Chemo Cycle 4: it’s almost over

I recently had my last Epirubicin infusion (in a vein in my left arm) and am now in the middle of feeling its effects. I had a really good appetite for the first two cycles, or at least I thought I did. I ate fresh fruit several times a day and was able to snack on fairly healthy food when I’d get the steroid munchies – except, of course, the numerous milkshakes I consumed J . The last two cycles my appetite has significantly decreased and I no longer can bring myself to eat the fresh fruit salad I prepare every few days. It’s such a wonderful mix of fresh fruit…pineapple, grapes, raspberries, blackberries, strawberries, blueberries, apple, orange, kiwi, and a can or two of fruit like peaches, mandarin slices or pears. I make a huge Tupperware container full and it lasts the two of us several days. Now, this huge vat of fruit has to be consumed by Husband alone and a couple of times the fresh fruit has turned into what is likely a dangerous mix of alcohol and decaying fruit. I hate to throw out food, but I console myself with thoughts that the Robins and other birds are likely very thankful for the feast I add to the compost pile.

I worried at first that I would gain weight because of the steroids and the steroid munchies but that hasn’t happened. My weight dropped a bit, and was enough to concern my oncologist and then a chemo nurse. She then insisted I see the dietician at the Cancer Centre. I agreed, only because I needed some help with trying to figure out just what I might be able to THINK about eating without feeling nauseous. I knew I wasn’t eating properly but I had NO appetite whatsoever. It seems like my stomach has forgotten how to growl  in hunger, however I know I need to eat so I force myself to drink apple juice, have some toast with peanut butter or to drink an Ensure. Milkshakes have continued to be my “drug” of choice and I’m sure my local McDonald’s has gotten used to a certain bald chick coming through the drive-thru for a medium chocolate shake at all hours of the day and night. Husband has even been kind enough to pick up shakes for me at 10:30 in the evening! I have ventured to other Saskatoon hot-spots for milkshakes including Dairy Queen and the Broadway Cafe (nothing beats their shakes, served in the massive metal container). The best milkshake however, if I’m feeling up for the drive, is to the Dairy Queen on 8^th Street. It’s the one that’s the oldest location in Saskatoon and is only open during the summer months or until it just gets too cold out. I know I can go there on an afternoon when it’s not busy and ask the guy behind the screen if he’ll make me a peanut butter milkshake. Even though this glass of heaven isn’t on the menu, he’ll make it for me. I never go when it’s really busy and lined up to the street, but I’ll stop at 2 on a weekday afternoon for some peanut butter afternoon delight. Damn. Now I want one!!!

I met with the dietician recently and we discussed my problem. She calculated my BMI and saw that I’m right in range (which I already knew) and then calculated how many grams of protein I require daily. During chemo, it’s really important that you consume protein. I haven’t been able to stomach meat lately and my main source of protein has been from Ensure or the odd piece of toast with peanut butter. When I’m lucky there are left-over waffles from Sunday brunch (courtesy of Husband) that I can smear with peanut butter and maple syrup and consider it supper.  I’m nowhere near the amount of protein I need to ingest and I’m not sure I can get there. I’d be eating all day. I have taken many of her suggestions and have been able to considerably “up” my protein intake, even though it’s mostly liquid. The dietician recommended mixing ¼ cup of skim milk powder with 1 cup of milk and then using it on my cereal or mixing it with my Ensure. I also found out about BeneProtein from her. I’m not sure if it’s made by the same people that make BeneFibre, but I do know it’s a tasteless powder you can add to almost anything to increase your protein intake. I got a couple of sample packets from the dietician and will have to see if I can find it somewhere close. If not, it’s off to Nordon Drugs – they carry almost everything “medical” that you need in Saskatoon.

One major thing the dietician was able to figure out is that only COLD food appeals to me right now. Mostly because it doesn’t smell. Many times I’ve had a craving for something and then made it for supper, only to discover I can’t even consider the THOUGHT of eating it. Being in the house when food is cooking turns me off of whatever food it is. When visiting friends in Edmonton recently I was able to consume pork tenderloin and even a home-made BBQ burger (which I consider amazing because of the problems I’ve had with meat). With the dietician’s help, we realized I had been OUTSIDE while the food was being prepared and cooked. I only walked in when supper was ready and I was able to sit down and eat it. I shocked myself that I had no problem eating what was put in front of me there, but I couldn’t eat anything either one of us cooked at home. Now I understand why. I’m just happy this will soon be over, because Cycle 4 was my LAST CHEMO (insert loud scream of joy here:_______) and I know I’ll be feeling better in a couple of weeks and will soon be back to normal as far as eating is concerned. It will be nice to be able to watch commercials for food on TV. I haven’t even been able to handle that for the last 6 weeks.  I should also add that I have NOT puked. Not the first time in chemo ten years ago, or this time.

Right now I’m in the middle of tanking white cell counts and nose-diving neutrophils (the infection fighters) so I’m a little light headed at times, and I’m more tired than usual. It was a beautiful hot summer day today but I really needed a nap. Two and a half hours later I woke up feeling much better and in a much better mood too. Husband is thankful for that J

I’m feeling really optimistic that my upcoming CT scan and MUGA scan on my heart will show shrinking tumors and a heart that is still functioning fine. Then, we see what my oncologist has in mind for me next. Some of my tumors are fairly large, especially the one in my liver and one in my abdomen. My theory is that the Epirubicin kicked the shit out of ME, so therefore it must have kicked the shit out of the cancer. God, I hope I’m right. I swear these 4 rounds of Epirubicin were harder on me than 6 months of weekly Taxotere was ten years ago. I told my first chemo nurse that the other day and she said “Keep in mind, you are older now. The older you get, the harder the chemo can be to tolerate.” I wonder if my menopausal mind has just conveniently forgotten what it was like ten years ago? Unfortunately I didn’t keep a daily journal. Even a couple of months later I wished I HAD. It would have been great to be able to go back and know how I was feeling and what I was going through. I recall telling many people (even on the radio over the years of the Radio Marathon) that chemotherapy was a walk in the park for me and that radiation was the worst. For that treatment regime, it WAS true. The radiation to my neck and the T12 vertebra in my spine kicked the crap outta me and gave me uncontrollable vomiting. The chemo was once a week and was therefore a lower dose than the every three weeks type of treatment. I did tolerate it fairly well, except for my fingernails. Every finger and 2 of my toes looked like they’d been smashed with a hammer. I had blood drained from two fingers at the doctor’s office, and wore band aids on every finger for well over six months AFTER treatment was over. It affected my nails for years – until I had gel nails put on.

I’m still struggling a bit every day with feeling light-headed, a rapid heartbeat and lack of appetite but I just keep telling myself: “only a couple more weeks and you’ll be feeling so much better”. One day at a time. I’m still taking it one day at a time.

ANTHRACYCLINE EXTRAVASATION UPDATE: (or more simply – ARM UPDATE)

One week after seeing the plastic surgeon I went into the Cancer Centre to talk to some of the nurses about my arm. I still have a reddish-purple SORE area around my port. It’s hot to the touch and is very tender. I did not take the plastic surgeon’s word that I could shower and held off. After talking with a couple of experienced chemo nurses I had my first shower a few days ago! It was a quick one, but it felt sooooo good. I have to make sure I carefully pat the area dry.  I even got permission to go swimming in the lake for my upcoming holidays! I just have to be very careful that something like a life jacket doesn’t rub against the area and I need to pat it dry after. The key is to keep it dry, not rub/scrape/scratch the area and to keep an eye on it. They feel it’s come a long way but I still need to be careful.  It’s impossible to forget it’s there because I get twinges of pain every day from that area, and it’s itchy. I still ice it a few nights a week just to cool it down and relieve the pain. I’m hoping it will only improve as time passes. Just like the rest of me J