Tuesday, July 29, 2014

Numb

I got a curveball yesterday when I met with Dr. A.

I had aced my side effects test with the nurse during my pre-cycle 6 consult but just after she told me she wanted to clone my blood (except the cancer part, peut-ĂȘtre), I told her my neuropathy was progressing.

Neuropathy is nerve damage in your extremities from things like diabetes or chemo, and over the past month or so, I've been noticing tingling in my toes and fingers... not enough to keep me from jammin' on the 6-string with my garage band, but enough to notice when I tie my runners too tight or wash dishes in hot water. 

The way the cancer docs see it, a little nerve damage is okay, but if it gets to the point where you can't do up the pearl buttons on your cardigan, the chemo drug causing the neuropathy must be shot down from the Empire State building.

In my case, it's the Coke Classic of chemo drugs - Taxol - that's doing the damage. It's also responsible for the other typical side effects, including my teenage skin, eyebrow removal, loss of taste and digestive woes. It's the drug that takes the longest to infuse, the one I need to pair up with a bump of Benadryl and a steroid, and the one I actually feel going into my jugular during some sessions, filling me up with a sick, poisonous warmth.

When Dr. A came in the room after the nurse had left, she said she was concerned about the neuropathy.

"We've been very aggressive with your unusual weekly treatments... we took a big chance with you and you've handled it all very well, but this is a judgement call now. There's no real evidence that 8 cycles is more effective than 6, so I recommend we stop the Taxol now."

"Um... I haven't started the sixth yet..."

"Oh... let me look back at things here." Flip, flip, flip goes my giant binder of all things cancer.

At this point I'm thinking Dr. A needs to get to her French chateau, stat. Or at least get a proper assistant to brief her before every appointment. And when I see I weakness, even outside my area of expertise, I get all control-y and assert myself more than usual.

"I feel quite comfortable going ahead with the Taxol to complete cycle 6," I said in all my infinite cancer-trained wisdom. "The neuropathy isn't that bad and I'd like to see this through."

Dr. A got that faraway, focused look on her face, smiled a bit and nodded at absolutely nothing, like she was listening to my 6-year old yammer on about how some dogs are brown, but others aren't. We sat in silence like that for an awkward 20 seconds. 

"I recommend we stop the Taxol now," she said.

Apparently, the nerve damage can continue past the last session, and she didn't want me to turn into a 42-year old with completely numb hands and feet, so the risks outweighed the benefits in her mind. I could have pushed, but I had nothing to offer up and this is Dr. A's only wheelhouse. She knows chemo like no other doc. I couldn't take that away from the little lamb. So I relented.

This means that beginning today, my chemo consists of two drugs, not three. It also means chemo moves from weekly to every three weeks. No nasty steroid and Benadryl side effects, perhaps a growing of caterpillars over my eye holes and an official move to phase two of my treatment, a whole three weeks early.

It seems fitting to insert a gigantic "YAY" here, but like everything in cancer land, a girl needs to take a moment to process and get out of the numb state of a curveball first. 

Chemo is like a safety blanket - albeit one that stinks like shit and slaps you across the face when you're not looking - but a safety blanket nonetheless. Taxol, which comes from the bark of a yew tree, is one of the only proven drugs used to treat metastatic breast cancer that's been around for decades. So it's a jerk, but it still mops your floors. And now our relationship is over for good. 

I'm still in for several more months of chemo, but dependent on how today goes, the side effects may be minimal. And if the PET scan in August shows good news, I will move on to phase three, where the chemo-lite continues but I move onto more dignified conversations about radiation and surgery.

Fuck it. Let's give this unexpected news a big "YAY" for now. I'll move on from the relationship and figure out a way to reverse the neuropathy, even though Dr. A said, with a touch of medical smugness, that nothing helps and only medication can address any pain. 

When my garage band goes big, the good doc will get front-row seats, so she can see my fingers happily bleeding and gets the spit flying from my microphone as I swing it all Joey Ramone stylez. 




2 comments:

  1. YAY, for sure! and, if anyone can figure out a way to reverse the neuropathy, it'll be YOU. thanks for an awesome read.........love it and you! xo

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  2. I'm so glad you bowed to your doctor's larger amount of experience on this one ... I know you are a voracious researcher, but she has the medical degrees, right?

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