8 Days and 7 Nights - The Aftermath of Chemotherapy

As I mentioned before, receiving a chemotherapy treatment and the Neulasta shot a day later was really no big deal.  It wasn't particularly painful and I wasn't really sore or tired in the 2 days following the initial chemotherapy treatment. I was told that every person's body handles chemotherapy differently, so I thought I was just one of those lucky people who really wasn't affected by all the possible side effects of the chemotherapy drugs.  I was wrong.

Hello Nausea

The word 'nausea' and 'nauseous' used to be 2 words that I was most likely to misspell for most of my life.  I have overcome that challenge.  I wrote those words so many times over the past 8 days that I can spell it in my sleep.... on Facebook, on Emails, on text messages, in chat rooms.  The story of my life for the foreseeable future - nausea. 

I have been nauseous before. I have had 2 babies and was nauseous for the first 12 weeks for each of them.  But it wasn't really 12 weeks. For each of them, on the day I was officially 12 weeks pregnant the nausea would end.  The first 4 weeks of each pregnancy I didn't know I was pregnant yet, and never experienced the nausea until I found out.  Almost within a day of finding out I was pregnant I would start with the morning sickness. For this reason, I had convinced myself that morning sickness was in my head.  I could handle that. This was different.  I kept asking myself why I couldn't tolerate this nausea. It wasn't that bad when I was pregnant. Why is it bad now? 

When I was pregnant, I could ward off nausea by eating something.  This is why I gained weight when I was pregnant -not because I had a baby growing inside of me, but because for 8 weeks I was eating constantly trying to not get sick.  So I tried this now.  Like when I was pregnant, eating helped me feel better.  But AS SOON as I swallowed, I was sick again. I was going to double in weight by the time this ordeal was over.

I was given some great advice on how to control this nausea. I was told to eat ginger. I love ginger. I don't like ginger while I am on chemo. In fact, the smell of it makes my nausea worse.  I was told to try ginger snaps. I don't like crunchy cookies so I ordered up a special batch of chewy ginger snaps from my one and only Cha-Cha Tina (my Mom's best friend.... I think 'Cha-Cha' means Aunt in some language).  I had one and felt better! So I had a second one and felt sick again. I was told to eat lemon candy and my 'cousin' Jenna brought me a whole bag of them! (cousin is in quotes because I don't think we are actually related in any way, but my family has friends that are so close and so loved, they might as well be family).  I ate a lemon candy and was exhilarated! I ate a second one and got sick again.  So what I learned is that if I find something that makes me feel better, STOP! Enjoy feeling better and don't push it. 

When I say I got sick, let me be clear that I at no time vomited. That would actually make me feel better I think. Normal nausea is a building tension you feel before you puke. The puking is like the orgasm of the nausea... the climax. Then afterwards, you feel better. Relieved.  Ready to move on.  This nausea had no climax. It was bound to drive me to death at some point.  When I was able to fall asleep, I would get relief only to wake up, sit up, and start the nausea all over again. If I woke up to use the bathroom in the middle of the night, I was nauseous.

Nothing was appetizing.  The smell of food would launch warfare on my stomach. I would gag occasionally for <gag> no reason and with no outcome. I would be on the phone and <gag> mid sentence just start gagging. But it would be unceremonious and I would pick up my sentence right where I left off without so much as an apology for my gag, much to the disgust of the person I was talking to. Sometimes I would be very comfortable on my recliner and when I felt this way I couldn't move. If I so much as turned my head to look at the person talking to me, the nausea would return. 

Before I left the chemo treatment on Tuesday, the nurse gave me a script for Prochloperazine for nausea. I took this immediately, first thing on Thursday morning. It did not really help the nausea, it just helped the gagging. So I called the doctor Thursday afternoon. The doctor called me back Friday to see if it was getting better and I told them it had not, so they called me in Zofran. They told me to take the Zofran AND the Prochlorperazine at the same time because they both target a different neurotransmitter. I thought 2 different anti-nausea meds at the same time has to work, right? Not.  Luckily for me, Saturday came and the nausea lightened a bit. I still felt like crap if I moved, but it was better. At this point, it was like pregnancy nausea. Maybe a little worse, but worlds better than Thursday and Friday. 

Finally on Thursday, 8 days after my Neulasta shot, the nausea got to the point where I could function. Just in time to see the doctor for a checkup.

Thanksgiving Turkey

The day after the Neulasta shot, I got a symptom less common than the nausea, but just as uncomfortable.  Some people report a metallic taste in their mouth. I never got that, but I did get a salty taste in my mouth. I always felt like I just gargled with salt water and was extremely thirsty. I just couldn't get enough water, so I drank it. Now I usually drink a ton of water anyway... usually 5 or 6 refills of my 32 ounce Weight Watchers mug.  And I was more thirsty than usual.  Usually when I drink all my water, it comes back out again.  Now it didn't.  But I was losing weight.  Where was all the water going? I'll tell you where, it was collecting in a large pocket right below my ribs where my diaphragm was.  It was very uncomfortable and more importantly I looked ridiculous.  Imagine a woman with no breasts whatsoever and now, thanks to my failed DIEP transplant, no lower abdomen. I was completely flat from neck to pelvis... except for a kidney shaped protrusion halfway between my chest and my belly.  I looked like I was ready to be stuffed and basted for Thanksgiving. 

I called the doctor about this strange shaped protrusion I had coming out of me on Friday. They didn't seem to care so much that I looked deformed as they were about the water going in not coming back out.  A couple things they mentioned included electrolyte imbalance, diabetes, dehydration, among others. They had me come right in for blood tests.  Of course my blood tests came back completely normal so the nurse told me not to worry about my new body shape and just keep chugging along. 

Luckily for me, come Saturday morning what went in finally came out and my shape returned to normal. I continued to be thirsty for quite a while though, which is no big deal because I love water more than I love wine. This is especially a good thing because the smell of wine was beginning to make me sick. 

A Saved Trip to the ER

When I returned to work on Monday, 7 days after my chemo treatment, my nausea was being controlled so I was able to get some work done. I say 'some' because it is extremely hard to focus on

one task with nausea, even if it is controlled.  I was controlling the nausea with animal crackers, meds, and oranges.  I was told to try some ginger ale so I brought a liter of it to work with me and drank it while I had my meetings.  This was a mistake. Just as ginger snaps and lemon candy bothered me when I tried more than 1, the ginger ale really bothered me. I started to think that maybe it was the sugar that was triggering the severe nausea.  The ginger ale did in fact make me more nauseous but it also triggered a much more acute symptom - reflux.  I drank one glass of ginger ale on Monday afternoon and for the rest of the day I couldn't eat anything without it coming up and burning the back of my throat. Water would cause worse reflux so I stopped drinking water and started getting very thirsty. 

When I went to bed Monday night, I began getting acute stomach pains.  Short lived, super sharp pains in my lower abdomen woke me from a sound sleep all night long. No doubt you know what these pains feel like.  If you have ever been warned of an oncoming poop with stomach pains, or been notified that you haven't taken a poop in too long with stomach pains, you know what this feels like.  So I spent Monday evening walking from the bed to the bathroom.  But it was all to no avail. Neither of these 2 situations applied to me, I was just getting the pains. 

When 7am Tuesday came I was as tired as I used to be when I had babies nursing all night or worse, puking all night. And I still had nausea and reflux. Tuesday really flipping sucked. The reflux and nausea continued throughout the day and even though I was eating every few hours, my weight was going down. Hooray! Finally something good was coming out of this misery!

Tuesday night I remember sleeping without pain or incident and I think it was from sheer exhaustion. I couldn't have stayed awake to experience pain if I tried.  And I think that because Wednesday the pain picked up right where Monday night left off.  I experienced sharp stomach pains, reflux, and nausea.  I was on a strict regime of my anti-nausea meds, Loritabs for my chest incision pain, oranges for the nausea, and Tums for the reflux.  I had some Moe's chips and queso on Wednesday because I was so nauseous and it was free! It helped the nausea for almost 2 hours which was a welcome break.  Unfortunately, none of the other pain subsided. The Loritabs were barely working anymore (the fact that I forgot to bring them with me to work didn't help matters. They can't work if you don't take them).  The Tums weren't helping the reflux.  The abdominal pains were getting more frequent and there was nothing I could do to help those except get on my hands and knees and rock back and forth. 

Wednesday night was like Monday night continued. I rocked on my hands and knees most of the night trying to control the sharp abdominal pain.  At one point at around 4am I actually started to cry.  There was no way that this was normal or good.  I contemplated driving myself to the ER, but I have been there before. I will sit there in just as much pain as I was in at that moment for the next 8 hours and the end result, if I even get seen, will be that there is nothing wrong.  I had an appointment that day at 1pm with Dr. Dougherty to review side effects. If I was going to sit in the ER for 8 hours fruitlessly, I would wait 9 hours to see a doctor who could actually help me.

Thursday was another useless day. When you are operating on about 3 hours of sleep, feel like puking, and end up crippled over in pain every 30-40 minutes, you can't get much done. I couldn't wait to see the doctor.  When I got there, they found that I had lost 6 pounds since the Friday before.  Even though this thrilled me, it did not amuse Doctor Sullivan, Doctor Dougherty's nurse practitioner. (Yes, I know she is not a certified doctor but I have just as much if not more respect for NP's as I do doctors).  Nancy Sullivan ordered me to get hooked up to an IV right away for rehydration.  I didn't think I was dehydrated, especially since I drank so much water. It also concerned her that I was still nauseous after 10 days. She included some Zofran in that IV, to make sure it was getting into my system and staying there. This ruined my whole afternoon because I was in the infusion room, with an IV hooked to my mediport (UGH! I HATE MY MEDIPORT AND IT FLIPPING KILLS!) for the whole afternoon. I almost missed Brandon's last basketball game. My 1:00 appointment kept me there until 5:45!

While I was there, Doc Sullivan ordered an ab X-ray on me.  The sharp pains were troublesome to her, especially since they didn't start until day 8. The pains along with the water retention I had the week before lead her to believe I may have a bowel obstruction. I don't know exactly how the bowel can be obstructed, but I really didn't want to find out.

I got the Xray results right away, and the results were surprising.  Doc Sullivan told me that the Xray showed no obstructions, but instead an irregular gas pattern. First, I was shocked that you could see such things with an Xray. I thought Xrays were to see bones?  Why did they use an X-ray to look for a soft tissue obstruction in the first place?  And how in the world did they see a gas pattern with an X-day and... Wait a second.... I got an X-ray to tell me that I needed to fart really bad? Isn't that what they mean by 'irregular gas pattern'?  Are you kidding me?  Thank GOD that I didn't go to the ER the night before. Can you imagine my fury and embarrassment if I sat there for 8 hours in pain just for the ER doctor to tell me that I needed to fart???  Doc Sullivan gave me a script for reflux, which is very common in chemo (who knew) and a digestive aid to cut down on the gas pains. I still can't believe it.  I guess when you have cancer, they take everything very seriously. 

A Glorious Day

I woke up Friday a brand new woman! All traces of the nausea were gone.  All my stomach pains were gone. I had gained 5 of those 6 pounds I lost back. Easy go, easy come back I guess.  I had energy to spare.  I was motivated to get projects done.  I slept well.  And most of all, I was HUNGRY!  I would have eaten anything, even liver.  I went out to lunch at The Grapevine and enjoyed a huge lunch of eggplant parmesan, spaghetti, and a big salad with croutons and ranch dressing. This may sound like just a lunch out to you, but at the time it was the best meal I had eaten in my whole life! I went home and wanted to clean, and work on my blog, and make jewelry, and clean out my closet, and shop. If I ever did cocaine, I think this is what it would feel like. Maybe I was dehydrated. The IV fluids and Zofran not only helped me get rid of the nausea but infused me with energy! The silver lining of chemotherapy... FINALLY!

So, going forward we are going to adjust my treatment a bit.  Day one will be chemo. Day two after my Neulasta treatment I will be getting 1000ml of saline and Zofran via IV. Then I will come back again on day 3 for another 1000ml of saline and Zofran.  Doc Sullivan believes that my problem is that the chemo drugs were not moving through my system fast enough... they were hanging around and reaping havoc. So the forced fluids and going to force it through my veins and right back out again.  In addition, I have been given a new anti-nausea medication to take at home called Marinol.  Marinol sounds fun, it is a synthetic version of the active ingredient THC which is found in Marijuana. I have the Marinol pills now, but haven't had to try them yet because the nausea went away after Thursday's IV session.  The good news is that I have them for my next treatment and I am hoping this time, I can head off the nausea before it gets that bad.