Tag: Paclitaxel

vaseline

Thin Skin Begins

In an earlier post I mentioned how the killing off of cells in the esophagus and stomach can result in heartburn. Turns out that there are more cells in the gastrointestinal tract that are affected. I’m sure you’ve heard of the mucous membrane. It lines all body passages that communicate with the air, such as the respiratory tract, and have cells and glands that secrete mucus. Makes sense.

When you have chemo, the mucous membrane is affected. Bad things happen. Smart people call it mucositis. 

 

mucositis

The part of this lining that covers the mouth (oral mucosa, go figure), is one of the most sensitive parts of the body and is particularly vulnerable to chemotherapy. You don’t want oral mucositis. Open sores, bleeding gums, pain, pain, discomfort, hard to eat, yuck. So I’ve decided to pass on that side effect. 

An ounce of prevention … 

I’m doing some simple things, like:

  • changing to a soft toothbrush
  • using a less harsh toothpaste 
  • swishing twice / day with flat soda water (you can also use baking soda and water, but YUCK!!)
  • avoiding foods that would irritate the mouth (spicy, acidic, you know all about it…)

I’m also doing something called “oil pulling”. It’s an Ayurvedic practice that is simple and boasts very positive results for oral hygiene. I’ve been doing it since Christmas when my big brother told me about it – and I have already noticed a difference in how my teeth feel. 

How to oil pull: put up to 1 tablespoon of an oil such as sesame, sunflower or coconut in to your mouth (ok, I use about 1 teaspoon) and actively swish it / pull it through your teeth for 20 minutes. No swallowing! Then you spit it out (not in the sink or toilet as it will harden) and rinse with warm water, spit that out (not in sink or toilet), and then brush and floss (gently in my case). I use coconut oil because it also has lauric acid in it, which is apparently very good. Plus it tastes better (not that you taste it, to be honest, but I imagine that it tastes better). 

coconut
I am too lazy to warm it up in the morning so I take a teaspoon of it in its solid state and chew it / let it melt in my mouth. Kinda gaggy, but you get over it. Or you can not be lazy and warm it up.

At first I could only do 5 minutes. But I worked up a few minutes each day and now I have no problem with 20 minutes each morning. And it’s amazing how much I can get done while I’m swishing … light the furnace, chop some wood, make the bed, … 

So far my gums are healthy and I have no indications of any sores developing. I’m sticking with it! 

Sniffle

My nose, however, is starting to suffer. The skin cells are not reproducing any more, the hairs that normally trap the mucous are disappearing, and the membranes are thinning. This results in:

  • dry, crusty nose – feels like there are scabs in there ALL THE TIME
  • bloody bits and smears and chunks in the mucous coming out of my nose (I have a photo, but it’s just too gross)
  • sniffling 
  • did I mention that it feels really dry? 

So I’m working at increasing the humidity in the house – water on the woodstove, vaporisor by my bed. And I LIBERALLY coat the inside of my nose with Vaseline. 

vaseline
Where did this even come from? Kroger mystery. Is there a shelf life on Vaseline? So many questions. 

Apparently, if my nose does start to bleed, it may take a while to stop, since my platelets are affected by chemo. So NO NOSE PICKING! 

Butt wait, there’s more!

On a related note, remember how I was talking about how toxic I am?  The other day I search the Drug Monograph for Paclitaxel in order to see if there are contraindications for the use of essential oils and medical marijuana (that’s for another post, so sorry). There is a section called “elimination” that breaks down exactly how the Paclitaxel is getting out of my body. It says that there are “high concentrations found in bile; 71% excreted in feces in 120 hours”. OK NO WONDER MY ASS WAS ON FIRE!! 

elimination
This drug monograph is 14 pages long. Very informative.

And so you can understand why this mug is my companion, and why I send poop emojis to Annie so that she can be updated. (She loves it. Really.) 

poop mug and me
Sometimes there are fireworks.

Meanwhile, my head is feeling a bit numb / tingly. I think my next post will be about alopecia. Just a guess.

saltine

Heartburn Doth Strike

Heartburn appeared pretty much as soon as the cocktail of “pre-meds” wore off (one of which was a dose of Zantac). I felt really good on treatment day (apart from being high as a kite from the Benedryl), and the next day too. Then after a fab dinner of chili, Liam and I went to his Grade 9 Open House where I proceeded to SUFFER. 

As a consequence I am now armed with heartburn information and meds. Here are the highlights:

What is heartburn?

It’s often called Acid Reflux. Basically it’s when acid from your stomach that is there to digest your food goes starts to hurt you. Generally speaking, the acid in your stomach splashes up into your esophagus (food tube). There might be too much of it, your stomach might be too full or the muscle that acts as an elastic band between the stomach and esophagus might be too weak.

The official name for it is GERD (Gastroesophageal reflux disease) which is a disease that affects the muscle I was talking about. The official name is the Lower Esophageal Sphincter (there is more than one, sphincter! Ha!). As I mentioned, the LES is between the stomach and esophagus – it’s a band of muscle. GERD can also happen to pregnant women since the LES is more relaxed due to all of the hormones. Also, the baby pushes up against the stomach which drives food up through the LES. (I ate a lot of Tums.) Other folks who have a hiatal hernia can get GERD. That’s where part of the stomach and esophagus get pushed up into the chest wall where it doesn’t belong. 

Here’s a diagram that I drew for you (including my recent incisions and my portacath too). It  shows you where things are:

heartburn
Should have put the diaphragm in. Forgot that. 

Why does heartburn affect people on chemo? 

Chemo targets cells that divide at a really fast rate because that’s what cancer cells do, they multiply and take over and wreak havoc in the body. So any other cells in my body that also rapidly divide will be KILLED by the chemo. And the cells in the lining of my stomach and esophagus, which protect my digestive organs from acidic stomach acid are in the list of fast growing cells.

So basically, during chemo any stomach acid in my digestive system is going to hurt me because the protective coating (cells) are being killed off. I don’t have GERD per se, but during chemo I will have the same symptoms as GERD. Make sense?

What can I take for heartburn?

This is interesting! There are 4 different ways to go:

  • Tums, Rolaids: These are acid neutralizers that contain calcium and act as a buffer between you and the acid – but they can actually cause more acid to be produced once the barrier is gone (called acid rebound). Use occasionally. 
  • Gavisgon: This contains alginates (derived from algae) that also act as a barrier (coats the stomach). Very cool. Makes a “raft” and prevents the acid from getting up and out of the stomach. I think I will try the raft. 
  • Zantac: H2 receptor blockers (such as ratinidine) that reduces the amount of acid from building up but increase the risk of cardiovascular problems and osteoporosis – GAH! And I bought this! 
  • Nexium, Prevacid: Getting stronger now – prescription strength! These are “Proton Pump Inhibitors” that also prevent acid from forming – they seem to be like Zantac but are stronger, and not for occasional heartburn. These are for people who suffer badly from GERD and their esophagus is getting damaged. Lots of side effects. Avoid avoid! 

What can I do to avoid heartburn? 

Being a person who likes to avoid taking drugs, I am aiming to prevent heartburn rather than having to take the medications listed above. (Of course I WILL take it if I have to – I’m not into any extra suffering at this point!)

Prevention tips 1 and 2:

  • eat smaller amounts at a time
  • eat more regularly (this is a LOT harder than it seems)

Most importantly though, I have to stop ingesting:

  • caffeinated tea and dark chocolate – ok, anything with caffeine
  • wine / alcohol
  • oily / fatty foods (don’t even talk to me about this category, I can barely manage the first two)
  • citrus
  • tomato based foods
  • spicy foods
  • garlic & onion
  • more good stuff
  • more good stuff 
  • more good stuff

Basically, I’m going to eat BLAND food, very regularly, with lots of water. Oh boy. 

What is the silver lining? 

Let’s just be clear. When people mention the “silver lining” to a shitty situation, it’s akin to saying “there are plenty of fish in the sea”. Just shut up already. But if I had to pick the silver lining for this one, it’s 

Ok I can’t think of one. 

 

toxic logo

Toxic

Chemotherapy medicines are toxic. So therefore, when you’re receiving chemotherapy, anything that leaves your body is toxic. You have to be careful where it goes and who comes in contact with it.  

Naturally there are some basic safeguards – some that make tons of sense, some that are perhaps a bit surprising. Here’s the basic list:

1. Pee

You may not think that this is a big deal. Just flush it down and Bob’s your uncle (I know, he IS!). There are actually rules to the flushing. First one is to sit. Not a problem for me, as I always do. But dudes have to sit to pee. Not that that has anything to do with me, but I tought it was notable. Secondly, put the lid down before you flush. Who does that? Last, and the most disturbing to me, double flush! 

Flush sign

This may not seem upsetting to anyone … but I’m an environmentalist. Having grown up at a cottage, I’m already conditioned to NOT flush unless it’s very very yellow & stinky or brown. (Note: At home I do flush after I pee (promise), but I flush once.) So I find this to go against my principles. (I can tell you this, though, if I’m peeing during the time that I am receiving treatment at the cancer suite, you can bet I’ll be flushing twice! People track you with their eyes and likely listen for the double flush.)

The other thing about pee is that when you’re female of a certain age, it tends to be less able to stay in it’s correct location when coughing or sneezing or laughing or jumping on the trampoline.

I have been told that each time any pee gets on me I have to wash thoroughly (probably twice since that seems to be the norm) and if it gets on my clothing or sheets I have to wash them TWICE. Separate from other items. Geez. This seems like a lot of work. (Am I going to be wearing Depends?)

2. Sweat

I told the nurse that I don’t sweat. She raised her eyebrows as if to say “reeeeaally” or “you don’t sweat YET”. She then asked about hot flashes and night sweats. Hmm, well, I don’t sweat much …. ok, I’ll wash my sheets more often. Fine.  (But I’m not washing them twice.)

3. Vomit

I’m hoping I don’t have any issues in this department, but if I do, I have to follow the same rules as above – two flushes two washes. Of anything it touches. (I think I’m in denial on this one, but I’m not a puker.)

4. Stool

Who says stool?? It’s POOP, people!! I don’t think this will be a problem at all, since I haven’t generated very much since my 1st treatment. I know. It’s not a good thing. I’m on it …

poop inducers
Pear juice, herbal tea, bran muffins and a supportive mug. Bam!

5. Vaginal Fluid

Hold the bus. What? Yep – it’s toxic. So sex must involve covering it all up. Uh huh. A condom… and for other activities enjoyed by women, a dental dam. Ya, that’s not happening. 

What’s not on the list:

I asked the nurse why saliva is not on the list. I am going to try to reiterate what she said, but it didn’t make any sense to me so I’m not going to sound convincing. It’s ok because it is less likely to come in contact with someone. Um … what if I cough? Not enough. Or spit on someone? Funny look. What about kissing? Not enough. (Ok that woman must be a dry kisser.) I let it go. 

Some of the Additional Rules:

  • Anyone who deals with my “body fluids” has to (obviously wash it off their body asap, twice?), wear gloves and be given a medal. 
  • Any “body fluids” needing to be cleaned up are collected with paper towel that is then sealed in a plastic bag and put in the garbage – which is then sealed. (Of course I’m wondering what will happen if I toss it in the fire instead …)
  • If any of my “body fluids” get into my eyes or someone else’s eyes (ok … what??), the eyes must be flushed 2 or 3 times. Hard to get that image out of my mind. Projectile vomit? 

Good times, people, good times. 

And yes, you can visit me. Just stand back a safe distance. I’m toxic.

Waiting room

In the Brown Recliner

Prior to this cancer journey I didn’t pay any mind to the recliner chair. I began to see the light a few days back when I had my information session with a Cancer Centre nurse. Her job was to be sure I understood about the chemotherapy, the side effects, and the procedures at the Centre, but she actually helped me to understand the power of the recliner. Specifically the brown recliner.  

What I found out:

– The name of the place that I get my chemo is called “the suite”.
– The chairs for patients are all recliners.
– The brown chairs have a massage feature in them.
– It is chilly in the suite. Blankets are recommended.
– The brown chairs heat up. 
– There are less brown chairs than beige chairs.
– Wednesdays are the busiest days (this has to do with Tuesdays being the days that most of the oncologists meet with patients – which happens the day before treatment)
– Since I go on Wednesdays I may not get a brown chair.
– People can bring me food and drinks but they can’t eat or drink with me.
– TVs are all on mute. I must be able to read the closed captioning.
– There is one chair beside every beige and brown recliner … I can only have one visitor who is not eating or drinking.
– The washrooms in the suite are not for visitors.
– I cannot go to Tim Horton’s but I can go and pee with my IV pole. But not with my visitor. 

What I noticed on my tour:

– There are 4 sections in the suite, each one assigned to a different nurse. 
– Each section has 4 or 5 recliners. A couple of them are brown.
– There were only 6 patients in the suite, scattered in the different sections. All of them were in brown recliners. None of them were talking.
– As I walked through, each of the patients glanced at me with a knowing look.
– Chemo drip bags come through a hermetically sealed window at the far end of the suite. 
– There are 2 washrooms. (For patients.)

What I determined:

No picnics. No singing. No visits from loud friends. No way I’m missing out on a brown recliner. 

Brown chair
Coveted.

My first treatment is happening while I write this. And yes, I got here early, in hopes of a brown chair. Oh ya, you guessed it … I got one! 

Me in the chair.
Very comfy indeed.

My bum is nice and warm.  

What I’m Doing in the Chair Today:

Schedule for the today (week 1):

– begin with a “loading dose” of Herceptin (8ml / kg) that lasts 90 minutes (the next doses are not as big … they are called maintenance doses with 6ml/kg)
– They watch me for 1 hour. For side effects, but likely also to see what kind of patient I am … complainer? Rule breaker? Under prepared? No friends? Chatterbox? Eavesdropper?
– Then I get approx 1 hour of “pre-meds” before the taxol. They include 4 things:
1. Oral dose of anti-nausea pills that I have to remember to bring with me each week. Oh oh. 
2. Benadryl (oral)
3. 15 min of Zantac drip (coats the stomach, helps with nausea)
4. 15 min Dexamethadrone drip (steroid)
– FinallyI get the nasty stuff, Taxel for 1 hour and 15 min.
– Then I get a ride home at around 2.

My drip
Very impressive system!

Extra Curriculars:

I’ve got a load of things to keep me amused. All the technology: iPhone, iPod, ipad (yes, Apple junkie). Lunch & drinks. Knitting. Journal. Book & magazine. Etchasketch. 

Better get busy! Lots to do.