Sunday, August 25, 2013

Taxol Renders Quite a Punch!

My sixth chemotherapy treatment was scheduled in mid August and began like the previous five…blood work, followed by an appointment with my magician of an oncologist, Dr. Issam Makhoul, and then my three-hour encounter with intravenous poison.
Marla Crider, breast cancer, patient stories, UAMS
Marla receiving her 2nd Taxol treatment. Only
two more to go! 

My brother Mike and sister-in-law Barbara drove from Northwest Arkansas to be with me for the treatment.  I can’t emphasize enough how important and meaningful it has been to have my family surround me with love and support as I battle breast cancer.  Mike and my middle brother, Marion, alternate trips to Little Rock every other week to ensure that I have family around each time I must endure another chemo treatment. I’m convinced they, and my beloved Don, are the reasons I have been able to tolerate the chemotherapy drugs with minimal side effects.  My family and countless friends have all contributed to my positive state of mind, which is extremely important in fighting cancer.

When Mike, Barb and I arrived at the UAMS Cancer Institute, we were handed face masks as soon as we entered the building and instructed to wear them as long as we were in the cancer wing.  A flu epidemic was spreading throughout the multiple myeloma section of the hospital and in order to contain the sickness, the public was asked to wear masks to minimize spreading germs.  Multiple myeloma patients undergoing chemotherapy virtually have no immune system because the treatment destroys the patients' bone marrow.  The flu can be extremely dangerous to all cancer patients in treatment but especially to those with multiple myeloma. 

The three of us donned our face masks and made our way to the infusion clinic where I awaited my turn for the blood draw.  It was an odd scene when we entered the waiting area.  Every person in the room was wearing a mask, just like us.  We were all trying to do our part to control the flu epidemic and protect my fellow cancer patients. I learned quickly that sporting a face mask escalates hot flashes.  My inclination was to rip the mask off my face and fan myself with it, but I didn’t.  Instead, I let the abundant perspiration drip off my chin and catch in the trough created by my bra, which was quickly becoming saturated.  Bras serve multiple functions and sweat-catcher is one of them.

As I fanned myself furiously with a magazine, I heard a nurse call my name from the infusion room door.  I was anxious to follow her into the (always) frigid treatment room.  Before I could reach my cool destination, I had to step on the scales and check my weight.  I had only lost a half pound and was still in the “safe” category.  I was delighted when the nurse told me I didn’t have to wear the mask in the infusion area because it was super sterilized. It only took me a second to remove the hot, contraption from my face.  I immediately began to cool down.  The nurse, who was unfamiliar to me, escorted me to a vacant recliner and began preparing for the blood draw.  Like a broken record, I told her about my port-on-nerve situation and requested that she not insert the needle until I took a deep breath.  She agreed.  Thank goodness, our in-unison approach produced pain-free port access.  Since learning about the deep breathing method a few weeks earlier, I no longer dreaded the blood draw.  It was now just a routine part of treatment day.

After collecting four vials of blood, I was dismissed from the infusion center and told to pull the protective mask over my nose before re-entering the waiting area to meet my entourage.  Masks in place, my group took the elevator seven floors up for my appointment with Dr. Makhoul.  As we exited the elevator, there were dozens of people in the clinic lobby all wearing white or yellow face masks and doing their part to eradicate the flu epidemic.  We found chairs together and began the wait. Surprisingly, I was called back to Dr. Makhoul’s exam area within 30 minutes.  It was another 20 minutes before the very busy doctor rushed into the cubicle to give me a hug. We bantered with ease about my remarkable response to the chemotherapy.  I was quick to give him credit for my progress because of his genius as an oncologist.  He is a humble man who uncomfortably accepts compliments.  I would have expected nothing less.

Dr. Makhoul was very curious how I handled the first infusion of Taxol.  I told him about the severe bone and joint pain, as well as the serious diarrhea.  He encouraged me to take the pain tablets – Tramadol – that he had prescribed to reduce the musculoskeletal discomfort.  He also instructed me to use Imodium, an over the counter anti-diarrheal medication for the first few days after chemo to help eliminate the symptoms. I assured him that I would.

He was anxious to examine me and check the size of the tumor after just one treatment of Taxol.  He used his handy dandy scale to measure the mass.  He looked up at me with a grin and said, “We’ve come along way from the 5.6 centimeters when we started.  There has been a significant reduction to 2.2 centimeters.”  I was overwhelmed with joy and felt reassured that that the tumor might actually shrink to nothingness.

Dr. Makhoul quickly signed my chemo orders and told me he was very proud of me.  I told him it was because we had a great doctor-patient relationship.  And I do believe that.  I’m convinced that if you don’t have faith in your medical team, the results of the chemotherapy might not be as effective.

Marla Crider, breast cancer, UAMS, Taxol, patient stories, chemo, side effects
Marla Crider with her brother, Mike Crider, at UAMS.
Mike, Barbara, Don and I returned to the infusion center and waited to be called back to the room where the magic happens.  Everyone in the waiting area was wearing a face mask, including all of us. As soon as I sat down, beads of perspiration began rolling down my face, neck and back.  I immediately started fanning myself with a magazine.  I had decided the mask was making me feel slightly claustrophobic, which was triggering the hot flashes.  Just for a few short moments I dropped the mask below my chin and began to immediately cool off.  It was at that time, the nurse called my name.  Thank goodness, I could remove the mask once I got beyond the infusion room door… and I did just that.  What a relief! 

Barbara accompanied me to my assigned recliner and observed the nurse as she prepared me for the treatment process.  Yet another new RN would be overseeing my treatment.  I learned that Mr. Nurse Ratched was attending a conference as were four other nurses I had come to know.  I rather missed them.  

My new caregiver provided me with three more steroid tablets (five total for the day) to prevent nausea.  (No wonder I was restless and felt as though I could dance on the ceiling.) In addition, the nurse injected Pepcid into my intravenous tubing to help calm my stomach before the Taxol was administered.  Following the Pepcid, she injected Benadryl into my port to prevent an allergic reaction to the Taxol.  As soon as the Benadryl reached my veins I felt a “rush” of sorts and started laughing uncontrollably for about three minutes.  My laughter was contagious as others around me started laughing, as well. Once my giggles were under control, the bag of poison was hung from the intravenous pole and the treatment began. A few minutes after the Taxol entered my system, my right breast started tingling.  The poison had already found its way to the cancer-ridden mass.  It was a rather remarkable feeling.  For the next three hours, my family alternated positions as my support team in the infusion room.  It certainly helps pass the time when conversation is exchanged.

I experienced no allergic reactions during the treatment and completed the process feeling pretty good.  Before leaving the infusion room, the nurse handed me two days worth of steroids to keep the nausea at bay.  While steroids are a God-send when it comes to the prevention of nausea and vomiting during chemotherapy, the medication also contributes to insomnia and wreaks havoc on diabetes.  After six treatments, I had finally learned how to adjust my insulin to compensate for the extremely high blood sugars.  As for the insomnia, nothing much helps with that inconvenience.

The day following the treatment, the diarrhea returned but I was able to curtail the seriousness of it by taking Imodium as soon as I had the first episode.  On day three the bone and joint pain returned with a vengeance.  The discomfort in my hips, lower back, knees and shins was debilitating and lasted three consecutive days.  As much as I deplore taking pain medication, I had no choice.  It was my only source of comfort.  I managed to go to work but not without a couple of Tramadol tablets to get me through the day.  By the seventh day after the Taxol treatment, the bone pain had finally subsided and I was (somewhat) back to normal.  No matter how uncomfortable the side effects may be, I admittedly welcome them as proof that the chemo treatments are doing exactly what they are designed to do – kill the cancer.  And if that means I might have to endure a few throbbing bones and a bout of diarrhea, then so be it.  My goal of being cancer free is just two treatments away.  And I can tolerate anything for that along. 


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