Finally...a drug combo that works! I spent the first day and night after chemo sleeping, but that's way better than heaving over a bucket in the bathroom!
So my new daily medication routine is this:
Every morning, Days 1-2: 1 scoop glutamine (amino acid to prevent neuropathy and help maintain good gut health) mixed in soy milk, 5 pills predinsone (part of the chemo treatment), 1 pill Granisetron (Kytril, for nausea), 1/2 pill Lorazepan (Ativan, for nausea and anxiety), 1 pill Aprepitan (Emend, for nausea), 1 Vitamin D supplement (for good general treatment outcomes), 1 Magnesium Hydrochloride tablet (for constipation) crushed into my cereal milk.
Every morning, Days 3-5: same as Days 1-2 but no Emend, and Kytril and Ativan only as needed
Every morning, Days 6-10: same as Days 3-5 but no prednisone and Ativan only as needed
Every morning, Days 10-22: same as Days 6-10 but no Ativan
Every evening: 3 mg melatonin (for reflux)
Also, as needed: ginger tea, crystallized ginger, hot water bottle (an experiment, seems to help soothe my stomach), propping my bed horizontally
I'm still suffering from almost continuous reflux, which is contributory to nausea but not the same thing. I'd like to know more about upright GERD, as the symptoms seem to be worse first thing in the morning when I get out of bed. It's weird because I would have thought that my stomach would be empty by then. But I always burp a few times and experience reflux anyway.
Showing posts with label chemo side effects. Show all posts
Showing posts with label chemo side effects. Show all posts
Monday, June 29, 2009
Tuesday, June 23, 2009
Supplements
A friend who survived breast cancer recommended taking glutamine preventively for neuropathy. It seems like it could also work for alleviating my digestive issues, which are persisting now through this cycle (Cycle 4) mostly in the form of burping and reflux. http://en.wikipedia.org/wiki/Glutamine. Surprisingly, this wiki article didn't even mention neuropathy. But maybe I'll end up with muscles like Linda Hamilton in Terminator 2, since it's used by bodybuilders to build muscle. And I'll be chuffed if it helps with my memory, since I've had problems with memory all my life.
My nutritionist friend told me that melatonin might help generally against garden-variety reflux and might even have some effect against cancer: http://en.wikipedia.org/wiki/Melatonin. I take 3 mg now before I sleep. It's super-easy to take. The pills are tiny and they melt under my tongue.
I also went to an acupuncturist. She poked some needles in my stomach, gave me 3 bags of round pellets that resemble cat food, and charged me 89 euros. I'm supposed to take 13 pellets at each meal. They are very hard to swallow, and keep getting stuck in my windpipe. I was only able to stick to this for one day; then I lost interest in complying, especially as I didn't notice any dramatic difference in my stomach problems. The acupuncturist also told me that I have a 'cold' disorder, which means that I should only eat hot foods and drink hot drinks. Also, she thinks that I don't ingest enough protein or iron.
The last new treatment add-on is an ayurvedic masseuse. She comes to my apartment once a week and charges about 35 euros for the hour. She doesn't claim that she can do anything about my cancer or side effects, but it's a good way to relax and even meditate a bit.
My nutritionist friend told me that melatonin might help generally against garden-variety reflux and might even have some effect against cancer: http://en.wikipedia.org/wiki/Melatonin. I take 3 mg now before I sleep. It's super-easy to take. The pills are tiny and they melt under my tongue.
I also went to an acupuncturist. She poked some needles in my stomach, gave me 3 bags of round pellets that resemble cat food, and charged me 89 euros. I'm supposed to take 13 pellets at each meal. They are very hard to swallow, and keep getting stuck in my windpipe. I was only able to stick to this for one day; then I lost interest in complying, especially as I didn't notice any dramatic difference in my stomach problems. The acupuncturist also told me that I have a 'cold' disorder, which means that I should only eat hot foods and drink hot drinks. Also, she thinks that I don't ingest enough protein or iron.
The last new treatment add-on is an ayurvedic masseuse. She comes to my apartment once a week and charges about 35 euros for the hour. She doesn't claim that she can do anything about my cancer or side effects, but it's a good way to relax and even meditate a bit.
Friday, May 22, 2009
Treatment Against Nausea
Here's the advice I've collected on the internet against GERD so far:
Avoid anything carbonated or effervescent. [Note: There is a lot of contradictory information out there about carbonation. My doctor recommended that I try original Coke. But both days that I actually drank a Coke (Day 1 and Day 7), I vomited. I've also been recommended to drink ginger ale and ginger beer for nausea.]
Eat bland food.
Avoid dairy products, sugar, fat, and spices.
Prop up the head of the bed 6 inches, or sleep in a recliner.
Cut HALF a banana, mash it, and eat it, chewing slowly.
Sip room temperature water to dilute the acid.
Wear loose-fitting clothes.
Avoid lying down for 3 hours after a meal.
Avoid citrus fruits such as oranges, lemons, grapefruits, tomatoes, and cranberries.
Avoid caffeine in all forms.
Don’t overeat.
Yesterday, I had eaten a late lunch of Dutch pancakes with bacon, apple, and syrup along with a Coca-Cola. We then biked to a cafe outside of town where I shared an apple pie with whipped cream and a Bitter Lemon. At dinner, I had a mango juice and shoarma smothered with a mix of garlic sauce, hot sauce, and mild salsa. At the bar afterwards, I had a bottle of cranberry juice.
In other words, I had broken almost every rule above and am now paying the price. When I came home, I felt awful. I vomited around 2am, and again around 4am, and didn't feel better even after that, though I had nothing left in my stomach to eject. I spent almost all day today collapsed on the couch marathoning 30 Rock episodes, it's almost midnight, and I still feel nauseous. I'm actually afraid to lie down.
I feel like I'm Bill Murray in Groundhog Day, doomed to repeat the same day again and again, until I figure out how to do it right. Now I am in Cycle 3 of 8 and I've figure out how to manage or eliminate constipation, mouth sores, neuropathy, and hair loss. But I'm still struggling with nausea and vomiting.
So far, I've tried all of the following, with no noticeable improvement and some uncomfortable side effects:
Granisetron (Kytril), only prescribed for the first 3 days and hasn't stopped me from vomiting on the first day of each cycle
Zantac (H2-receptor antagonist)
Maalox (antacid)
Pantecta (a PPI), strong side effect of heart palpitations
metoclopramide, strong side effect of dizziness and drowsiness
sativa marijuana, strong side effect of dizziness
original Coke
ginger beer
HCl Plus
My doctor thinks the problem is GERD. For a brief while, I thought the problem was not enough stomach acid. But now I'm wondering whether the problem is dyspepsia -- simple indigestion. I don't have heartburn and only once in a while do I taste stomach acid in my throat, but that's always due to burping. Burping is my biggest symptom and that seems to be caused primarily by excess gas in the stomach, not a weakness of the muscle that separates the stomach from the esophagus.
According to Wikipedia, clinical trials show that antacids and H2-receptor antagonists like Zantac have little to no effectiveness against dyspepsia when compared to placebo. Also very interestingly, metoclopramide, which my doctor prescribed, has also been shown to be ineffective.
The same Wiki article stated that a herbal remedy called Iberogast and PPIs have been proven to work. So next I'll try the Iberogast and ask my doctor to prescribe another PPI besides Pantecta.
* * * * * * * * * * * * * * * * * * *
UPDATE: well, I tried the Iberogast. A little bottle sells here for about 15 euros, and I'm supposed to take 20 drops three times a day. The taste is somewhat awful, and I didn't notice a difference after taking it once. I stopped taking it, because the burping has gotten somewhat more tolerable now that I'm on Day 11 of this cycle. I saw today that another blogger (Carrie's NHL Blog) wrote that nausea wasn't a big problem for her: "Zofran, Compazine and Ativan work great and, when I just need a little something, I take 500 mg – 1000 mg of ginger." So I plan to do some further investigation of this option before my next consult.
Avoid anything carbonated or effervescent. [Note: There is a lot of contradictory information out there about carbonation. My doctor recommended that I try original Coke. But both days that I actually drank a Coke (Day 1 and Day 7), I vomited. I've also been recommended to drink ginger ale and ginger beer for nausea.]
Eat bland food.
Avoid dairy products, sugar, fat, and spices.
Prop up the head of the bed 6 inches, or sleep in a recliner.
Cut HALF a banana, mash it, and eat it, chewing slowly.
Sip room temperature water to dilute the acid.
Wear loose-fitting clothes.
Avoid lying down for 3 hours after a meal.
Avoid citrus fruits such as oranges, lemons, grapefruits, tomatoes, and cranberries.
Avoid caffeine in all forms.
Don’t overeat.
Yesterday, I had eaten a late lunch of Dutch pancakes with bacon, apple, and syrup along with a Coca-Cola. We then biked to a cafe outside of town where I shared an apple pie with whipped cream and a Bitter Lemon. At dinner, I had a mango juice and shoarma smothered with a mix of garlic sauce, hot sauce, and mild salsa. At the bar afterwards, I had a bottle of cranberry juice.
In other words, I had broken almost every rule above and am now paying the price. When I came home, I felt awful. I vomited around 2am, and again around 4am, and didn't feel better even after that, though I had nothing left in my stomach to eject. I spent almost all day today collapsed on the couch marathoning 30 Rock episodes, it's almost midnight, and I still feel nauseous. I'm actually afraid to lie down.
I feel like I'm Bill Murray in Groundhog Day, doomed to repeat the same day again and again, until I figure out how to do it right. Now I am in Cycle 3 of 8 and I've figure out how to manage or eliminate constipation, mouth sores, neuropathy, and hair loss. But I'm still struggling with nausea and vomiting.
So far, I've tried all of the following, with no noticeable improvement and some uncomfortable side effects:
Granisetron (Kytril), only prescribed for the first 3 days and hasn't stopped me from vomiting on the first day of each cycle
Zantac (H2-receptor antagonist)
Maalox (antacid)
Pantecta (a PPI), strong side effect of heart palpitations
metoclopramide, strong side effect of dizziness and drowsiness
sativa marijuana, strong side effect of dizziness
original Coke
ginger beer
HCl Plus
My doctor thinks the problem is GERD. For a brief while, I thought the problem was not enough stomach acid. But now I'm wondering whether the problem is dyspepsia -- simple indigestion. I don't have heartburn and only once in a while do I taste stomach acid in my throat, but that's always due to burping. Burping is my biggest symptom and that seems to be caused primarily by excess gas in the stomach, not a weakness of the muscle that separates the stomach from the esophagus.
According to Wikipedia, clinical trials show that antacids and H2-receptor antagonists like Zantac have little to no effectiveness against dyspepsia when compared to placebo. Also very interestingly, metoclopramide, which my doctor prescribed, has also been shown to be ineffective.
The same Wiki article stated that a herbal remedy called Iberogast and PPIs have been proven to work. So next I'll try the Iberogast and ask my doctor to prescribe another PPI besides Pantecta.
* * * * * * * * * * * * * * * * * * *
UPDATE: well, I tried the Iberogast. A little bottle sells here for about 15 euros, and I'm supposed to take 20 drops three times a day. The taste is somewhat awful, and I didn't notice a difference after taking it once. I stopped taking it, because the burping has gotten somewhat more tolerable now that I'm on Day 11 of this cycle. I saw today that another blogger (Carrie's NHL Blog) wrote that nausea wasn't a big problem for her: "Zofran, Compazine and Ativan work great and, when I just need a little something, I take 500 mg – 1000 mg of ginger." So I plan to do some further investigation of this option before my next consult.
Day-by-Day Breakdown, Chemo Cycle III
Day 1: vomiting approximately 8 hours after leaving the hospital
Day 2: nausea in the morning, fatigue, slight cough, hyperactivity leading to sleeplessness (side effect of prednisolon), very slight neuropathy in my right thumb
Day 3: same as Day 2
Day 4: same as Day 2 plus extreme dizziness and drowsiness after taking metoclopramide in the morning
Day 5-6: same as Day 2 plus burping (note that the only anti-nausea meds I took on these days was Maalox)
Day 7: same as Day 2 plus heavy burping, vomited twice in the middle of the night (note that I made the mistake of eating shoarma with hot sauce and ran out of Maalox)
Day 8: same as Day 2 plus burping and nausea (took 2 Zantac pills)
Day 9: nausea, burping, fatigue, slight cough
Day 10: nausea, burping, fatigue
Day 11: burping
Day 12: burping
I really need to find a good solution for the nausea and burping!
Day 2: nausea in the morning, fatigue, slight cough, hyperactivity leading to sleeplessness (side effect of prednisolon), very slight neuropathy in my right thumb
Day 3: same as Day 2
Day 4: same as Day 2 plus extreme dizziness and drowsiness after taking metoclopramide in the morning
Day 5-6: same as Day 2 plus burping (note that the only anti-nausea meds I took on these days was Maalox)
Day 7: same as Day 2 plus heavy burping, vomited twice in the middle of the night (note that I made the mistake of eating shoarma with hot sauce and ran out of Maalox)
Day 8: same as Day 2 plus burping and nausea (took 2 Zantac pills)
Day 9: nausea, burping, fatigue, slight cough
Day 10: nausea, burping, fatigue
Day 11: burping
Day 12: burping
I really need to find a good solution for the nausea and burping!
Monday, May 11, 2009
Treatment Against Peripheral Neuropathy
Two weeks ago, I experienced a little bit of peripheral neuropathy (tingling in hands and feet, fingernails and toenails turning black). My right thumb seemed to suffer the worst and alternated throughout the days between numbness and tingling.
I read that it's best to address neuropathic symptoms as soon as they are noticed; otherwise, more serious side effects can develop. But there is not so much information available on the web on how exactly to go about tackling the problem.
Other survivors have highly recommended taking 10 grams of glutamine daily, acupuncture, and (to a far lesser extent) professional massage or acupressure. Unfortunately, alternative treatments are not covered by my insurance policy. In some ways, this is a relief for me, because then I'd have to mount a campaign to persuade my not-so-holistically inclined doctor to refer me to one of these specialists. I don't think I have the energy for that.
In the meantime, as this particular side effect is not too bad at the moment, I tried self-massaging my hands several times a day using a combination of techniques from these videos:
Self-Massage for Hands
Ten Step Hand Reflexology Self-Treatment
Note that the Expert Village series also includes self-massage for the neck, tired eyes, bottom of feet and heels, feet in high heels, after-meal relief, arms, back, and lower back. Also, if self-massage doesn't appeal, one website recommended asking a partner or friend to learn massage and have them perform it on you (one way to test whether they really mean what they say when they say: "let me know if there's anything I can do!"). I quite liked that idea, but the nice thing about self-massage is that I can do it every day, several times a day, whenever I want.
The hand self-massaging feels good (I do it almost subconsciously now, when I'm waiting in line at the pharmacy, for example), but didn't produce any noticeable reduction of my existing neuropathic symptoms.
But yesterday, I massaged my entire body using a powerful electric massager I bought years ago from Sharper Image, focusing on the palm of my hand and all around my thumb. This not only provided instant relief, but even hours later, my thumb neuropathy has virtually disappeared.
I've also noticed recently that if I wear warm mittens and socks to bed, I don't wake up with tingling in my feet or hands. It makes sense to me that the blood should circulate better if it's kept warm, so I might try wearing my mittens around the house as well.
It could be that the neuropathic symptoms are simply waning as more days pass after my last chemo treatment. I'll have to see whether these techniques will continue to work when I plunge into Chemo Round 3, which begins next Friday.
* * * * * * * * * * * *
UPDATE: now it's Day 8 of my third chemo cycle, and I have (so far) less neuropathy than I did during Cycle 2 at the same time point. I use my massager on both hands and arms whenever I feel tingling in my right thumb, so approximately 2-3 times a day. So far, I haven't developed neuropathy anywhere else.
I read that it's best to address neuropathic symptoms as soon as they are noticed; otherwise, more serious side effects can develop. But there is not so much information available on the web on how exactly to go about tackling the problem.
Other survivors have highly recommended taking 10 grams of glutamine daily, acupuncture, and (to a far lesser extent) professional massage or acupressure. Unfortunately, alternative treatments are not covered by my insurance policy. In some ways, this is a relief for me, because then I'd have to mount a campaign to persuade my not-so-holistically inclined doctor to refer me to one of these specialists. I don't think I have the energy for that.
In the meantime, as this particular side effect is not too bad at the moment, I tried self-massaging my hands several times a day using a combination of techniques from these videos:
Self-Massage for Hands
Ten Step Hand Reflexology Self-Treatment
Note that the Expert Village series also includes self-massage for the neck, tired eyes, bottom of feet and heels, feet in high heels, after-meal relief, arms, back, and lower back. Also, if self-massage doesn't appeal, one website recommended asking a partner or friend to learn massage and have them perform it on you (one way to test whether they really mean what they say when they say: "let me know if there's anything I can do!"). I quite liked that idea, but the nice thing about self-massage is that I can do it every day, several times a day, whenever I want.
The hand self-massaging feels good (I do it almost subconsciously now, when I'm waiting in line at the pharmacy, for example), but didn't produce any noticeable reduction of my existing neuropathic symptoms.
But yesterday, I massaged my entire body using a powerful electric massager I bought years ago from Sharper Image, focusing on the palm of my hand and all around my thumb. This not only provided instant relief, but even hours later, my thumb neuropathy has virtually disappeared.
I've also noticed recently that if I wear warm mittens and socks to bed, I don't wake up with tingling in my feet or hands. It makes sense to me that the blood should circulate better if it's kept warm, so I might try wearing my mittens around the house as well.
It could be that the neuropathic symptoms are simply waning as more days pass after my last chemo treatment. I'll have to see whether these techniques will continue to work when I plunge into Chemo Round 3, which begins next Friday.
* * * * * * * * * * * *
UPDATE: now it's Day 8 of my third chemo cycle, and I have (so far) less neuropathy than I did during Cycle 2 at the same time point. I use my massager on both hands and arms whenever I feel tingling in my right thumb, so approximately 2-3 times a day. So far, I haven't developed neuropathy anywhere else.
Treatment Against Cough
I've had this @#$%ing cold since the week of March 1.
I can't get rid of it, because every time it's about to go away, I enter into the phase of my chemo cycle where my white blood cell count heads south and then of course my cold viruses figure the parents are out of the house and it's time to PARTY!
As I figure that I'm going to end up with terrible cold symptoms every 3 weeks until September, I've been doing my best to alleviate the cough and congestion via these techinques, gathered primarily from web research:
1) alternating peppermint tea with a tea made from ginger, lemon, honey, and a couple of shakes of cayenne pepper
2) a few drops of eucalyptus oil in a steaming hot shower
3) wearing a hat, gloves, and socks around the apartment
4) dosing with Nyquil (though I'm going to switch to prescription codeine as soon as I can) at night so that I can quiet the cough enough to sleep
5) drinking liters of water and barley tea
* * * * * * * * * * * * * * * * * * *
UPDATE: it's now Day 10 of Cycle 3 -- no more cough!!! It's a miracle! I'm now just crossing my fingers that it won't come back on Day 13, which is when my cough usually got much worse during my first two cycles.
I can't get rid of it, because every time it's about to go away, I enter into the phase of my chemo cycle where my white blood cell count heads south and then of course my cold viruses figure the parents are out of the house and it's time to PARTY!
As I figure that I'm going to end up with terrible cold symptoms every 3 weeks until September, I've been doing my best to alleviate the cough and congestion via these techinques, gathered primarily from web research:
1) alternating peppermint tea with a tea made from ginger, lemon, honey, and a couple of shakes of cayenne pepper
2) a few drops of eucalyptus oil in a steaming hot shower
3) wearing a hat, gloves, and socks around the apartment
4) dosing with Nyquil (though I'm going to switch to prescription codeine as soon as I can) at night so that I can quiet the cough enough to sleep
5) drinking liters of water and barley tea
* * * * * * * * * * * * * * * * * * *
UPDATE: it's now Day 10 of Cycle 3 -- no more cough!!! It's a miracle! I'm now just crossing my fingers that it won't come back on Day 13, which is when my cough usually got much worse during my first two cycles.
Tuesday, May 5, 2009
Treatment Against Burping
The burping and belching is still driving me mad. During Cycle 1, after spending all day googling on the search terms "burping", "belching", or "gas" plus "chemo" and "cancer", I didn't come up with much of anything useful, except a few community forum posts that indicated that I wasn't the only one who was perplexed by this not-often-mentioned side effect of chemotherapy.
On one thread, someone posted that he noticed that his mother burped continuously during her treatment period and was curious as to why, which provoked indignant responses like: "your mother has cancer and you're worried about burping?!" To this I would reply, it's hard to feel normal when your body does things it doesn't normally do. Plus, as I mentioned in an earlier post, the burping makes nausea worse.
My brother suggested over-the-counter Maalox, but that didn't work. Then I told my doctor, and he prescribed a powerful proton pump inhibitor called Pantecta (pantoprazole) to use in combination with the anti-emetics during Cycle 2. That didn't work either. In fact, I'm 90% sure it caused me to have severe heart palpitations (listed as a possible side effect for < 2% of the population), because I didn't have heart palpitations during Cycle 1, and they stopped almost immediately after I stopped taking Pantecta.
Then, I happened to be reading an website article on improving digestion and stumbled upon a few sentences about hypochlorhydria:
"Low stomach acid (hypochlorhydria) is common, especially in older people since as we age, we make less stomach acid. Research suggests that as many as half of the people over 60 years old have hypochlorhydria. A variety of factors can inhibit sufficient stomach acid production including the pathogenic bacteria, Helicobacter pylori, and frequent use of antacids. Hypochlorhydria is also associated with many diseases, such as asthma, celiac sprue, hepatitis, rheumatoid arthritis, osteoporosis, and diabetes mellitus. Signs of hypochlorhydria include a sense of fullness after eating, bloating, excessive belching, indigestion, multiple food allergies, undigested food in the stool, and peeling and cracked fingernails."
Bingo! I had almost every symptom listed to some degree.
After further investigation on the net, I discovered:
1) Hypochlorhydria is often misdiagnosed by doctors who almost always jump to the conclusion that antacids should be prescribed, which would only make the problem worse!
2) Burping can be a serious problem because it's a sign that the body is not capable of breaking food down into its component nutrients; you can eat all you want and still be starving and undernourished. I felt especially frustrated when reading this, because I had been spending so much time researching nutrition and preparing healthy food to eat, only to learn that most of it is just being flushed down the toilet!
3) Hypochlorhydria is a well-known side effect of proton pump inhibitors. After still more research, I discovered that proton pump inhibitors are recommended to mitigate some of the side effects of CHOP chemotherapy. But as far as I know, I hadn't been taking any proton pump inhibitors except for Pantecta, which I only took after I already experienced burping.
More detective work revealed that it is possible to self-diagnose hypochlorhydia by performing a challenge test with hydrochloric acid. In fact, the challenge test would also determine the appropriate treatment dosage for my level of stomach acid deficiency. Perfect.
The local Bio-Markt (Holland's version of Whole Foods Market) didn't have any hydrochloric acid in stock, but they offered to order HCl Plus by Biotics Research for me. This is a combination pill of HCl, pepsin (to simulate the body to produce HCl naturally), and Vitamin B12 (because persons with low stomach acid are always deficient in B12).
I still haven't tried the challenge test yet, but I plan to do it soon. It would be amazing to have this mystery solved!
***********
It's now a few days later and I've started taking HCl with every meal, but frankly: I can't tell whether it's working. I just read on the internet that one person took many pills, didn't feel any burning, but later got tested for stomach acid and found out that his level was normal. I don't feel any burning when I take one pill; I'm still burping, but I'm afraid to take more and end up with a self-created ulcer. So on Wednesday when I go in for my next consult, I'll see whether I can persuade my doctor to check my stomach acid level. I am now afraid to take anything for fear that my problem will worsen, but I'd really like to make these side effects go away for good.
On one thread, someone posted that he noticed that his mother burped continuously during her treatment period and was curious as to why, which provoked indignant responses like: "your mother has cancer and you're worried about burping?!" To this I would reply, it's hard to feel normal when your body does things it doesn't normally do. Plus, as I mentioned in an earlier post, the burping makes nausea worse.
My brother suggested over-the-counter Maalox, but that didn't work. Then I told my doctor, and he prescribed a powerful proton pump inhibitor called Pantecta (pantoprazole) to use in combination with the anti-emetics during Cycle 2. That didn't work either. In fact, I'm 90% sure it caused me to have severe heart palpitations (listed as a possible side effect for < 2% of the population), because I didn't have heart palpitations during Cycle 1, and they stopped almost immediately after I stopped taking Pantecta.
Then, I happened to be reading an website article on improving digestion and stumbled upon a few sentences about hypochlorhydria:
"Low stomach acid (hypochlorhydria) is common, especially in older people since as we age, we make less stomach acid. Research suggests that as many as half of the people over 60 years old have hypochlorhydria. A variety of factors can inhibit sufficient stomach acid production including the pathogenic bacteria, Helicobacter pylori, and frequent use of antacids. Hypochlorhydria is also associated with many diseases, such as asthma, celiac sprue, hepatitis, rheumatoid arthritis, osteoporosis, and diabetes mellitus. Signs of hypochlorhydria include a sense of fullness after eating, bloating, excessive belching, indigestion, multiple food allergies, undigested food in the stool, and peeling and cracked fingernails."
Bingo! I had almost every symptom listed to some degree.
After further investigation on the net, I discovered:
1) Hypochlorhydria is often misdiagnosed by doctors who almost always jump to the conclusion that antacids should be prescribed, which would only make the problem worse!
2) Burping can be a serious problem because it's a sign that the body is not capable of breaking food down into its component nutrients; you can eat all you want and still be starving and undernourished. I felt especially frustrated when reading this, because I had been spending so much time researching nutrition and preparing healthy food to eat, only to learn that most of it is just being flushed down the toilet!
3) Hypochlorhydria is a well-known side effect of proton pump inhibitors. After still more research, I discovered that proton pump inhibitors are recommended to mitigate some of the side effects of CHOP chemotherapy. But as far as I know, I hadn't been taking any proton pump inhibitors except for Pantecta, which I only took after I already experienced burping.
More detective work revealed that it is possible to self-diagnose hypochlorhydia by performing a challenge test with hydrochloric acid. In fact, the challenge test would also determine the appropriate treatment dosage for my level of stomach acid deficiency. Perfect.
The local Bio-Markt (Holland's version of Whole Foods Market) didn't have any hydrochloric acid in stock, but they offered to order HCl Plus by Biotics Research for me. This is a combination pill of HCl, pepsin (to simulate the body to produce HCl naturally), and Vitamin B12 (because persons with low stomach acid are always deficient in B12).
I still haven't tried the challenge test yet, but I plan to do it soon. It would be amazing to have this mystery solved!
***********
It's now a few days later and I've started taking HCl with every meal, but frankly: I can't tell whether it's working. I just read on the internet that one person took many pills, didn't feel any burning, but later got tested for stomach acid and found out that his level was normal. I don't feel any burning when I take one pill; I'm still burping, but I'm afraid to take more and end up with a self-created ulcer. So on Wednesday when I go in for my next consult, I'll see whether I can persuade my doctor to check my stomach acid level. I am now afraid to take anything for fear that my problem will worsen, but I'd really like to make these side effects go away for good.
Treatment Against Nausea
Nausea's usually one of the worst side effects of chemo, although it seems to affect everyone to a different degree and some not at all. I read that younger women are typically more affected.
The good news is that an array of powerful medications are available for fighting nausea, so if one combination doesn't work, then others can be tried until the right one is found. But in addition to that, there are a lot of other natural ways to fight nausea:
1) Sea bands, which use acupressure and can be found in any drug store in the U.S. I did indeed notice a difference when I put these on, but not enough to give up my anti-emetics.
2) Ginger: candied or raw or cut up into tea with some lemon & honey or in ginger beer (make sure the ingredients list real ginger, rather than ginger flavoring)
3) Marijuana: the indica variety (as opposed to sativa) is supposed to work wonders against nausea, appetite, and vomiting. A friend of a friend, who found the side effects of anti-nausea medications too debilitating, smoked 30-45 minutes before every chemo treatment and as often as needed afterwards. I tried smoking a few tokes around Day 10 after my first chemotherapy, but I didn't like the feeling of lightheadness and dizziness that went along with being high. It reminded me too much of my first few days after chemo.
4) Eating: eat many small meals per day instead of three large meals, eat bland foods, chew slowly, drink lots of water
5) Eating, Part II: make sure you eat, even if you have no interest in eating. Otherwise, the nausea will just get worse.
6) Pills: if the pill taste increases the nausea, try crushing them in food (usually meds that are not slow-release meds may be crushed) or enclosing them in gelcaps you can buy at the pharmacy.
I'm still looking for my nausea magic bullet. I still feel extremely nauseous and vomit-prone on Day 1 of chemo and then progressively less nauseous until Day 10. But my anti-nausea drug regimen -- taking granisetron (kytrol) during Days 1-3 and metoclopram preventively from Days 4-7 -- in addition to following the tips above, have helped a lot.
The good news is that an array of powerful medications are available for fighting nausea, so if one combination doesn't work, then others can be tried until the right one is found. But in addition to that, there are a lot of other natural ways to fight nausea:
1) Sea bands, which use acupressure and can be found in any drug store in the U.S. I did indeed notice a difference when I put these on, but not enough to give up my anti-emetics.
2) Ginger: candied or raw or cut up into tea with some lemon & honey or in ginger beer (make sure the ingredients list real ginger, rather than ginger flavoring)
3) Marijuana: the indica variety (as opposed to sativa) is supposed to work wonders against nausea, appetite, and vomiting. A friend of a friend, who found the side effects of anti-nausea medications too debilitating, smoked 30-45 minutes before every chemo treatment and as often as needed afterwards. I tried smoking a few tokes around Day 10 after my first chemotherapy, but I didn't like the feeling of lightheadness and dizziness that went along with being high. It reminded me too much of my first few days after chemo.
4) Eating: eat many small meals per day instead of three large meals, eat bland foods, chew slowly, drink lots of water
5) Eating, Part II: make sure you eat, even if you have no interest in eating. Otherwise, the nausea will just get worse.
6) Pills: if the pill taste increases the nausea, try crushing them in food (usually meds that are not slow-release meds may be crushed) or enclosing them in gelcaps you can buy at the pharmacy.
I'm still looking for my nausea magic bullet. I still feel extremely nauseous and vomit-prone on Day 1 of chemo and then progressively less nauseous until Day 10. But my anti-nausea drug regimen -- taking granisetron (kytrol) during Days 1-3 and metoclopram preventively from Days 4-7 -- in addition to following the tips above, have helped a lot.
Treatment Against Mouth Sores
I don't have to avoid citrus fruit or rinse my mouth with salt water anymore. I've figured out how to self-treat mouth sores.
Besides rinsing my mouth after every meal, brushing my tongue and where the gums meet the teeth once a day, flossing and using water pic once in a while, and using wooden toothsticks to massage the gums between the teeth every night, I've also started to massage my gums with the pads of my fingers. Not just the gum area around the teeth, but my entire mouth. It only takes a few seconds a day and it really works!
Besides rinsing my mouth after every meal, brushing my tongue and where the gums meet the teeth once a day, flossing and using water pic once in a while, and using wooden toothsticks to massage the gums between the teeth every night, I've also started to massage my gums with the pads of my fingers. Not just the gum area around the teeth, but my entire mouth. It only takes a few seconds a day and it really works!
Monday, May 4, 2009
Day-by-Day Breakdown, Chemo Cycle II
Day 1: extreme nausea (made some mistakes such as not taking my granisetron in time because it was not available at my pharmacy and not bringing enough food to chemo so that when I finally ate, I ate too fast and I ate everything on the sandwich, including the cheese), dizziness, and fatigue
Day 2: nausea in the morning, fatigue, slight cough, hyperactivity leading to sleeplessness (side effect of prednisolon), slight neuropathy, more hair loss
Day 3: slight nausea in the morning, slight cough, hyperactivity, a lot of hair loss in the shower, breakthrough pain
Day 4: slight nausea, heart palpitations, breakthrough pain
Day 5: same as Day 4
Day 6: same as Day 4
Day 7 (Queen's Day): slight nausea, heart palpitations, some breakthrough pain, fatigue, strange taste in saliva
Day 8 (took only Pantecta against nausea today): slight nausea, burping, very strong heart palpitations, slight cough, some neuropathy, some night sweats, toes black, thumbnails turning black, stiff/sore right leg, stiff right arm
Day 9 (took only metoclopram against nausea today): same as Day 8 but with only slight heart palpitations
Day 10 (took no medications against nausea today, started yoga/meditation/self-massage for hands): burping, congestion, slight cough, some neuropathy, toes black, thumbnails turning black
Day 11: same as Day 10 but with a bit more energy, actually one of the best days I've had since diagnosis
Day 12: same as Day 10 but with much stronger cough and congestion (I'm guessing that my dip period begins on Day 12)
Day 13: same as Day 10 but with much stronger cough and congestion (I'm guessing that my dip period begins on Day 12). I also accidentally cut myself on Day 12. It's was a tiny cut that would have ordinarily closed in an hour, but today it's still bleeding like a fresh cut. I put Bacitracin and a bandaid on it, to prevent infection, but the bleeding would probably indicate a low platelet count.
This chemo cycle seems to be better against nausea, though I have hopes that I won't vomit at all during Round 3, and I still feel queasy from time to time. I'm concerned about the atrial fibrillations. Even though they don't seem to be considered a serious side effect, I have this sensation that I need to take deep breaths to prevent myself from having a heart attack. I'm also concerned about the breakthrough pain; does it mean that the cancer is still fighting back?
I've had this cold since the week of March 1 -- thus, for more than two months. I am betting now that I'll have it for the entire course of chemotherapy.
Day 2: nausea in the morning, fatigue, slight cough, hyperactivity leading to sleeplessness (side effect of prednisolon), slight neuropathy, more hair loss
Day 3: slight nausea in the morning, slight cough, hyperactivity, a lot of hair loss in the shower, breakthrough pain
Day 4: slight nausea, heart palpitations, breakthrough pain
Day 5: same as Day 4
Day 6: same as Day 4
Day 7 (Queen's Day): slight nausea, heart palpitations, some breakthrough pain, fatigue, strange taste in saliva
Day 8 (took only Pantecta against nausea today): slight nausea, burping, very strong heart palpitations, slight cough, some neuropathy, some night sweats, toes black, thumbnails turning black, stiff/sore right leg, stiff right arm
Day 9 (took only metoclopram against nausea today): same as Day 8 but with only slight heart palpitations
Day 10 (took no medications against nausea today, started yoga/meditation/self-massage for hands): burping, congestion, slight cough, some neuropathy, toes black, thumbnails turning black
Day 11: same as Day 10 but with a bit more energy, actually one of the best days I've had since diagnosis
Day 12: same as Day 10 but with much stronger cough and congestion (I'm guessing that my dip period begins on Day 12)
Day 13: same as Day 10 but with much stronger cough and congestion (I'm guessing that my dip period begins on Day 12). I also accidentally cut myself on Day 12. It's was a tiny cut that would have ordinarily closed in an hour, but today it's still bleeding like a fresh cut. I put Bacitracin and a bandaid on it, to prevent infection, but the bleeding would probably indicate a low platelet count.
This chemo cycle seems to be better against nausea, though I have hopes that I won't vomit at all during Round 3, and I still feel queasy from time to time. I'm concerned about the atrial fibrillations. Even though they don't seem to be considered a serious side effect, I have this sensation that I need to take deep breaths to prevent myself from having a heart attack. I'm also concerned about the breakthrough pain; does it mean that the cancer is still fighting back?
I've had this cold since the week of March 1 -- thus, for more than two months. I am betting now that I'll have it for the entire course of chemotherapy.
Monday, April 27, 2009
Treatment Adjustments
Two days before every chemo infusion, I have a half-hour appointment with my doctor to review the results from the last chemo cycle.
Doctor Leeksma was quite pleased with the round 1 results. In fact, he even used the word "impressive". I told him that all outward signs of the tumor disappeared by Day 3 and I stopped taking pain medications by Day 5. He checked the site of the lump himself and didn't see any evidence that there was ever anything there, except for the small scar where they inserted the biopsy needle.
I told him that I suffered from nausea for 10 days, as well as non-stop burping for a few of those 10 days, and he indicated that they might be able to fix that.
My new regimen is:
100 mg Prednisolone every morning to kill tumor cells
1 Granisetron (Kytrol) tablet morning and evening to be taken against nausea and vomiting twice a day for the first 3 days in the chemo cycle
Metoclopramide HCl 3 x a day to be taken for nausea after Chemo Day 3
500 mg Magnesium Hydrochloride PCH with every meal for constipation
40 mg Pantecta every morning for acid reflux and burping
So basically, compared to the previous cycle, we dropped the Allopurinol, which he said was no longer needed because I did not appear to have any kidney reactions, and added Pantecta, which would help with the nausea.
This particular combination appears to be the winning one. I was nauseous only on the first day, but that was probably because I took the Granisetron late and didn't take the Pantecta at all. The following days, I had slight nausea in the morning but hardly any nausea for the rest of the day. The main issues I experience now are hyperactivity and sleeplessness (from the prednisolone) and residual coughing. I tried to get a prescription for codeine so I could sleep at night, but the doctor recommended that I avoid cough medications if I can. And it turns out that the coughing is not so bad now.
Besides the drug changes, we also spent some time discussing the further course of treatment. My brother told me that in the States, they would probably have done a PET scan and full CT scan at the beginning of treatment and after the third cycle.
My doc says he plans to order a full CT after the 4th chemo cycle. If after the 8th cycle, there's still residual tumor, he will order a PET scan to make sure that it's not active. It seems like they don't generally do PETs here as much as they do in the States, which may be a cost or radiation issue. I asked my brother later if he thought I should be more assertive in asking for an earlier PET scan. His (paraphrased) reply was:
"Let me run this by one of my attendings. As a standard, we do PET scans or gallium scans (functional imaging) prior to starting treatment and then repeat until it's negative. I can't say that he's doing anything wrong because there are few studies for this lymphoma. In other tumors, we would consider changing therapy if the PET didn't become negative after 4 cycles. We would even consider changing after 2 cycles if there wasn't significant improvement. I feel the problem with waiting until after 8 cycles is mainly that you have no prior scans for comparison, and the PET scan is overly sensitive and sometimes you can't tell what is tumor and what's not or what's new and what's old."
After his reply, I felt better because I'm confident that the current treatment is working just fine and doesn't need to be changed.
Yesterday, I was doing some research on the internet and stumbled on an article that seemed to indicate other regimens (e.g., MACOPB) combined with radiation produced the best results for mediastinal diffuse large B-cell lymphoma. I asked my brother about this too:
"I did look at these studies. Most people in the US would use R-CHOP. Those other regimens are not commonly used in the US. These regimens are probably more common in Europe, where they tend to favor stronger chemo regimens. There's not an obvious advantage for the more intensive regimens and have the price of higher toxicity and some require hospital stays for a few days to get the chemo in. Additionally, none of those regimens used Rituxan which should improve outcomes significantly. My attending, who has over 20 years of experience with lymphomas, would use R-CHOP."
"The radiation is a different story. I'm not sure how big the tumor was before starting chemo, but we tend to use radiation if it was big. We would probably use 6 cycles of R-CHOP followed by radiation. The drawbacks to radiation are that it can cause future health problems, such as early coronary heart disease, damage to the lungs, etc., although they carefully monitor how much radiation you actually receive. It seems that your doctor is using an extra 2 cycles of RCHOP in lieu of radiation because you're young and he doesn't want to cause long term problems with radiation. Difficult to say if this is right or wrong because we don't have the studies to tell us. These are more subtleties of medicine which you can argue for either side. I can only tell you what my attendings or I would do."
Again, I felt reassured after this explanation, as I remember that my doctor specifically stated he would prefer that we try chemo instead of surgery or radiation because I'm still young and both have such damaging long-term effects.
Doctor Leeksma was quite pleased with the round 1 results. In fact, he even used the word "impressive". I told him that all outward signs of the tumor disappeared by Day 3 and I stopped taking pain medications by Day 5. He checked the site of the lump himself and didn't see any evidence that there was ever anything there, except for the small scar where they inserted the biopsy needle.
I told him that I suffered from nausea for 10 days, as well as non-stop burping for a few of those 10 days, and he indicated that they might be able to fix that.
My new regimen is:
100 mg Prednisolone every morning to kill tumor cells
1 Granisetron (Kytrol) tablet morning and evening to be taken against nausea and vomiting twice a day for the first 3 days in the chemo cycle
Metoclopramide HCl 3 x a day to be taken for nausea after Chemo Day 3
500 mg Magnesium Hydrochloride PCH with every meal for constipation
40 mg Pantecta every morning for acid reflux and burping
So basically, compared to the previous cycle, we dropped the Allopurinol, which he said was no longer needed because I did not appear to have any kidney reactions, and added Pantecta, which would help with the nausea.
This particular combination appears to be the winning one. I was nauseous only on the first day, but that was probably because I took the Granisetron late and didn't take the Pantecta at all. The following days, I had slight nausea in the morning but hardly any nausea for the rest of the day. The main issues I experience now are hyperactivity and sleeplessness (from the prednisolone) and residual coughing. I tried to get a prescription for codeine so I could sleep at night, but the doctor recommended that I avoid cough medications if I can. And it turns out that the coughing is not so bad now.
Besides the drug changes, we also spent some time discussing the further course of treatment. My brother told me that in the States, they would probably have done a PET scan and full CT scan at the beginning of treatment and after the third cycle.
My doc says he plans to order a full CT after the 4th chemo cycle. If after the 8th cycle, there's still residual tumor, he will order a PET scan to make sure that it's not active. It seems like they don't generally do PETs here as much as they do in the States, which may be a cost or radiation issue. I asked my brother later if he thought I should be more assertive in asking for an earlier PET scan. His (paraphrased) reply was:
"Let me run this by one of my attendings. As a standard, we do PET scans or gallium scans (functional imaging) prior to starting treatment and then repeat until it's negative. I can't say that he's doing anything wrong because there are few studies for this lymphoma. In other tumors, we would consider changing therapy if the PET didn't become negative after 4 cycles. We would even consider changing after 2 cycles if there wasn't significant improvement. I feel the problem with waiting until after 8 cycles is mainly that you have no prior scans for comparison, and the PET scan is overly sensitive and sometimes you can't tell what is tumor and what's not or what's new and what's old."
After his reply, I felt better because I'm confident that the current treatment is working just fine and doesn't need to be changed.
Yesterday, I was doing some research on the internet and stumbled on an article that seemed to indicate other regimens (e.g., MACOPB) combined with radiation produced the best results for mediastinal diffuse large B-cell lymphoma. I asked my brother about this too:
"I did look at these studies. Most people in the US would use R-CHOP. Those other regimens are not commonly used in the US. These regimens are probably more common in Europe, where they tend to favor stronger chemo regimens. There's not an obvious advantage for the more intensive regimens and have the price of higher toxicity and some require hospital stays for a few days to get the chemo in. Additionally, none of those regimens used Rituxan which should improve outcomes significantly. My attending, who has over 20 years of experience with lymphomas, would use R-CHOP."
"The radiation is a different story. I'm not sure how big the tumor was before starting chemo, but we tend to use radiation if it was big. We would probably use 6 cycles of R-CHOP followed by radiation. The drawbacks to radiation are that it can cause future health problems, such as early coronary heart disease, damage to the lungs, etc., although they carefully monitor how much radiation you actually receive. It seems that your doctor is using an extra 2 cycles of RCHOP in lieu of radiation because you're young and he doesn't want to cause long term problems with radiation. Difficult to say if this is right or wrong because we don't have the studies to tell us. These are more subtleties of medicine which you can argue for either side. I can only tell you what my attendings or I would do."
Again, I felt reassured after this explanation, as I remember that my doctor specifically stated he would prefer that we try chemo instead of surgery or radiation because I'm still young and both have such damaging long-term effects.
Sunday, April 26, 2009
Hair Loss, Part II
I've decided that I won't look half-bad as a bald chick.
And my new look is slowly coming together.
My recommendations regarding hair loss to those who are starting chemo:
1. Don't do what I did and pay 60 euros to a top-stylist to get all your hair chopped short, unless you have plenty of money to burn. It is good to get it chopped short, but get a friend to do it for free because it turns out that the hair, if it's going to fall out (for some people, it doesn't), tends to shed like crazy already between the 12th and 18th day of the first chemo treatment. This usually happens most noticeably in the shower.
2. When this starts to happen, start immediately planning your new on-treatment look. I procrastinated a bit too long and ended up not washing my hair for DAYS because I didn't have my new look ready and still wanted to go out in public as a normal person and not as a cancer patient.
3. I highly recommend going to a neighborhood salon to get a complete shave (explain your situation and ask them if they can do something for you after-hours with the curtains closed; maybe you'll find it's no big deal, but it could also be more traumatic than you expect) or get someone to help you do it at home. I didn't go to a salon because I had already spent 60 euros on my hair just a few weeks before and figured that it wouldn't be so bad to have the hair fall out when it was so short. True that the shorter hair probably helped, but I still had way more hair to lose than I expected, as I didn't get a military buzz cut. I still had layered hair in the front down to my chin: a very stylish cut that lasted in its original form approximately 1 week.
4. I regretted not going bald sooner because my hair kept falling out in my bed and on the bathroom floor and in my food. Ugh. Also, when it does come out in the shower (and especially after not washing your hair for 4 days so that the hair is really READY to dive out of your scalp), it feels extremely creepy for it to clump up in your hand and get stuck to your body and pile up on the shower floor. I didn't cry, but I did have to recite all the things I was grateful for and keep my eyes closed while almost all of the rest of my hair fell out. I also had to take three showers in a row and emerge with lobster-red skin and pruney fingers at the end.
5. I found out that high-quality wigs are not hot and itchy like the wigs you buy at the costume store for Halloween. They are also very expensive (500-600 euros here in Amsterdam) and my insurance only covers 250 of that. I tried on a bunch; they all looked a little weird to me, especially on top, but I might be able to style them so they look more natural. We narrowed it down to three choices at the wig shop, one of which I wanted to see in a darker color, and they will come to my apartment for free after it arrives so I can try on the three again. I was told that shorter wigs are generally better because they are far less likely to get caught on things like sofas and jacket zippers. You apparently have to be really careful that they don't get pulled off or twisted.
6. But, there's also another cool option that was invented in Amsterdam, of all places! (lucky me again!) It's called a toupim: www.toupim.nl (you can click on a link on the home page for an English translation of the site) and it only costs 95 euros compared to the 500+ for a full wig. I had a lot of fun with this because I narrowed my options down to four and then emailed all my female friends to have them vote on which look they thought would suit me best. It was great because I got all kinds of advice and found out about clip-on hair extensions (http://www.headkandy.com/), which aren't too expensive and that I can add to my toupim when I'm feeling in the mood for a little jazzy color. I can attest to the fact that the hair is high quality and the hair band is very comfortable. I wish there was a little more hair framing the face in the style that I got (half-long Jasmijn) but I'm hoping that the hair extensions will help with that when I get them. Also, I must say that the customer service has been impeccable. I ordered my toupim online on a Friday evening, and it arrived special delivery (the owner apparently biked it over on her way home from work) one hour later. I emailed on Sunday if I could exchange it for a different size and the owner emailed me back the same night to say that would be fine; she'll drop by tomorrow to perform the exchange.
7. I fully intend to shave the rest of my hair off myself as soon as I get my wig (it's supposed to come today). Lurking on the Young Survivor's Coalition website (it's targeted for breast cancer survivors, but I find it helpful anyway), I learned that once you shave it, there will be stubble and the best way to clean off the stubble is with a lint roller!
And my new look is slowly coming together.
My recommendations regarding hair loss to those who are starting chemo:
1. Don't do what I did and pay 60 euros to a top-stylist to get all your hair chopped short, unless you have plenty of money to burn. It is good to get it chopped short, but get a friend to do it for free because it turns out that the hair, if it's going to fall out (for some people, it doesn't), tends to shed like crazy already between the 12th and 18th day of the first chemo treatment. This usually happens most noticeably in the shower.
2. When this starts to happen, start immediately planning your new on-treatment look. I procrastinated a bit too long and ended up not washing my hair for DAYS because I didn't have my new look ready and still wanted to go out in public as a normal person and not as a cancer patient.
3. I highly recommend going to a neighborhood salon to get a complete shave (explain your situation and ask them if they can do something for you after-hours with the curtains closed; maybe you'll find it's no big deal, but it could also be more traumatic than you expect) or get someone to help you do it at home. I didn't go to a salon because I had already spent 60 euros on my hair just a few weeks before and figured that it wouldn't be so bad to have the hair fall out when it was so short. True that the shorter hair probably helped, but I still had way more hair to lose than I expected, as I didn't get a military buzz cut. I still had layered hair in the front down to my chin: a very stylish cut that lasted in its original form approximately 1 week.
4. I regretted not going bald sooner because my hair kept falling out in my bed and on the bathroom floor and in my food. Ugh. Also, when it does come out in the shower (and especially after not washing your hair for 4 days so that the hair is really READY to dive out of your scalp), it feels extremely creepy for it to clump up in your hand and get stuck to your body and pile up on the shower floor. I didn't cry, but I did have to recite all the things I was grateful for and keep my eyes closed while almost all of the rest of my hair fell out. I also had to take three showers in a row and emerge with lobster-red skin and pruney fingers at the end.
5. I found out that high-quality wigs are not hot and itchy like the wigs you buy at the costume store for Halloween. They are also very expensive (500-600 euros here in Amsterdam) and my insurance only covers 250 of that. I tried on a bunch; they all looked a little weird to me, especially on top, but I might be able to style them so they look more natural. We narrowed it down to three choices at the wig shop, one of which I wanted to see in a darker color, and they will come to my apartment for free after it arrives so I can try on the three again. I was told that shorter wigs are generally better because they are far less likely to get caught on things like sofas and jacket zippers. You apparently have to be really careful that they don't get pulled off or twisted.
6. But, there's also another cool option that was invented in Amsterdam, of all places! (lucky me again!) It's called a toupim: www.toupim.nl (you can click on a link on the home page for an English translation of the site) and it only costs 95 euros compared to the 500+ for a full wig. I had a lot of fun with this because I narrowed my options down to four and then emailed all my female friends to have them vote on which look they thought would suit me best. It was great because I got all kinds of advice and found out about clip-on hair extensions (http://www.headkandy.com/), which aren't too expensive and that I can add to my toupim when I'm feeling in the mood for a little jazzy color. I can attest to the fact that the hair is high quality and the hair band is very comfortable. I wish there was a little more hair framing the face in the style that I got (half-long Jasmijn) but I'm hoping that the hair extensions will help with that when I get them. Also, I must say that the customer service has been impeccable. I ordered my toupim online on a Friday evening, and it arrived special delivery (the owner apparently biked it over on her way home from work) one hour later. I emailed on Sunday if I could exchange it for a different size and the owner emailed me back the same night to say that would be fine; she'll drop by tomorrow to perform the exchange.
7. I fully intend to shave the rest of my hair off myself as soon as I get my wig (it's supposed to come today). Lurking on the Young Survivor's Coalition website (it's targeted for breast cancer survivors, but I find it helpful anyway), I learned that once you shave it, there will be stubble and the best way to clean off the stubble is with a lint roller!
Thursday, April 23, 2009
If it's not one thing, it's another: Part II
It's my last day of Chemo, Round 1. Tomorrow I begin anew. A good time to fill in the remaining details of the first cycle.
Day 18: Heavy cough leading to sleeplessness, slight neuropathy (my arm falling asleep a few times)
Day 19: Heavy cough leading to sleeplessness, slight neuropathy, major hair loss (you don't realize how vain you are, until you lose more than half your volume of hair in the shower)
Day 20: Heavy cough leading to sleeplessness, more shedding
Day 21: More shedding, still coughing, and menstrual cramps! 4 days late. Some people lose their periods during chemo. Of course, that's just about the only side effect I didn't have during this cycle.
In other words, I haven't had a day without some sort of symptom since around March 15 -- March 1, if you count the lump.
Day 18: Heavy cough leading to sleeplessness, slight neuropathy (my arm falling asleep a few times)
Day 19: Heavy cough leading to sleeplessness, slight neuropathy, major hair loss (you don't realize how vain you are, until you lose more than half your volume of hair in the shower)
Day 20: Heavy cough leading to sleeplessness, more shedding
Day 21: More shedding, still coughing, and menstrual cramps! 4 days late. Some people lose their periods during chemo. Of course, that's just about the only side effect I didn't have during this cycle.
In other words, I haven't had a day without some sort of symptom since around March 15 -- March 1, if you count the lump.
Sunday, April 19, 2009
If it's not one thing, it's another
It's Day 17 after my first chemo. Every day, I have a different set of side effects and symptoms. There's always at least one thing happening with my body although after Day 9, the problems became more irritating than serious.
Here's a record of my side effects and symptoms starting from Day 1 of Chemo #1 (from memory, so the list may be slightly inaccurate):
Day 1: nausea, lightheadedness, fatigue, slight cough, pain at night, breakthrough pain during the day
Day 2: nausea, vomiting, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, pain at night, breakthrough pain during the day
Day 3: nausea, vomiting, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, severe weight loss, constipation, slight cough, pain at night, breakthrough pain during the day
Day 4: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, constipation, slight cough, breakthrough pain during the day, mouth sores
Day 5: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 6: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 7: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 8: nausea, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 9: slight nausea, slight loss of appetite, slight fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, frequent burping and belching
Day 10: slight fatigue, strange-tasting saliva, slight cough, frequent burping and belching
Day 11: strange-tasting saliva, slight cough, frequent burping and belching
Day 12: heavy productive cough, heavy sniffling, less frequent burping and belching
Day 13: heavy productive cough, heavy sniffling, less frequent burping and belching
Day 14: heavy productive cough, heavy sniffling
Day 15: heavy productive cough, heavy sniffling
Day 16: heavy productive cough, heavy sniffling, mouth sore
Day 17: heavy productive cough, heavy sniffling, mouth sore
Days 18-21: what next?!
The nausea and loss of appetite were the worst side effects. I was afraid I would never enjoy food again, and I have always been one of those people who finds food one of the biggest pleasures in life.
Weirdly enough, the burping and belching was a close third. I was burping in continuous streams almost all day. My speech was studded with tiny burps, punctuated with an occasional hearty belch. On the days when I was both nauseous and burping, I could smell and taste the food I ate earlier in the day, but in a more toxic form, in the same way that a bag full of garbage that has been sitting in the sun releases a ripened odor of the leftover food that is in it. The involuntary constriction of the throat muscles is the same constriction that happens when vomiting, so every time I burped, I had the feeling that I was vomiting little bursts of noxious gas. This was especially true while my saliva still tasted strange; I was convinced that both my breath and burps smelled bad. Once my saliva became less alien, I was more able to appreciate the ridiculousness of it all and pictured myself as a comic strip character with blank conversation bubbles appearing and disappearing above my head.
During the burping period, I must have had a constantly startled look on my face. Imagine having irregularly-spaced hiccups for four days straight. Besides that, the burping was so impolite and so unhideable that I didn't want to go out in public. I didn't want to explain to complete strangers or (even worse!) to acquaintances who had no idea of my current health issues: "Sorry, I have cancer and burping seems to be one of the lesser-known side effects of my chemotherapy treatment" Or not explain and feel their curious or disgusted stares on my back. Only uncontrollable farting would be more humiliating.
The coughing and sniffling are also somewhat interesting items on the list. They are not cancer symptoms or side effects of the chemo. They are symptoms of a cold that became worse due to one of the side effects of chemo.
I had a minor cold since a few weeks before the start of treatment. In fact, I think that I caught it around the same time that I discovered the lump in my chest, which means that I've had it now for 7 weeks. Although it was always present, I barely noticed it because I had other things to worry about. Of all the "children", it was the quietest and easiest to ignore. But now, it's active and clamoring for attention. The symptoms worsened considerably in the past few days. Especially in the mornings and evenings, I now have violent coughing fits that sometimes last for several minutes and bring tears to my eyes. I've already blown my nose through two boxes of tissues. The cold became strong because my immune system is weak.
In every chemo cycle, there is always a predictable dip in white blood cell count, which the Dutch name the "dip period". The literature I received from the hospital estimates that the dip period will occur roughly between the 10th and 15th days after each chemo infusion. Strangely enough, the Americans seem to believe that this period, which they don't seem to have an official name for, occurs between the 7th and 10th day. Is there a difference in the chemo dosages that could result in differences in cycle characteristics?
During the dip period, I am more vulnerable to infection. I am to avoid going to places where large groups of people congregate, taking public transportation, accepting fresh flowers, or doing anything that could result in a cut or a scrape. I am also to avoid eating: raw meat, raw fish, raw tofu, undercooked egg (e.g., no sunny-side ups), peanuts, certain cheeses, unpasteurized dairy products, homemade jams, any raw vegetables or fruit that are unwashed or difficult to properly wash (such as broccoli), fresh salads prepared in restaurants. It's hard not to become paranoid. I guess it's not so bad; otherwise, my doctors would force me to live in a plastic bubble.
Here's a record of my side effects and symptoms starting from Day 1 of Chemo #1 (from memory, so the list may be slightly inaccurate):
Day 1: nausea, lightheadedness, fatigue, slight cough, pain at night, breakthrough pain during the day
Day 2: nausea, vomiting, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, pain at night, breakthrough pain during the day
Day 3: nausea, vomiting, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, severe weight loss, constipation, slight cough, pain at night, breakthrough pain during the day
Day 4: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, constipation, slight cough, breakthrough pain during the day, mouth sores
Day 5: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 6: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 7: nausea, lightheadedness, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 8: nausea, loss of appetite, fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, mouth sores
Day 9: slight nausea, slight loss of appetite, slight fatigue, strange-tasting saliva, slight cough, breakthrough pain during the day, frequent burping and belching
Day 10: slight fatigue, strange-tasting saliva, slight cough, frequent burping and belching
Day 11: strange-tasting saliva, slight cough, frequent burping and belching
Day 12: heavy productive cough, heavy sniffling, less frequent burping and belching
Day 13: heavy productive cough, heavy sniffling, less frequent burping and belching
Day 14: heavy productive cough, heavy sniffling
Day 15: heavy productive cough, heavy sniffling
Day 16: heavy productive cough, heavy sniffling, mouth sore
Day 17: heavy productive cough, heavy sniffling, mouth sore
Days 18-21: what next?!
The nausea and loss of appetite were the worst side effects. I was afraid I would never enjoy food again, and I have always been one of those people who finds food one of the biggest pleasures in life.
Weirdly enough, the burping and belching was a close third. I was burping in continuous streams almost all day. My speech was studded with tiny burps, punctuated with an occasional hearty belch. On the days when I was both nauseous and burping, I could smell and taste the food I ate earlier in the day, but in a more toxic form, in the same way that a bag full of garbage that has been sitting in the sun releases a ripened odor of the leftover food that is in it. The involuntary constriction of the throat muscles is the same constriction that happens when vomiting, so every time I burped, I had the feeling that I was vomiting little bursts of noxious gas. This was especially true while my saliva still tasted strange; I was convinced that both my breath and burps smelled bad. Once my saliva became less alien, I was more able to appreciate the ridiculousness of it all and pictured myself as a comic strip character with blank conversation bubbles appearing and disappearing above my head.
During the burping period, I must have had a constantly startled look on my face. Imagine having irregularly-spaced hiccups for four days straight. Besides that, the burping was so impolite and so unhideable that I didn't want to go out in public. I didn't want to explain to complete strangers or (even worse!) to acquaintances who had no idea of my current health issues: "Sorry, I have cancer and burping seems to be one of the lesser-known side effects of my chemotherapy treatment" Or not explain and feel their curious or disgusted stares on my back. Only uncontrollable farting would be more humiliating.
The coughing and sniffling are also somewhat interesting items on the list. They are not cancer symptoms or side effects of the chemo. They are symptoms of a cold that became worse due to one of the side effects of chemo.
I had a minor cold since a few weeks before the start of treatment. In fact, I think that I caught it around the same time that I discovered the lump in my chest, which means that I've had it now for 7 weeks. Although it was always present, I barely noticed it because I had other things to worry about. Of all the "children", it was the quietest and easiest to ignore. But now, it's active and clamoring for attention. The symptoms worsened considerably in the past few days. Especially in the mornings and evenings, I now have violent coughing fits that sometimes last for several minutes and bring tears to my eyes. I've already blown my nose through two boxes of tissues. The cold became strong because my immune system is weak.
In every chemo cycle, there is always a predictable dip in white blood cell count, which the Dutch name the "dip period". The literature I received from the hospital estimates that the dip period will occur roughly between the 10th and 15th days after each chemo infusion. Strangely enough, the Americans seem to believe that this period, which they don't seem to have an official name for, occurs between the 7th and 10th day. Is there a difference in the chemo dosages that could result in differences in cycle characteristics?
During the dip period, I am more vulnerable to infection. I am to avoid going to places where large groups of people congregate, taking public transportation, accepting fresh flowers, or doing anything that could result in a cut or a scrape. I am also to avoid eating: raw meat, raw fish, raw tofu, undercooked egg (e.g., no sunny-side ups), peanuts, certain cheeses, unpasteurized dairy products, homemade jams, any raw vegetables or fruit that are unwashed or difficult to properly wash (such as broccoli), fresh salads prepared in restaurants. It's hard not to become paranoid. I guess it's not so bad; otherwise, my doctors would force me to live in a plastic bubble.
Saturday, April 18, 2009
Hair Loss
Today I had a small shock when, after my shower, I noticed there was so much hair blocking the drain that it took a few minutes for the water to disappear. Even when I had long hair, that never happened unless the drain was actually clogged.
Last weekend, I went to a pricey hair salon to have my hair cut very short for the first time in my life. I was nervous, because I always suspected that I would look like a boy with such a cut, but it turned out fine. My hair is now shag-carpet length in the back, stopping at the top of my neck. It's down to my chin in the front, with longish layers framing my face. It's quite a stylish cut.
Before the cut, my hair was super-thick and long, a few inches below my shoulders. I thought it would be too shocking (as well as messy) to have such long hair falling out, and I guess I was right. At least 4/5 of the volume was already cut away, so I can't imagine the hugeness of the hairball that would have been blocking my drain had I not had the haircut. Even with short hair, it was still a shock.
Luckily, having thick hair means that it might take at least a few weeks for it all to fall out. Looking in the mirror today, my hair doesn't look all that different. I read somewhere that the hair on my head will go first, then the eyebrows and the rest of my body. I'll be like a shorn sheep in a month or two. My insurance will pay for a wig, so I'll probably corral some girlfriends into coming with me on a wig-shopping expedition, followed by tea and cake at Taart van Mijn Tante -- a novel way to spend a Saturday afternoon in Amsterdam.
As I write this, I wonder if there would a market for a deck of cards called "52 Ways to Have Fun with Cancer". Decorate crackers with Cheeze Whiz smiley faces! For those days when you are too nauseous to eat anything else. Make art installations with all your hair that falls out! Cancer's a great opportunity to develop your creativity. Try tossing your pills in the air and catching them in your mouth! It's an exercise you can even do in bed.
3 down, only 49 more cards to think up.
Last weekend, I went to a pricey hair salon to have my hair cut very short for the first time in my life. I was nervous, because I always suspected that I would look like a boy with such a cut, but it turned out fine. My hair is now shag-carpet length in the back, stopping at the top of my neck. It's down to my chin in the front, with longish layers framing my face. It's quite a stylish cut.
Before the cut, my hair was super-thick and long, a few inches below my shoulders. I thought it would be too shocking (as well as messy) to have such long hair falling out, and I guess I was right. At least 4/5 of the volume was already cut away, so I can't imagine the hugeness of the hairball that would have been blocking my drain had I not had the haircut. Even with short hair, it was still a shock.
Luckily, having thick hair means that it might take at least a few weeks for it all to fall out. Looking in the mirror today, my hair doesn't look all that different. I read somewhere that the hair on my head will go first, then the eyebrows and the rest of my body. I'll be like a shorn sheep in a month or two. My insurance will pay for a wig, so I'll probably corral some girlfriends into coming with me on a wig-shopping expedition, followed by tea and cake at Taart van Mijn Tante -- a novel way to spend a Saturday afternoon in Amsterdam.
As I write this, I wonder if there would a market for a deck of cards called "52 Ways to Have Fun with Cancer". Decorate crackers with Cheeze Whiz smiley faces! For those days when you are too nauseous to eat anything else. Make art installations with all your hair that falls out! Cancer's a great opportunity to develop your creativity. Try tossing your pills in the air and catching them in your mouth! It's an exercise you can even do in bed.
3 down, only 49 more cards to think up.
Tuesday, April 7, 2009
Fighting Nausea
I'm never hungry anymore, but I think about food all the time.
It's like I'm the worried parent and the sick kid at the same time. I know I have to keep my weight up, so I (the worried parent) plot what I'm going to make for myself (the sick kid) that won't trigger extreme nausea. Planning and preparing the food has become a necessary chore, like brushing my teeth. Usually, once I start eating, the food tastes good. Sometimes it stings a little; they warned me about mouth sores at the hospital. I still need to make an appointment with the cancer-specialized dental hygienist about that.
After a few vomiting episodes over the weekend, despite the strong anti-nausea medication I was taking, I wised up and searched the internet for articles on nausea. It turns out that it's better to eat smaller meals more frequently, eat slowly, not mix hot and cold foods, eat blander foods, and drink ice water. In general, cold food is better than hot. These tips helped a lot.
The nurse at the hospital had also emphasized that I had to be careful not to get trapped in the downward spiral of not eating because of nausea, as that just leads to more nausea, when the stomach continues to contract in expectation of food. She was right. A few times, when I was feeling most nauseous, I forced myself to eat just a small amount of food and felt instantly better.
My staple foods, for the moment, are blueberries and raspberries with muesli mix and soy milk in the morning. A mango later in the morning. Rice porridge with a few add-ins for flavor. I managed to work in some leftover Thai food, although it made me sick the other day, and it was all right. I do worry that, after 6 months of this, I'll never be able to enjoy a blueberry again. But I suppose that's a small price to pay for the honor of calling myself a cancer survivor.
It's like I'm the worried parent and the sick kid at the same time. I know I have to keep my weight up, so I (the worried parent) plot what I'm going to make for myself (the sick kid) that won't trigger extreme nausea. Planning and preparing the food has become a necessary chore, like brushing my teeth. Usually, once I start eating, the food tastes good. Sometimes it stings a little; they warned me about mouth sores at the hospital. I still need to make an appointment with the cancer-specialized dental hygienist about that.
After a few vomiting episodes over the weekend, despite the strong anti-nausea medication I was taking, I wised up and searched the internet for articles on nausea. It turns out that it's better to eat smaller meals more frequently, eat slowly, not mix hot and cold foods, eat blander foods, and drink ice water. In general, cold food is better than hot. These tips helped a lot.
The nurse at the hospital had also emphasized that I had to be careful not to get trapped in the downward spiral of not eating because of nausea, as that just leads to more nausea, when the stomach continues to contract in expectation of food. She was right. A few times, when I was feeling most nauseous, I forced myself to eat just a small amount of food and felt instantly better.
My staple foods, for the moment, are blueberries and raspberries with muesli mix and soy milk in the morning. A mango later in the morning. Rice porridge with a few add-ins for flavor. I managed to work in some leftover Thai food, although it made me sick the other day, and it was all right. I do worry that, after 6 months of this, I'll never be able to enjoy a blueberry again. But I suppose that's a small price to pay for the honor of calling myself a cancer survivor.
Day 5 of the First Chemo Cycle
The magic of Day 5. This afternoon I forced down my last pills of this cycle and told myself I was "a good girl" since no one else was around to witness the heroic act.
I still feel queasy and tired. I slept almost 12 hours last night. The weird taste in my mouth, like an extra thin layer of alien mucous coating my tongue and cheeks and teeth, is still there. I feel fragile, but that could be a result of staying in bed for almost 3 days and losing 2 kilos.
I had a not-so-ambitious list of things to do, and then proceeded to do even less than what was on the list. I managed to walk to the mail box to send my DVDs back to DVDPost (decided that I could and should watch the ending of Sweeney Todd after my 6 months of treatment are up). I also managed to walk a bit further to the pharmacist, to ask if they had gelcaps to hide the bitter flavor of prednisolone that I dreaded taking every day. The woman and the man behind the desk looked at each other and laughed. I somewhat expected the reaction, but it still hurt. I'll readily admit that the Dutch are tougher than we Americans. If I want easy-to-swallow, nice-tasting medicine, I always look for American brands. Still, I can't help feeling that the Dutch who take the attitude of 'grin and bear it' suffer unnecessarily more than they need to. The chemo treatment is bad enough; I'm going to do everything I can to make it more bearable.
On the way back from that unsuccessful mission, I passed a bakery which smelled delicious. But when I went inside, I found the sights and smells overwhelming and backed out again. Then I tried the chocolaterie. Thankfully, the strong chocolate smell still smelled good and didn't make me queasier. I was thinking that chocolate might be a way to fatten me up again. Ironic: I spent the whole past year trying in vain to lose a few pounds, but I found that the 'accomplishment' of this goal in just a few days time so alarming that I'm now set on trying to reverse the trend. Unfortunately, in my light-headed state, I had managed to leave the apartment without my wallet. So the chocolates are still in the store, but I'll go back shortly to pick them up.
Tonight I have a ticket to see Ojos de Brujos, a ticket that I bought months ago. I plan to go, although I'm not convinced it's a wise idea. I seem to be unusually sensitive to sights and sounds and smells. Usually I like to have background noise, such as iTunes or the television, as I clean up around the apartment or fix a meal. But in the last 2 days, I've preferred quiet indoors. It's nice to hear the birds outside and the shouts of the kids in the neighborhood playing in the park. I noticed on my walk today that some trees have sprouted green. Spring is really here at last.
I still feel queasy and tired. I slept almost 12 hours last night. The weird taste in my mouth, like an extra thin layer of alien mucous coating my tongue and cheeks and teeth, is still there. I feel fragile, but that could be a result of staying in bed for almost 3 days and losing 2 kilos.
I had a not-so-ambitious list of things to do, and then proceeded to do even less than what was on the list. I managed to walk to the mail box to send my DVDs back to DVDPost (decided that I could and should watch the ending of Sweeney Todd after my 6 months of treatment are up). I also managed to walk a bit further to the pharmacist, to ask if they had gelcaps to hide the bitter flavor of prednisolone that I dreaded taking every day. The woman and the man behind the desk looked at each other and laughed. I somewhat expected the reaction, but it still hurt. I'll readily admit that the Dutch are tougher than we Americans. If I want easy-to-swallow, nice-tasting medicine, I always look for American brands. Still, I can't help feeling that the Dutch who take the attitude of 'grin and bear it' suffer unnecessarily more than they need to. The chemo treatment is bad enough; I'm going to do everything I can to make it more bearable.
On the way back from that unsuccessful mission, I passed a bakery which smelled delicious. But when I went inside, I found the sights and smells overwhelming and backed out again. Then I tried the chocolaterie. Thankfully, the strong chocolate smell still smelled good and didn't make me queasier. I was thinking that chocolate might be a way to fatten me up again. Ironic: I spent the whole past year trying in vain to lose a few pounds, but I found that the 'accomplishment' of this goal in just a few days time so alarming that I'm now set on trying to reverse the trend. Unfortunately, in my light-headed state, I had managed to leave the apartment without my wallet. So the chocolates are still in the store, but I'll go back shortly to pick them up.
Tonight I have a ticket to see Ojos de Brujos, a ticket that I bought months ago. I plan to go, although I'm not convinced it's a wise idea. I seem to be unusually sensitive to sights and sounds and smells. Usually I like to have background noise, such as iTunes or the television, as I clean up around the apartment or fix a meal. But in the last 2 days, I've preferred quiet indoors. It's nice to hear the birds outside and the shouts of the kids in the neighborhood playing in the park. I noticed on my walk today that some trees have sprouted green. Spring is really here at last.
Monday, April 6, 2009
Constipation
I never realized how debilitating constipation could be.
I thought it was just a problem of not shitting for a few days.
What's far worse is when your body still, against your will, wants to expel its waste. But now it feels like the waste is a compact solid mass 5 times wider than the straw hole it's supposed to push through, and with little glass shards and pebbles buried within it. Is there anything less dignifying than squirming, shouting, crying on the toilet seat for two hours in the middle of the night in order to eject a little ball of shit the size of a mouse pellet?
I'm surprised the neighbors have not come by this morning to ask "what the @#$%?!"
There's a mad woman haunting their building.
I thought it was just a problem of not shitting for a few days.
What's far worse is when your body still, against your will, wants to expel its waste. But now it feels like the waste is a compact solid mass 5 times wider than the straw hole it's supposed to push through, and with little glass shards and pebbles buried within it. Is there anything less dignifying than squirming, shouting, crying on the toilet seat for two hours in the middle of the night in order to eject a little ball of shit the size of a mouse pellet?
I'm surprised the neighbors have not come by this morning to ask "what the @#$%?!"
There's a mad woman haunting their building.
Weight Loss
I weighed myself this morning and was shocked to find that I had lost 2 kilos seemingly overnight. For the past 3 weeks, my weight had been steady at 57 kilos. It's no wonder. I have to force myself to eat, and then I'm afraid to eat too much, because it's likely that I'll just throw it up. The pills and the water make me feel full; I have never drank so much water in my life. In the beginning, it tasted good, but now, even water has a strange and alien flavor. I really hope I get my taste buds back. I miss enjoying food.
Saturday, April 4, 2009
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