Wednesday, March 10, 2010

A Year without Chemo

22 weeks, 5 days

March 10, 2009 was the date of my last Taxol infusion. They were running out of good veins in my left arm to access. They never do chemo in the arm in the side of surgery due to possible lymphedema. Too bad because that's where I have my best veins. I hated the search underneath my skin randomly jabbing at various veins-very painful and creepy. In the end they made do with a substandard one. Alarms would go off unless I held my arm at some painful angle which on that day was for 5 hours. Good times. Taxol has to be delivered very slowly due to possible allergic reactions. To ward these off, we are pre-dosed with steroids and various antihistamines-all causing their own side-effects. Taxol itself is not the allergen but the vehicle used to solublize it made from castor bean oil (same bean the toxin ricin comes from). Back in the lab, any potential drug not readily soluble in the usual vehicle (water)would be dissolved in this 'cremaphor'. Sometimes it was hard to tell if the effect was from the drug or the cremaphor. Little did I know they actually use this stuff in humans and that would be in me. Taxotere has a different vehicle, much more costly but the'cheap' stuff for me as I tolerated it. Taxol itself is not cheap. It is a natural product, an alkaloid found in the bark of Pacific yew trees. It has nine stereocenters, which doesn't mean much to many readers but makes it almost impossible to make. For a while, it was the holy grail of synthetic chemistry. I listened to many lectures at meetings with chemists showcasing their brillance in developing routes to make it. A route was needed as the Pacific yew supply was running dry. Eventually it was discovered that a crucial intermediate could be obtained by plant cultures of the cultivated yew and then converted to the actual Taxol. Later it was discovered that certain fungi produce it which might make it easier to cultivate (fungi grow faster than trees). Also these fungi produce other 'taxanes'. Maybe one would be better than Taxol? I am sure they are working on that.
So my last infusion left me with a throbbing purple lump on top of my left wrist which slowly became smaller and less painful as time went by.Now it is a faint purple line. What bothered me the most about Taxol is the neuralgia it caused especially 3 days after dosing. All my muscles, especially around my hips and trunk would be painful to pressure meaning I couldn't sit, lie down without being in pain. It was neuropathic pain which does not respond to the usual pain killers. One of its minor side effects is damage to the nails. Many lose their nails to it. I was left with white ridges and brown stains.It felt that my nails could fall off at any time but I just lost 2 toenails. But of the 3 poisons I had injected in me, from what I read Taxol was probably the most useful in preventing recurrences. The jury is still out on what the Red Devil did for me.

I get updates from the Susan Love Foundation about 'breaking news'. The aspirin a day cutting recurrences by 50% update was in my in-box the other day. This is the same number I was given for what chemo would do for me. Certainly gobbling aspirin would have been easier. But at this point, it is not being recommended until further study. Why the hell not? Yesterday I read a report in the 'medical breakthrough' section of the Wall Street Journal that men taking NSAIDs regularly were more likely to have hearing loss-something about changes in blood flow to their cochleae. No mention about what happens to women. But less heart attacks and strokes and lower recurrence of cancer versus possible hearing loss and stomach make the call. For the record, my stomach is still shredded by the Red Devil, which along with the Cytoxan, has been known to cause deafness (along with heart damage, more cancer,..)

So a year later, I am alive with a full set of healthy nails, sweat glands, oil glands, and normal blood values. I am no longer puffy due to steroids. I still weigh too much-how much no one knows, most of all me. I do have muscle tone though and can run for a long time without gasping for air. I now fret that my hair is growing too fast (expensive to keep dyeing it) and its chemo curl is relaxing into chemo waves. I still have right arm pain that is probably due to treatment. Yesterday , our warmest day ever in the past 4 or 5 months, Naomi and I walked at glacial pace to the playground (along with her (thankfully) clearing infection, she has now developed back pains from all the sitting in one position) to bask in the sun. I used the various equipment there to stretch out my frozen joints, it seems to help. We returned home for more studying (Tuesday is intensive study day) and to watch one of those birthing shows on TLC. Yesterday was the silliest birth yet. The crazoid mom insisted that her 4 year old watch the whole proceedings done without any epidural. While the mom screamed in pain, the child stuck his hand in her mouth to shut her up. Naomi thought that was funny. Meanwhile, the husband and grandmother stood uselessly to the side. Shanna was in the birthing room when I had Naomi but she was almost 12 and not especially squeamish. I had more or less given birth quietly without drugs for the older two. I thought that a third birth would be easy-peazy especially as by then, I was a marathon runner who I thought could push herself through anything. But even so, I know circumstances are different with every birth and I didn't want to scare her childless so I told her that if I said to leave, she'd leave and wait to be called back in. My waters ruptured 2 weeks early and the midwives told me to wait for 3 days before an induction as most likely I would go into labor. After dripping around for 2 whole days, I couldn't take it any longer and at the first sign of a contraction, I demanded to be admitted. The induction caused me to go from no labor to end-stage labor in just a few minutes. After the first contraction, I was demanding relief (this was after how I was bragging just a few minutes early how I had a 10 lb baby-Josh- with no drugs). I sucked on laughing gas, which was heaven sent. Naomi was born after 1.5 hours total from start to finish. Sometimes I wonder if the rapid delivery somehow caused her problems though usually, physical problems are the result and she was unbelievably athletic. But maybe that frontal lobe was deprived from oxygen for a few seconds..Anyways Shanna was not traumatized and went on to have her own 2 babies.

And now Naomi, the baby, is pregnant.

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