The Downhill Run

I'll admit - I'm a bit of a math geek.  I hated math as a child, but learned to love Algebra - and fractions - when I started to bake.  Kinda important when you're halving or doubling a recipe to know how to add those freaky, odd numbers.

Yesterday gave me another special appreciation of math, particularly these:

5/10  and 1/6

5/10ths can be reduced to...1/2, or .5, or 50%.  In plain English I have now completed 5 of my total of 10 chemo treatments.  I am halfway done,  50% of the way there!

1/6th can't be reduced, but doesn't really need to be - yesterday, I completed the first of my total of 6 Taxol treatments.  One down, five more to go!

We get to the center at 8:00 am.  Apparently, I am so excited to start treatment that I arrived 20 minutes early for my appointment, so we sit and wait for a little while.  Pre-treatment exam looked great - still haven't gained but two pounds total, all my counts (particularly my white cell count) are wonderful (they always sound surprised when they say that).  My red blood cell count is down a little, so I promised to eat a little red meat once in a while, and nosh on more spinach smoothies (not as bad as you might think, and I still have pounds of blueberries in the freezer to flavor them nicely!)  My Palmar-Plantar Erythrodysesthesia (PPE, or hand/foot syndrome) is healing nicely; the blisters on my left hand are doing well, and the tender skin areas are far less tender.  I still have numbness on my first two fingers, but even that is getting better slowly.

As a side note, my doctor had on the shortest dress I've ever seen, and yes, I am jealous.  Not only is she smart, she's also beautiful, and always makes fashion look easy. 

I have left the Red Devil (Adria) and Cytoxan behind, and have moved forward to Taxol.  I was more pre-tx afraid of the Taxol than I ever was of the AC, because there is a potential for allergic reactions with Taxol infusion:  itching, hives, chills, facial flushing, shortness of breath, and oh wait - stopping of the breathing.  So, as usual, I started to cry when I got to the infusion center, and as usual Julia (my favorite nurse ever) sits with me and holds my hand.  She shares that reactions are rare; they'll load me up with steroids and Benadryl to keep that from happening, and they'll watch me closely to ensure that everything is okay.  "But we'll give you some Ativan, just to help." 

How about a little extra today?  No?  Okay...

There are far fewer pre-meds with Taxol than with AC - in fact, no anti-nausea medications at all, as that is not a SE.  I can't complain, as those meds tend to bring with them really ugly constipation problems.  So I get my Ativan first (yeah!), then a good does of Benadryl...and I find myself quickly drifting in and out of nappiness.  Next comes 20 mgs of Decadron - the steroid - and I freak out a little:  During my first AC treatment they gave me 10 mg of Decadron, which produced a "galloping horses" heatbeat for a few days, so they reduced it to 5 mg after that.  And now you want to give me 20 mg?  God almightly, I'll be riding in a cattle drive across the West with all those steroids coursing through my veins.  But, it's important to have that dose - you know, the whole "not breathing" thing is more important than a few horses in my chest.

And finally - the Taxol.  Nothing red, no huge syringes - just a little bag of clear liquid hung on my pole.  Another way to lessen reactions is to deliver the drug slowly, so the Taxol will take 3 hours; if there's a reaction they can lengthen that to 4 hours.  I'm getting a "dose dense" treatment; typically Taxol is delivered once a week for 12 weeks; I am getting twice the dose, every two weeks, for 12 weeks (but only six actual treatments).  Twice the dose means a longer delivery time, and may mean some adjustment in pre-meds or delivery time.

So it starts...and I sit and wait for something epic to happen.  And I wait.  After about 5 minutes my nose itches, so I scratch it.  Minute later my arm itches, so I scratch it.  Then my leg.  My nurse comes over and asks if I'm "itchy," and I tell her I had to scratch a couple of places.  She immediately stops the treatment, and calls over another nurse.  They look at my face and determine my forehead is "pink" (thinking maybe I'm flushed), so they call the doctor.  She's there in a matter of seconds.  I mention I scratched an itch but don't feel "itchy" in general.  No hives.  And I'm not flushed, I'm just pink.  I tell her I'm willing to continue, and will certainly notify anyone if there are any other problems, so the drip is re-started.

Ten minutes later I am drifting off in my little chair, obviously still breathing, not itching anywhere, no pink or flushed face.  In fact, the worst problem of my day is that my head keeps sticking to the infusion chair (I chose to go topless in public!!) and so the nurse brings me a warm blanket to lay on the back of the chair.  After that, I drift back off to sleep for half an hour or so.  I wake and realize almost everyone around me has left.  Ken kindly runs down to the cafeteria and brings me lunch.  We chat, I drift in and out of sleepiness, and wake to a very loud and exciting game of cards being played by another couple down the row (he was there before I arrived, and he remained after I left - I have nothing to complain about!)

Finally, the Taxol is all delivered!!  My port is flushed with Heparin, which I can taste in the back of my mouth - and I cry just a little.  I realized this taste is the taste/smell I associate with the infusion center, with treatment, with all the icky and nasty stuff that happens here.  It is also very similar to the taste/smell that has happened during my post-AC days, when my mouth tastes like metal and my sense of smell changes to acrid and sharp and unpleasant odors. 

But now, I am done.  As we walk out and the sun warms my face and the breeze greets my bald head, I realize it's 2:00 - a 6-hour infusion day.  I go home and right to bed, and don't get back up again until 6:30.

It's done - the first Taxol.  The one I was most afraid of.  And nothing epic happened, nothing exciting or scary, nothing to be worried about.  This morning, I feel great - no steroid hang-over, no jitteriness, no horses galloping.  I don't have to take oral steroids for three days (as I did on AC; they were used to lengthen the effectiveness of the anti-nausea meds) so I won't have to deal with the sleep and mood issues.  It's like yesterday is over, and now I move forward with the next two weeks.

There are SEs with Taxol, to be certain - different than with AC.  My hair may continue to fall out, or it could start to grow back - only time will tell.  The worst SE is neuropathy in the hands and feet, which is usually short-term and dissipates after treatment ends. 

I'll deal with that if, and when, it happens.

When I (used to, but will again) run, I took a route that required me to run up a very short but very steep hill; at the top I would turn a corner and begin a slow, easy descent down to the end of my run.  I always said that downhill run was my reward for having made it up that difficult hill, and so I feel the same now about my final 5 treatments.  I made it through the first 4 toughest treatments, pushing myself all the way as I would have with that uphill run.  These 6 Taxol will be my reward for having made it through the worst of the worst, and while there are more of them, they're like a slow, downhill run with a reward at the end - being done.  And as with any run I've ever done on that route, I hate it when I'm running, but I never regret it when it's over. 

I never wish I hadn't done it.