My second round began on the Friday before the new term started. Luckily, both my parents were able to come out a little before that, so we had some time together while I was pretty conscious. We went to Ash Lawn, James Monroe's house, on the orders of my mother's doctor, who is from Virginia and expressed possibly well-justified annoyance that everyone goes to Monticello (which we had the previous year) and no further. Well, we are no longer guilty of this oversight, and it was lovely there. Then it was time to get knocked out again. Luckily, too, I had no teaching duties during the first week of school. I did go, in a bit of a daze, to the first day of three classes: the history lecture for which I am TAing, and the two classes I had originally intended to audit before all this happened. I wanted to get the syllabus for each and try to see if I would feel up to attending at all...after a few more days of recovery.
One of the best things my care team suggested for this round was to get me something for the pain. You see, the shot I get on the day after my major treatments, the one that increases my blood cell production, works amazingly well. I'm naturally a little neutropenic—deficient in a certain type of white blood cell—and if my levels aren't at a certain minimum they can't administer treatment at all. So this shot is very crucial for keeping me on schedule. Unfortunately, since blood cells are made in the bone marrow, when the medication is working it makes my bones hurt! A lot! The first time, I got up Sunday morning walking very much like Frankenstein and I never slept that week past 4am. It was worst in my thighs and upper arms, but the pain was present in most other places, too, especially in my sternum and joints. When I mentioned this, pain meds were quickly offered, and the second time I didn't have any trouble sleeping. For this, I am truly grateful!
That seems to have been the bright side. The weird effect on my mouth and taste took longer to begin but also lasted longer. It's difficult to describe, because it seems like several things are happening at once. My whole mouth gets sensitive to everything: heat, spice, pointy food. Even the crust of bread must be eaten very gingerly. If I lick my lips, it feels like they have been in the tub too long—somehow a little pruny. They're not, really, but they sure feel like it. Food either tastes like nothing (a fruit smoothie with no flavor), or like only one thing (primavera pasta that tastes only of black pepper), or like something totally different than it is (a mild Chinese brown sauce now inexplicably sour). I thought when I first learned about this particular side effect, clinically called “taste perversion”—which sounds, my mother points out, like a different problem altogether—I thought that it would last for the duration of treatment. I have been delighted that this and most of the really unpleasant side effects have so far faded within a week or ten days.
The nausea was slightly more intense, but was thankfully controlled with an extra dose of zofran and/or ativan here and there. The fatigue was worse, too, but not by much. I slept for an extra day—through Monday this time, when last time I was up and in the classroom Monday morning at 9:30am. I had a slight fever over the weekend, too, which was new.
Once I recovered, some trial and error in the wide world over the next couple of weeks led me to conclude that I shouldn't be out of the house for more than about 3 1/2 to 4 1/2 hours at a time. This last discovery forced me to make the difficult decision to stop attending one of the two classes I was hoping to pop in and out of as a rather unreliable auditor. It was too much, even during the last and most functional week of the cycle, to go to class on the days I had most of my teaching duties, too. I tried it. No good. So Greek Lyric Poetry had to go on hold. I still do try to attend Fragmentary Latin Historians when I am well enough.
The biggest change between round one and round two was the development of peripheral neuropathy, which started as tingling and stiffness in my hands and feet. I'm not thrilled about this. When I was first reading all the copious amounts of material that the breast care center gave me, I came across a pamphlet describing the many possible side effects of chemotherapy. I knew about most of them. I didn't know about the nerve damage. Even more disturbing was the caveat that such effects usually fade over time, but sometimes they don't.
I suppose this is a risk with many things. Hair loss can become permanent. So can infertility. But, for some reason, it was the nerves that led me to ask my doctor about whether chemotherapy at my young age made me more at risk for delayed side effects when I get older. There are some such risks, of course, but she said that it was my youth that gave me the best chance to overcome some of these more troublesome things—like the three I just mentioned—that just take time to return to normal. If the nerve problems become debilitating along the way, if I start falling over inexplicably or the like, they can reduce the dosage of the chemo. They'd rather not, of course. So the tingling is yet another reminder that cancer treatment really is designed as a delicate balance of poisoning the cancer without poisoning you quite too much. It is also yet another opportunity to practice not worrying overmuch about an uncertain future. My life is as full of such opportunities as ever, as you might imagine! So far, so good, anyway, and it does seem to be working! And that's the first priority.
