Sunday, October 25, 2009

Catching up-- Part Two (the effects)

Wow! The coping medicines are amazing!!

When I go into the office for treatment, they start me out with a IV version of Emend, which is the high-powered drug to combat nausea. Then I follow up with a pill version of the medicine, one pill per day for the two days following treatment. It can be taken without food, which is a good thing because sometimes my stomach is on the verge of being queasy when I first wake up.

In the office, I am also given a drug called "Neulasta" which stimulates white blood cell production. That's a good thing, because I still go out in public and run the risk of exposure to flu or other sickness. I'm grateful to have those white blood cells to combat infection-- particularly since I had a fever last week, so my body was obviously fighting something.

Dr. Litton sent me home with a list informing me what my chemotherapy regimen is called, what chemo medicines I'm currently receiving, and listing all of the (initial) drugs, both prescribed and over-the-counter, that I would or could be taking. Some of the drugs are to combat nausea, like the Emend, Decadron and Compazine. Some can be generic versions of the medicines, others have to be the name brand.

Some of the meds are for situational use. With the Neulasta, there is the possibility of bone pain in the large bones (like leg bones) and for some strange, unexplainable reason, Claritin which is generally used for allergies, helps to alleviate the pain. Other potential side effects are constipation or diarrhea or mouth sores-- but I've had no real problems with any of them. If I did, there were over-the-counter solutions for them. One of the prescriptions that they wanted me to have on hand was for Levaquin, in case I got a fever of over 100.4.

About 7 days after my initial treatment, I found that I did have a fever that hit that numeric threshold. My instructions were before taking the medication, I was to call the doctor or on-call physician before taking the pills. I called and they told me to start taking the meds.

It should be mentioned, how very grateful I was that Dr. Litton had gone over the prescriptions in his office when he first gave them to me. When I took the 5 prescriptions to be filled, the pharmacy failed to include the instruction to call the doctor before taking the Levaquin. When I got home and reviewed the pill bottles, I didn't find that particular instruction on any of them. Fortunately, I thought I remembered that it was the Levaquin, but I had to call the pharmacy to verify that it was that particular drug that had the added instructions, which I then proceeded to write on the bottle myself.

I was also thankful that on the day of my first treatment, the doctor gave me the list that had all of the instructions in one place.

In terms of how I feel, things are pretty good. The instructions are to take the meds whether I feel nauseated or not-- its better to be proactive rather than try to treat it once you really feel awful. I've felt a little queasy upon occasion, but with a little compazine, it's not been particularly bad. I've been able to eat regular meals, but I should admit that my palate is kind of fickle. The past few days the thought of eating meat or casseroles isn't particularly pleasing-- I want fruit, preferably in milkshake or smoothie form. Bread and toast are pretty safe, as a yoghurt and cottage cheese, but the milk products can be iffy.

The biggest challenge has still been pain. I've always associated it with the tissue expander, but one of my friends said that she just couldn't ever move her arm because of the pain. So maybe it's just part of the healing process from the surgery. I've been taking Alleve and an anti-anxiety drug which helps to extend the effects of the Alleve, but it just wasn't working. It's been good having Mari here, because she just insisted that there was no excuse for the pain. She was actually kind of upset that I didn't ask for pain meds when I called about the Levaquin. With the pain, I couldn't sleep at night, it hurt during the day, but since I wasn't feeling completely debilitated, I thought I just had to live with it. Now that I've been given pain med, I cannot believe the difference that it makes. Even though I'm allowed to take it every 4-6 hours, I only take it twice a day-- that's enough to keep me going.

Since I wasn't sleeping, Friday they also gave me a prescription for Ambien. I was definitely given the caveat to make sure to take it with enough time so that I could get 8 hours of sleep. I took the pain med first on Friday and then took the Ambien just before bed. Almost immediately I felt like a zombie. I was able to sleep, but was still able to wake up to use the bathroom. The problem, however, was that I didn't feel very steady on my feet. As a matter of fact, it kind of scared me-- I was afraid I would fall. The pain med was enough so that I could find a comfortable position to sleep, so I've decided to take the Ambien only as a last resort. It was just a little too much.

But, let me tell you, I woke up on Saturday morning and felt fully alive!!! I was amazed at how good I felt! I don't know if it was lack of pain or just a good night's sleep, but I felt great! I felt so good that I kind of pushed my activities for the day. I actually ran out of steam about 4 hours after getting up, but because we hadn't finished my/our list for the day, I kept going for another 4-5 hours. It was too much.

Superheroes listen and heed the advice of those who have the knowledge and experience to help them through difficult situations. They are humble enough to admit that they don't know everything. The big lesson, however, is to ask questions. I don't seem to be the only person to know that we don't always have to suffer through situations. Mari was here to say, "this isn't necessary"-- and I needed to know that. I was doing the best I could, based on the paper I had been given, but the paper didn't really say anything about dealing with pain. I guess the doctors expected me to let them know that I wasn't doing well and I thought that the pain threshold was too low to ask about it. I guess I forgot that when I was in the hospital, they told me on a scale of 1-10 (ten being the highest), I should aim for 2-3. I was probably experiencing 5 on that scale. It wasn't enough to completely stop me, but it was a constant presence. Until I changed how it was being treated, I really had no understanding as to how limited I was feeling and acting. I am so very thankful to have learned this lesson and to have had someone here to teach it to me!

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