“So how you doin’?”
It’s a question I get a lot when meeting up with friends I haven’t seen in a while. They typically ask in a sort of hushed tone, with a facial expression clearly projecting the concern they have for my well-being and the deep friendship they feel toward me. I always see it coming, I always appreciate it, and I always give them as much answer as they want to hear. It usually goes something like this:
“I believe I am one of the most fortunate and blessed cancer patients to walk the face of the earth. Cancer has been gentle but chemotherapy has left some scars.”
In August of 2014, after 5 sessions of chemotherapy, I was received a CAT scan and the disease was pronounced to be “in complete remission.” No signs of cancer could be detected. And the ugly effects of aggressive MCL have continued to remain at bay. But I’m not off the hook completely.
Chemo drugs are powerful killers.
They are designed to enter your body, seek out cancer cells and destroy them. But as is often the case with deadly offensive assaults, collateral damage is a price you pay for the destruction of the invaders. And one of the major casualties was my blood cells.
About half way into my chemo regimen I began to feel tired and weak, particularly in my legs-that hasn’t changed yet.
A casual dog walk became a trek. Climbing the fifteen steps from the main floor to the bedroom often left me rubber-legged and gently panting. Naps were no longer indulgences-they became necessities. All this was the result of red blood cell counts reduced to below acceptable minimums.
You’ll remember from science class that red blood cells (and the protein ‘hemoglobin’ contained in them) are what carry fuel to your body parts. Muscles, bones and organs were clamoring for more oxygen and my heart was going pitty-pat to supply their demand. Meanwhile, I’m standing at the top of the stairs sucking air into my lungs and waiting for the lactic acid “burn” in my legs to subside. Thank goodness the bed is only a few feet away!
The weakness and fatigue have stuck with me and remain the most notable side affects of chemotherapy.
Almost overnight, both shoulders started hurting-bad. The pain was (and remains) equal, and located in the same places, in both shoulders. Joint pain is a common side-effect of chemotherapy, as is the skin rash and lesions I put up with for a few weeks. (on the upside of that, I was relieved to know that the blood spots I found on the sheets had nothing to do with bed bugs!)
I’m not as “sharp” as I used to be.
The pros call it “cognitive impairment”. Those of us who have trouble remembering their SS#’s or how to get home from the grocery store after chemotherapy call it “chemo brain”. Chemo brain can produce trouble concentrating, disorientation, memory loss, or difficulty organizing thoughts or finding the right word. Those symptoms emphasized (or is it “empathized”?) in bold seem to be my biggest challenges.
I had a portacath implanted a few weeks ago.
Since this adventure began, I estimate that I have been poked with needles at least fifty times. And all but a few of those needle pricks have taken place on the underside of my forearms or the back or my hands. That means that a few veins have been assaulted repeatedly with needles and poison and they seem to have decided that enough is enough.
I’ve become what’s known as a “hard stick.” Apparently, blood veins will only take so much abuse until they band together and collectively refuse to be coaxed to the surface of the skin, knowing they will be made to suffer yet another assault from a well-meaning phlebotomist or RN. In several of my most recent needle sessions, the “sticker” has had to excuse themself to go get someone more proficient at digging out and spearing those troublesome, hard-to-find veins. And that’s usually after they’ve made several failed yet painful attempts of their own. Enter the portocath.
A portacath, or “port”, is a small (about the diameter of a quarter) medical device that is surgically implanted under the skin. It is comprised of a reservoir with a catheter attached to it. The catheter runs through my jugular vein and into my inferior vena cava, terminating at the entrance to the right atrium of my heart. That allows for:
- easy withdrawal of blood.
- easy insertion of IV’s.
- more efficient delivery of drugs.
The technician simply pierces the skin covering the port and enters the reservoir through the permeable top of the port. No hunting for uncooperative veins, and needle-stick pain is reduced substantially.
And that’s about it. The cancer cells that were not killed by chemo have taken refuge in some deep, dark burrow and been rendered harmless for now. Chemotherapy has left me tired and a bit foggy-headed, made my shoulders hurt and made my skin itch for a while. I would call my physical challenges more of a nuisance than anything, and certainly not comparable to what a patient with aggressive MCL endures. All these symptoms should improve with time-something I believe I have plenty of left.
In Memory of These Fighters
Bill Cluster, February 2015