Day 90, The Chemo Cycle

It’s been about three months since my diagnosis, and I’m at the beginning of chemo cycle #3 of 6.  These cycles are rapidly become routine.  This time they were able to find a vein on the first try.  My infusion started off at full speed and I had no reaction, though my face is somewhat red today, which according to my wife is the same as the other two cycles.

There isn’t much news to report.  My blood numbers continue to improve, though not as dramatically as before.  That’s not surprising as my PSA at 0.08 is now down to the point where the other substances the test can be sensitive to become a factor.  While I still have some pain, it is more annoying than limiting, and my energy and ambition greatly improved in the last week of the previous cycle.

I’m still experimenting with the medical marijuana, and have recently tried vaping.  This is a much better delivery method when learning, as effects happen much faster (a couple minutes instead of a couple hours), and go away sooner (3-ish hours versus 10-12).  I’m still planning to write another MMJ post, but as I’m still learning it’s still a work in progress.

So what happens during each cycle of chemo, you ask?  It starts with taking a steroid called dexamethasone the night before, and then two more pills in the morning before going to the oncologist’s office.  This is intended to suppress an allergic reaction to the chemotherapy drug.  At the office I get a blood test.  If that shows that my counts have improved sufficiently after the previous treatment I get the next treatment.

The treatment consists of two parts: A pre-treatment consisting of more dexamethasone and benadryl, again to prevent reactions to the drug, as well as anti-nausea and anti-acid meds to prevent side effects.  That takes about 15 minutes, and after that it’s about an hour to get the docetaxel (the chemo drug).

Initially, I’m tired and groggy from the benadryl. As that wears off, the dexamethasone takes over, which is stimulating.  Yesterday I came home, took a nap, then couldn’t get to sleep until about 1am, after dosing myself with melatonin. Did I mention I’ve turned into a human chemistry set?

Initial side effects for me include a bit of constipation (from the dexamethasone), lost of taste and appetite, a sore throat and mouth, and usually vague discomfort throughout the digestive tract and lunch, all from the docetaxel affecting fast-growing normal cells.  On the bright side, the MMJ seems to help greatly with appetite and taste, as lunch was much more enjoyable than breakfast today.

I’ll go running at the indoor track tonight.  My heart rate will probably be much higher than usual (see “I’m a chemistry set,” above), and my lungs may not let me go 100%, but my body generally won’t have any trouble.  It won’t take much effort to get there either, as it’s a long developed habit and that trumps what little fatigue I may be feeling today.

In a couple more days the dexamethasone will be out of my system and I’ll start to feel the side effects directly.  Docetaxel generally causes a bit of diarrhea.  As I usually take some milk of magnesia to counteract the dexamethasone, this transition can be a little dramatic.  Perhaps I should have mentioned not to eat while reading this post?

Without the stimulating effects of the dexamethasone, fatigue hits full force.  Also I’m prone to a bit of nausea (easily controlled with medication so far) and acid reflux around this time.  It’s generally a good time to lay around on the couch, though I do try to get out for a walk if possible.  This is also the time my immune system goes offline, which probably adds to the fatigue.

Once that’s out of the way, I’m pretty good for about a week, but don’t have full power.  I’m somewhat anemic by this point, and my lungs are at their worst for the cycle, so my running pace falls off drastically to around brisk walk territory.  At lesser efforts I’m pretty good and so can do most things, only slower than normal.

Near the end of the second week my immune system and blood counts start returning, and that can lead to another round of fatigue, malaise, and general aches and pains.  After that passes, I’m pretty much good until the start of the next cycle, with improving energy and lower heart rates as the anemia eases.

So that’s a cycle.  It’s a great sign that each cycle is getting easier, but that may not last.  My initial improvement may be partly caused by my continued recovery from the radiation treatments a couple months ago.  To counter that, my blood counts aren’t completely recovering by the end of the cycle, and that as well as other chemo caused  damage to normal tissue which doesn’t fully recover all starts to accumulate as the cycles add up.

But, I only have three more cycles after this one, so even if the later ones are a bit tougher it won’t be long before I have some extended recovery time.  Also, as I become more familiar with the MMJ I may be able to better manage the side effects, or at least not feel as stressed about them which has to help.