lie down now” kind of fatigue.  The kind of fatigue that makes you ask yourself why you’re wearing ankle weights.  Then you realize, of course, that you’re doing no such thing.

I’ve noticed the fatigue setting in sooner and lasting longer with each successive treatment.  I suppose this is what they meant when they said there would be a cumulative effect.  I finished today’s treatment just after lunch, and by late afternoon, I already needed a lie-down.

On a more positive note, today’s treatment was the last dance I’ll ever have with the Red Devil.  Even if my cancer recurs down the road, I can’t have Adriamycin again; there’s a limit to how much you can have in your lifetime, and I think I reached it this afternoon.

Not the Red Devil, but close enough. My mom circa 1980s.

Not the Red Devil, but close enough. My mom circa 1980s.

I do have twelve more chemo treatments to go; however, the Taxol is supposedly not as harsh for most people.  There may still be fatigue and hair loss, but I’ll no longer have to return the following day for a shot of Neulasta to boost my white blood count.  One possible side effect of Taxol that I’m not looking forward to is neuropathy.  This happens when there is damage to the nerve endings, normally in your toes and fingers, that causes numbness and tingling.  For most people, it’s a temporary condition, but for a few it can persist and become a permanent problem.  Some people with neuropathy end up not being able to button up their own shirts.

After my first round of Taxol, I’ll go to see my surgeon again.  She wants to evaluate the chemo’s effect on the tumor to see if it’s shrinking.  If it shrinks enough, (and by enough I mean an awful lot), I’ll be able to have a lumpectomy.  If not, I’ll have to have a mastectomy.  So far, it appears that the tumor is softening, but not necessarily getting any smaller.  My oncologist says that’s normal for where I am in the treatment process, so I suppose there’s still some hope that I won’t have to have a body part lopped off.

I’m not vain, and I’m not really worried about losing some part of my femininity, but I’d rather not start cutting body parts off.  How much more terrible it must be to lose an arm or a leg, or something more noticeable like a nose or an eye.  And yet I’m not comfortable with losing anything.

My friend, Joy, who went with me to today’s treatment, reminded me that as you age, you do lose things.  Maybe not entire body parts, but there is a definite sense of loss as you get older, when things no longer function as they used to, or you have to give up certain activities because they’re just too difficult to continue doing.

I understand her point.  Although I’m not entirely comfortable with the aging process either, I realize that it’s inevitable (if we’re lucky enough to make it that far).  I needed reading glasses for the first time a few years ago, and I still mourn this loss.  I’ve always welcomed change, but loss is a type of change that I’m evidently not well-equipped to deal with.

So the thought of my body drastically, irreparably changing in this way is a hard pill to swallow.  But if it’s a life-saving pill, I suppose I’ll have to learn to swallow it.

My oncologist told me today to stay positive and that’s what I’ll try to do.  Maybe the chemo will shrink the tumor significantly.  Maybe at the end of it all, dancing with the devil will have been worth the trouble.

Whatever happens, I say goodbye to him today, and thank him for his efforts to kill my cancer cells.  I wish him well with his next patient, and if my treatments prove to be a success, I promise to thank him every morning as I snap my underthings in place, getting ready for the day ahead.