Friday, September 3, 2010

Next Time the Shit Hits, I hope I am Sucking an Eclair

Medical News Today

Neuropathy is a collection of disorders that occurs when nerves of the peripheral nervous system (the part of the nervous system outside of the brain and spinal cord) are damaged. The condition is generally referred to as peripheral neuropathy, and it is most commonly due to damage to nerve axons. Neuropathy usually causes pain and numbness in the hands and feet.

There are a variety of treatments available for peripheral neuropathy. They range from traditional pills and creams to special diets and therapies that stimulate the nervous system. Antidepressants, especially tricyclics and selective serotonin-norepinephrine re-uptake inhibitors (SNRI's), are a favored treatment for neuropathies. They will relieve neuropathic pain in non-depressed persons.

See all the good stuff you are learning about?

I saw The Good Witch today.  Showed up for my usual appointment Friday mornings at my favorite place and yours, The Cancer Center.  Good Morning Krissy and Lady Brown Sugar Grace and Vonda and Mariah and Kitty.  Good Morning Angels.

Vonda did her usual, weighed me, blood pressured me, and shoved a thermometer under my tongue.  I know that is her favorite part.  Shutting me up for a couple minutes.  Lol.  Hi Vonda.  Love you.

Kitty doesn't need to wheel a cart in now, she hand carried all my stuff in like when Rachael Ray goes to the cupboard and grabs everything she needs, and precariously carries it to the cutting board.  Hello Kitty.  Love you too.

This is Taxol number nine.  Nine out of twelve.  Just get me there baby.  Just get me there.

Nothing like a cool flush of your PICC, the coolness flowing into that slack of line and you can feel it against your arm, then going into your body.  I can feel the cool travel towards my collar bone, but lose it somewhere in there.  After that, Kitty empties other syringes of their contents, and then the taste comes and the smell, and it is so strong now.  Repulsive.  Absolutely repulsive.  and then I get sleepy.

I pop an almond.  I sip water.  I pop a cashew.  I ate a plum.  Clean food.  Whole food.  All help mask the medicinal, metallic taste and smell of my life saving poison.  It's like sucking on a radiator and drinking anti-freeze, or so I imagine.

There is something so up close and personal, this relationship you have with your chemo nurse.  It is difficult to describe, other than to say it is intense, there is a lot of touching, touching that brings pain, touching that brings comfort.  I don't think Kitty reads my blog, so she doesn't know how much I love her.  I really do.

Yes, you too Vonda, you already know that!

I told Kitty about this whole neuropathy thing, she said it's good that I got so far into Taxol before it hit.  She said Ibuprofen rotated with Vicodin is good, extra Vitamin B, rest, massage, little stretching exercises for your feet.  I wasn't hooked up long to chemo this morning before it was time for Vonda to come get me for my appointment with The Good Witch.

Vonda wheeled me down, Exam Room Number Three.  I waited for her Magicness to fly in and land next to me, and there she was.

We talked about the neuropathy.  She told me of another patient that after only two rounds got severe neuropathy and she had to take her off the Taxol and switch to something else.  I am in the homestretch, only three more to go after today.  She asked me to describe my symptoms in more detail.  I had already told her at our last appointment how I was dropping things a lot at home.  A glass.  A jar of pickles.  My keys at the front door more than I can count.  Things just flying out of my hand, and you look at the item on the floor, and it is so puzzling, how did that happen?  I know I had it.  I know I did.

I told her about work last Wednesday night, what I didn't want anyone to know.  I had to very consciously think about it and talk to my hands when I carried a tray, or a dish, or placed a cocktail on the table for a guest.  I had to really talk to my hands, grip tight and careful.  It was exhausting.

When I was walking, I kept feeling the urge to look down at my feet, to make sure they were there or stepping like they should.

It required so much mental energy, having to think out loud regarding these tasks that are usually completely taken care of by my brain without any effort on my part.  It just happens.  You hold a glass.  You walk.  Thank you brain for all the things you have been doing for me for years, without a thought on my part.  Breathing, talking, walking, holding, blood pumping, organs working, thoughts and vision and taste and smell.

That's a lot of work, The Good Witch said, requires a lot of mental energy when you are also trying to do all the parts of your job.  I think I have mentioned before that The Good Witch worked ten years as a server.  She knows all about it, like nobody's business.

The good news?  The neuropathy will pass, and will get dramatically better after chemo is done.  In the meantime, she reviewed the pharmaceutical remedies.  She asked me about my moods and was I continuing to experience "menopausal" symptoms.

I told her that would be an emphatic yes, like I described in my blog, a pink elephant crashing into 1000 stacked crystal glasses.  It ain't pretty.  One day I am my usual self, cheerful, joyful, optimistic, and the next day I feel as if I could weep all day, cry me a river baby and float down it on an inner tube.  Hot flashes?  I am either freezing and need a hot bath, or I am in a sweat and have to kick the covers off and remove soaked jammies.

The Good Witch laughed.  That's a good way to put it, crashing into menopause.  First you were the 51 year old girl whose periods would not give up the fight, now you are in the mix of menopausal symptoms in all their glory.  Not experienced gradually, naturally, over five years or more, but crashing into it like being thrown through a window.

All that considered, she suggested the antidepressant Cymbalta might be just the ticket for me, and she'd like me to try it.  It's been found to really help sufferer's of neuropathy, and a side benefit, a little boost to my mood and mental equilibrium.  Ok, I'll try it. [Only later when I picked it up, it's $45 for a one month prescription, and that's with a pretty good prescription plan.  Cash price?  $288.99]

We talked more about my job. I got the feeling that what she was saying to me was this - we need to get you through the next three weeks, on the Taxol, on time, on schedule. There is nothing more important than that. We will do what we have to do. I am going to hope for a Hail Mary that I will be able to continue to work.

We talked about my meeting True North, and The Wizard, and I explained to her about the whole out of network thing with the micro surgeon.  I get the feeling that The Good Witch is not completely on board with me doing a prophylactic mastectomy on Mopsy.  I told her about what was explained to me, about a better cosmetic result, eliminating the worry, and that even with a lift and reduction, Mopsy would already be reduced to a shadow of herself.  That made sense to the Lady that flies.

She asked about my nipple on that side, since I will be losing Flopsy's nipple.  She asked how much are my nipples involved in my sexual pleasure.  Not everybody has a lot of sensation there.  Um, for me it's huge.  The Good Witch was very concerned about that since the nipple will be removed and then re-attached and may have a good appearance but could lose all its former sensation.  I told her how The Wizard explained that even with a reduction, they'd have to remove the nipple and re-attach it.  Even if they lifted and reduced the breast, the nipple would not be in the right place anymore.

Ok, so either way, the nipple will have to be removed and reattached?  Uh huh.

I gave her my tentative surgery date.  She asked if I had met with the radiation oncologist yet.  Um no, that wasn't set up or anything but I'd like to.  She seemed a little perturbed by this, thinking she had already asked this be done for me at our last appointment.  She asked Vonda to tell Krissy that the referral needs to be done right now.  I stopped at the Radiation Desk on the way out, they will be calling me next week.  It will be good to know exactly how much radiation I will need, how soon after my surgery will they start, and what affect is anticipated on my new boob.  Only my left side will be radiated, on the site where Flopsy used to live, and up into my armpit and lymph nodes.  I won't know how many lymph nodes will be left until after surgery.

Both The Good Witch and I are very curious about what they will find, or not find when they actually get in there during surgery.  Good Witch does not feel anything in the breast anymore and said that Flopsy's nipple shows no signs, as opposed to when I first came in and Flopsy was "tethered" to the cancer.

She asked if plastic surgeon will be able to take care of the weird hole of a scar where my port was.  Yes, I'm not sure if during the initial surgery or if it will be later.  I meet again with True North next Wednesday, and sure we will go into a lot more detail about the surgery.  She did mention that I may have to come back for touch-ups or adjustments to the primary surgery.

I always feel better after talking to The Good Witch.  She is my quarterback.  I asked her, what will it look like after my treatment plan with her is done?  How often will I come back and for what tests and such?  If I do the double mastectomy, no more Mammo's or MRI's on the breasts.  I will still come in for follow-up appointments every three to six months.  Maybe the occasional PET scan and blood work.  The Good Witch will always be in my life, the rest of my life.  She will turn me back over to my primary care physician though for all the other stuff.

It is hard to imagine no longer going to the Cancer Center.  I can't believe I've gone through 4 months and one week of chemo.  Damn.

Vonda rolled me back to my chemo chair.  "You feel better, talking to her?"

"I always do."

Vonda shook her head in agreement.

Kitty came back in to change my dressing, peel off the Tegaderm glued to my skin, and clean me all up.  Oh, I forgot.  I asked Good Witch, when can I get my PICC out?????????  The last day of chemo if I want.  I told Kitty.

"Ok great, I can take it out right here, we just pull it out."

Gulp.  Give me my vitamin L that day.

Three more weeks.  Three more weeks of the hardest five months of my life.

So far.  :)

Shit, I hope this ain't the training for some other big who-dee-do.  Gulp.  Double gulp.

Welcome to your life.  Savor the sweet moments.  You never know what shit is right around the corner, making its way down your street, knocking at your door, and asking to be let in.

Savor the sweet.


Late afternoon I was talking to Midge on her drive home from work.  I went to sit on the patio and was listening to her talk about her day and upcoming weekend.  There is a wild fennel plant growing in my yard, at least six feet tall.  Tall lime green stalks with lacy flower heads, now all turned to seed.  A flock of the tiniest sweetest birds landed on the plant, and all of them chirped away as they munched on seeds that will never be made into Italian sausage.  Hello.  Hello littlest birds.  Hello.  and then they were gone.



Jill said...

I love your positive attitude and sense of humor -- two very important things for surviving cancer. Keep hanging-in there!

Anonymous said...

Dear Sweet Lady ~

Keeping all your appointments straight and remaining so upbeat through the tears; you are amazing! You are so "very" special to so many people. Lots of "love" and positive energy coming your way!

Hugs and Kisses xoxox

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