Tag: mucositis

Irritated

I am a gal who is easily irritated. Years ago when I was a scrapbooker, I created a page called “100 things that bug me”. I’ve attached the page at the bottom so that you can see for yourself. This is REAL. I live my life in a relatively high state of irritation. I think that this is what my friend Sonal would attribute to being “gold”. Whatever the reason, I am constantly having to self talk so that I don’t say something off base / rude when I’m irritated. For example, at the cottage around 8 years ago people were arriving for a long weekend and I said boldly “oh you can put that case of water back in your car – we don’t use disposable water bottles here.” RUDE! But I knew that otherwise it would piss me off all weekend … my punishment is that I still think about it today.

During this cancer journey I have to deal with a LOT of irritants that affect both my body and my quality of life. My solution is to focus on eliminating the irritant rather than trying to ignore it. It’s a basic research cycle that goes like this: identify it, find info on it, try a remedy, write it down, gauge progress, make changes, observe again. It’s entertaining! And it’s currently my day job.

Top 5 irritants (you knew it was coming):

1. Horrific Nose – top irritant by FAR

As I mentioned before, mucositis is a common side effect. The chemo essentially destroys the mucous membranes from nose / mouth to anus. The whole she-bang. 

My main focus is coping with the scabbing / bleeding cycle that takes place in my nasal passages CONSTANTLY. There is nothing to stop it from happening, but I found a few things that help manage it:  

  • vaporizer in my room – feels like a rainforest in here sometimes 
  • walnut oil – this was a total experiment – I saw it at Sullivan’s and thought I’d give it a try – you just squirt it up there … so soothing! 
  • Secarus – put it on a Q-tip and rub it inside the nose for some relief (downfall is that you can’t get up there very far) – no more Vaseline … it’s no where near as effective
Me in my doo-rag. Comfy but questionable.

Ok, let me reinforce that this side effect is REALLY irritating. This will help you to understand: I try to only blow my nose when the sniffling is bugging even me or when it is completely full of scabs and I can’t breathe anymore. Other times it gets to the point of being so itchy that I repeatedly sneeze which inevitably loosens the scabs. Once they are out it bleeds a bit – I stick my remedies up there and then it begins to scab up again. (Of course my kids hate it when I want to show them the scabs. They are HUGE. Yeech. Gross. Gak.)

 

2. Poop Trouble 

I have never been a good pooper. I listen to other humans (mostly men) offhandedly brag (?) about their morning constitutional and I think REALLY??? In my regular life, pooping has always been directly proportional to how much of the good stuff I ingest (water, veggies and fibre) versus the stuff I like (gluten, dairy, caffeine and junk food). It’s a balance that I had perfected. 

Then came the chemo and pre-meds. Constipation is high up the list of side effects for both. My struggles have made me very empathetic of all of my friends who struggle with Crohn’s or irritable bowel syndrome!! 

So ya, I am hyper focused on pooping – I take an inordinate amount of pills (see below), and have changed my diet a LOT. Much more greens, dramatically reduced gluten intake (sad sad sad) and more drinking than seems reasonable. Honestly, for a person in education who has spent 28 years never drinking in the daytime since there is no time to pee, this is horrific, the water intake. I mean, seriously. It is BORING!! I have to force myself to drink more. I make a lot of deals with myself. It’s rather sad. But the poops make it worth it in the end. No pun intended.

poop inducers
These do the trick, but you’re not supposed to become dependent on them. So I only use them prior to chemo and on the night of chemo and whenever I’m in dire straights.

 

3. Gut Pain

I was first introduced to the idea of severe gut pain precluding puking when I was a new teacher. It was illustrated by Kathleen, one of my Grade 1 students at the Point. I’ll never forget it. We were sitting in a circle at the carpet – someone was sharing. She suddenly jumped up, ran across the circle clutching her stomach. “It hurts!” she said. I pulled her onto my lap (MISTAKE MISTAKE MISTAKE). Less than a minute later she was puking red hot grossness into my cupped hands (save the carpet!) while I tried to pick her up and get us to the bathroom. 

Gut pain is real. For the majority of people it comes right before puking. But I’m not a puker (unless related alcohol poisoning or food poisoning). I think I’ve puked less than 10 times in my entire life. With the chemo I have gut pain – it can be ‘kicked in the stomach’ gut pain or ‘low level constant aching’ pain. Either way, I have it for approximately 3 days in my 7 day chemo cycle. Irritating.

Three of the pre-meds I take work against nausea (Ondanestron, Dexamethasone, Raninadine – more about them in an earlier post). So I’m numb for a day and a half and then the gut pain comes. I have more of these drugs that I can take if I wish but they are very bad for constipation. For this reason I’m wary of taking ANY more drugs than I have too – their side effects are often not worth it. 

Of course a drug that manages nausea well for chemo patients with relatively few side effects is medical marijuana. I talked to both my oncologist and GP about it. You’ll never guess – they were reluctant to give me script (“I can give you other drugs for that.”)! Such a surprise. My GP didn’t flat out say no – but prescribed Nabilone which is a synthetic cannabinoid that mimics THC. Work exactly the same but is man-made and provided in doses. I think that this gives the medical community the feeling of having more control over its usage. Still – seems strange not to be able to use a very helpful and naturally derived drug. I mean… I have SO MANY DRUGS from this journey that are far more problematic in terms of addictions and harm to the body (e.g., Oxycodone, Percoset and Tylenol 3’s from my bi-lateral mastectomy). Clearly there is a need for research on the use of medical marijuana so that we can get on with treating people with the least invasive drugs. Ridiculous!

Nabilone
This is a shit ton of pills – agreed? In 0.5mg doses. I can have up to 2mg, 2x/day. No sharsies.

The negatives with this particular solution is that Nabilone takes a while to kick in, I can’t drive and the dry mouth is irritating (I drink enough water already, for Christ’s sake!). But the gut pain leaves completely – as well as any heartburn. Bonus!  

 

4. Kibosh on Reward Eating

I’m a person who is highly motivated by the prospect of food. I know it’s wrong. Food should be fuel. You should only eat what you need. You should only eat when hungry. BLAH BLAH BLAH. 

Prior to chemo the following 3 reward schemes defined the boundaries of my poor eating habits:

  • the chips / junk food reward
    • used to be when the kids were finally in bed, now it’s any time after dinner (On a daily basis, yes! Big problem, I know…)
    • when I drive long distances (very motivating, keeps me awake – chewy candy is the BEST – makes the trip enjoyable!)
    • when writing or reading report cards (the pain of it doesn’t stop when you’re in Admin…) 
  • the Starbucks / crap drinks reward – “you deserve this because you are an entitled white person who can afford this ridiculously expensive high calorie drink with a stupid ass name” – so wrong, but somehow helps you get through meetings at the Big House much more easily
  • the alcohol reward – for just about any issue or getting through a tricky day at work or a long week, or a crisis, or a tragic Netflix show – oh how I miss a glass of wine at night!!! sad sad sad

Why can’t I eat this stuff? I can’t eat lots of sugar because it is too harsh on my taste buds – feels like I’ve burnt my tongue on a hot tea. Same with salty snacks. Chips will rip holes in my face. Alcohol is dehydrating and burns all the way down. Starbucks treats are high in caffeine which is dehydrating. (Remember, dehydration will slow down the poops even more…) 

So no more reward eating. Life is not very much fun without all of my typical vices. Truth. On the flip side, ice cream, home made juice popsicles and frozen yoghurt are options that also make my throat feel so much better. So I’m enjoying them A LOT.

5. Tiredness

This is just starting to happen now. The treatments are piling up, so my legs feel a bit more leaden and my overall energy is lower. Naps are happening. It’s weird. It’s hard to get anything done. Dinner is a drawn out affair with NO multitasking (omg) and I’m often bitchy by the end. I am best to prep dinner in the morning or the kids will suffer (In this way, I think that this side effect is actually most irritating for my kids!) After dinner I lock myself away in my rainforest and sit on my ass. Yoga in the evening is beyond me now. Being tired is very boring. 

Coping

So ya. This chemo thing is irritating … but I’m surviving it by being proactive and with self talk. Get over yourself! You’re not dying. Shut up already! (I reserve these for when I’m having a lot of pain / discomfort.) Keep going! You can do it! (when climbing flights of stairs at the hospital) I also do visualizations of the spring and summer when the chemo will be behind me. 

This too shall pass and I’ll once again perseverate over the small stuff. And eat chips. Crunchy crunchy chips with salt and vinegar. 

Scrapbook page
Ya, … the small stuff. 

 

 

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.