The Lost Weekend

Unfortunately, it wasn't spent in an alcoholic daze. No, I wasn't drunkenly jumping on the bed, like Jack Lemmon*. I was lying on it, wishing I could actually catch a few Z's. Friday night, I hit the so-called "nadir" of chemotherapy, when the effects of the previous treatment cause one's blood-cell count to tank, and in general make you feel like shit. The nadir hits 4-7 days after treatment, so I already knew I was up for a fun and active weekend. I spent most of yesterday in bed, and my attempts to complete even the most basic tasks today have been desultory. My accomplishments, other than this post: taking a bath, and making coffee. I also was very encouraging as my husband removed the two window unit air conditioners and carried them down to the basement. I'm going to try to do a load of laundry this evening--wish me luck.

*Thanks to Wikipedia, I now realize that I was thinking of The Days of Wine and Roses, although The Lost Weekend is looking even more interesting, due to the fact that it was scored with a theremin, and the original story involved an incident of gay-baiting.

Chinatown

"Feel OK?" Dr. F. asked. I did feel OK, but tried to remain as motionless as possible. I was bristling with acupuncture needles: feet, shins, knees, stomach (upper and lower), hands, ears, and a jaunty single right between my eyebrows.
He positioned a warming lamp over my feet and closed the door, leaving me alone in the darkened treatment room. Chinese music came from some distant part of the office, barely audible.

My first experiment with non-western medicine arose out of desperation. After several weeks of early morning hot flashes, I was almost demented from lack of a good night's rest. Already a little fogged by chemo, my brain wasn't up to handling sleep deprivation. The parking lot incident at the dentist's office was the final straw. As I walked toward my car, I was covered in confusion. A green Escort--that's it, all right. But what door was I supposed to unlock? I opened the nearest one and sat down. It was the front passenger seat. When I saw the steering wheel on the other side, I laughed. Still, it was unnerving.

Research indicates that acupuncture is mildly beneficial in reducing the severity of hot flashes. An acquaintance gave me the number of Dr. F, a traditional Chinese medicine doctor. She said he had worked wonders with her husband's chronic sinusitis. I was willing to give anything--anything but Effexor--a try.

Dr. F, a slim man with silver hair, works out of a grim little second-floor office in Chinatown. The dented waiting room divider is decorated with a silk diploma banner from a Chinese college, and a calendar depicting cartoon zodiac animals dancing in some kind of frenzy. After I arrived, Dr. F started a medical history, and the briefest of examinations. He timed my pulse, and then asked to see my tongue. He scrutinized it pleasantly, and jotted some notes. He asked about my liver function, and recommended I get a blood test. "Chinese herbs maybe too strong now for your liver." At least, that's what I think he said. Dr. F has a pronounced accent. It took a while for me to understand his question about my "white blood cell" count, which I gamely tried to repeat back to him. Wide brood sole? Wait blue sew?

After he had taken my history, Dr. F led me back to the treatment room, past metal shelves stacked with bins of wonderful-smelling herbs. After sterilizing the entry sites, he began to insert the needles, which looked nearly as fine as human hair. I glanced down and saw him deftly poking one into the meat below my thumb. It was absolutely painless. Four needles, the ones on my abdomen and knees, were attached to electrodes. Dr. F adjusted the current until I felt a tiny jumping sensation at each point. The whole thing took about half an hour. Afterwards, I felt mildly invigorated. Perhaps a placebo effect, but a nice one.

After I left Dr. F's office, I went to a nearby bakery and bought a "dry pork bun," expecting it to be filled with barbecued pork. I was suddenly famished, and my mouth watered as I bit into it. I discovered that its primary ingredient was mayonnaise. I ate it, anyway.

Photo: like, totally

Chemo 6/8

Almost done...almost done...that's my mantra. Once again, my oncologist Dr. G. was out, and the nurse practitioner examined me. My husband was disappointed, most especially since he was prepared to "tear him a new one" over the vague information about my surgery schedule and the lack of palliative care. BCH* does a great job with the drug delivery, but not so much with information-sharing or emotional support.

Friends have asked me the following:

Do they have a support group? I dunnoh--can't find evidence of any associated with the hospital. They do have a brochure for Gilda's Club, which offers support services. The Nurse K., the nurse practitioner who examined me this time, offered to give me the contact information for another nurse who had survived breast cancer and is now on Tamoxifen, an estrogen antagonist that has some nasty side-effects itself. It's the first time I've received any offer from BCH staff to be put in touch with another survivor.

Do they offer therapeutic massage? No. As a matter of fact, I haven't seen evidence of any palliative care (i.e. counseling, support groups, meditation or yoga, massage) Some smaller Chicago area hospitals offer these services, but not BCH.

Oh, and I received my first billing for chemotherapy. If I didn't have insurance, would have to pay $2500 per session. That doesn't include the cost for blood work or examinations. Every time Dr. G looks at my boobs for ten minutes: $158.

Am I receiving the best treatment for my cancer? In fact, I probably am receiving excellent care. So why do I feel so uncared for? Perhaps BCH will eventually launch a research study on whether patients are also feeling human beings. I hope the results are statistically significant.

The final chemo drug Taxotere Paclitaxel has a new set of side effects, including bone pain, watery eyes, and rosacea-like pimples and rash on my upper body. My eyelashes and eyebrows are scanty, now. About four or five days after chemo I get very tired and easily winded--probably a sign that both my white and red blood cell counts are bottoming out. My hot flashes are on a more predictable schedule, although one that interferes with early morning sleep. From about 4 to 6 am, it's covers off, covers on, over and over. During this time, sleep is in short snatches until the next one hits.

That's all the news, which as per usual is in the form of a complaint. They were right: when you have your health, you have everything. Too bad I had to get terribly sick to appreciate that axiom.

*Big Chicago Hospital

Chemo 5/8

This was a botched shot, but a rather sublime one. I think I was having a hot flash as well, just to add to the ordinary spit-and-shine polish.

To friends and family who listened to me talk, and sometimes cry, over the phone last week, love and thanks. I was really low, and you helped bring me up. L & E, thanks especially for sharing the details of your own experiences with me. Knowing someone else was strong enough to get through that helped me feel a little stronger, myself.

The hot flashes have reduced in number and intensity, and (knock on wood), I seem to have regained control of my pelvic muscles. I won't have to add Depends to my shopping list any time soon, thank god. I talked to the nurse about it, and she was mystified. She suggested a prescription for Effexor, an antidepressant used off-label to treat hot flashes. Such a trade-off: the side effects of Effexor vs. the side-effects of my violent hormone fluctuations. I declined, for now.

Today was the first chemo with a new drug, Taxotere, On the plus side, it won't damage my heart, like Adriamycin, and I don't have to take steroids or antinausea meds. On the down side, it can cause peripheral neuropathy, i.e. nerve damage in the fingers and toes. Numbness is a common side-effect; severe reactions to the drug include nail loss and residual pain. I did my research this time, and found a study in France where subjects who wore frozen medical gel gloves during treatment experienced minimal neuropathy.

You guessed it: I brought a cooler full of frozen gel pacs and gripped them during my therapy. Nurse L let me do it, although she clearly thought I was a little nuts. It was, uh..uncomfortable, to say the least. But, I just shelled out nearly $200 on private guitar lessons. If freezing my hands for two hours every two weeks keeps me playing, it was worth it.