Friday, July 30, 2010

Secondary Effects

For cancer patients we all have the dreaded "after chemo" effects, and although they are different for every patient, there are similar classifications, or groups, of these effects.

Once I started chemo, I had several effects that I could count on every time.
  • The day after I had so much energy. My mom used to joke that I could run La Luz (the hiking trail from the base of the Sandia Mountains to Sandia Peak in Albuquerque, NM) the day after my chemo. 
  • Around day 3 I started feeling like I was hit by a truck. I had no energy and would get nauseated. 
  • My tastebuds would react to the Decadron steroids. I could not eat or drink ANYTHING with sugar or carbohydrates. Bread was horribly sweet, even water didn't taste right. I called it fuzzy. The only way I can explain it, is that is wasn't cold or crisp, it did not have a refreshing effect on me. I learned to combat this taste issue by eating high acidic items. Lemon drops hard candy were my favorite. It could break through the fuzziness on my tongue.
 Another dreaded aspect was losing my hair. But that will be an entire post of its own.

The biggest secondary effect that I am still living with is Hypomagnesemia. This means low magnesium level. Apparently, my chemo, a combination of Taxol and Carboplatin (more likely the platinum from the Carboplatin) wrecked my kidneys. The tubules in my kidneys have small holes were the magnesium leaches out.

I was diagnosed with Hypomagnesemia in September of 2004, 16 months into my cancer treatments. I had been hospitalized after returning from an Alaskan cruise, with Marshall. I had been home for about a week, and had a fever of 103 degree that I just could not shake. While I was in the hospital, my face began to tingle, like it was going numb, and my hands cramped up, such to the point that my hand looked like a claw. This happened to me once before, while visiting Marshall in Georgia. I thought I was having a panic attact at that time, but he took me to the emergency room, where they did blood tests and found nothing.

During this second "panic attack" my oncologist walked in and wanted to know what was wrong with me. With my face tingling, also came the muscles in my face contracting (like those in my hands), so I could not speak. Dr. Guidice ordered more lab tests right then. I tried to relax, and my mom sat by my side and rubbed my back. I finally fell asleep, and when I awoke, I was okay. Turns out that I had an extreme electrolyte shortage. I was low on Magnesium, Potasium, and Calcium. For the Potassium and Magnesium they gave me that through IV infusions, and the Calcium, well, they gave me Tums. :)

Turns out that Calcium is pretty easy to get under control, Potassium, too. Magnesium, not so much. Right there in the hospital, I started what would lead to multiple daily infusions. I was given 2-3 liters of Magnesium in saline, every day. When I was released from the hospital, my insurance allowed for home infusions, so I would not have to go into the hospital. This lead to needing a new IV started every three days.

I went through 19 months of chemotherapy, having an IV started each time, with no real trauma to my veins. Two months of daily infusions wrecked my veins. I had a portacatheter inserted for my infusions in December 2004, AFTER I was finished with chemo.

By January or February of 2005, I noticed that I was gaining A LOT of weight. I was down to one liter of saline a day, but that was 7 liters (6 1/2 Coke bottles) of SALT WATER that was being pumped through my body. I talked to my doctor and they decided that could deliver the magnesium in 50 milileters of Dextrose (a type of sugar) instead. That's 95% LESS fluid! I wish I had thought to ask that from the very beginning! I may not have gained close to 100 pounds!

My Magnesium level slowly but surely started to hold, and I was able to go from daily infusions, to 2-3 times a week, to once a week, to completely stopped in June 2006. All the while I was having the infusions, I was also taking Magnesium supplements. I would take 5 400mg pills, 4 times a day. That's 8 GRAMS. All to keep my Magnesium Level above a 1.0. The normal level is 1.5-2.5. On a really good day I was between 1.2 and 1.4. I learned from my Nephologist (a kidney doctor) that so long as I remained above 1.0, I was unlikely to suffer from Cardiac Arrhythmia, his biggest concern.

While I no longer need infusions, I still have to take the supplements. However, I have decreased the amount significantly. I still take 5 400mg pills, but only once a day. Every now and then, I know my level may be low. I get cramping in my feet and toes. It is really uncomfortable, but Marshall taught me a great trick to help loosen the muscles: find something round, like a tennis ball, and roll your foot over it, paying attention to the tightest areas. This is quite painful at first as well, but it's better than continually trying to pry your toes apart. 

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