Fun with Anxiety Meds

trying out some different approaches to my port-a-cath bulbs

This week marks 75% of the way through my 20 weeks of chemo. On Wednesday I had my 8th round of taxol, my 12 infusion overall, and my 16th week of chemo. Just four more Taxol infusions after this one. All my remaining infusions are on the same calendar page. I also got the results of my ultrasound. No evidence of cancer in the lymph nodes (we already knew this) and the tumor has shrunk from 2.7 x 2.4 cm in November to 1.3 x 1.1cm! The MRI coming up will be more precise, and hopefully also smaller since I'm still doing chemo.

twins

When I started Taxol, they were concerned that I could have a reaction to the chemo during the infusion. For the first several weeks they monitored me for that reaction. I did have some discomfort, but it was during the premeds (antinausea, steroids, and pepcid in the IV and a Benadryl pill to swallow). The discomfort was a pain or pressure in my chest, but as it was happening before the Taxol, it didn't seem to be a major concern. I was pretty uncomfortable, though, and I brought it up to the nurses who suggested that it was indigestion. I was having similar discomfort, though not as severe, pretty much every day, so on the nurse's suggestion I started taking Pepcid daily. Later I switched to Omeprazole which seemed to help a lot more with the daily discomfort.

underglazed and ready to fire

By the fourth week of Taxol, the pain in my chest during premeds was pretty intense, causing me to be unable to read or talk or watch a video until the pain subsided, so I brought it up again to the nurse. My nurse that day said, as they all have said, that there really was no reason I should be having pain during premeds. I indicated that it had been a problem for all of Taxol but not during A/C. (Telling me that I shouldn't have pain during premeds is like the nurse telling me I should calm down when I came into the hospital in labor. I was holding onto the bed rail and she told me it wasn't that bad. Then she did an exam and told me I could hold on to the rail all I wanted as I was further along than she thought. Let's maybe just assume that I know when I am in pain and how intense that pain is).

first layer of underglaze for the sculpture in progress

The next week I brought it up to my oncologist who saw that one of my antinausea medicines had been changed from when I was doing the A/C, so she changed it back. When I told my mom about asking for help with the pain and then getting something changed to address it, she laughed at me for being surprised that the issue could be resolved. I just figured discomfort and pain during the infusion were normal. (Read on to see who was right.)

partway through the second layer of underglaze

The next day during my infusion, I felt no pain during premeds. That was the case for weeks 5 and 6 of Taxol. Excellent! I thought, changing the antinausea medicine took away that unpleasant part of the process and things are going to be smooth sailing for the rest of the infusions. Mom was right! (Spoiler: Mom was not right.)

second layer of underglaze complete

But, of course, that's not how these things go. Last week, during week 7, I was feeling really great. I had done a more intense workout the day before, was still feeling a bit of a high from that, was feeling really cheerful about getting nearer the end of the chemo, and was chatting away with my nurses. Everything was humming along, when suddenly, during premeds, I started feeling the same pain and pressure in my chest. I'd taken Omeprazole that morning and the Taxol hadn't started yet. I called my nurse over and asked if maybe they'd accidentally switched the antinausea medicine back to what it had been before.

the top broke, so I'm firing it separately

She checked and confirmed that the medicines were all the same as the two previous weeks (when I'd had no symptoms). I talked to her about the pain and what might be causing it. She said it was strange to have the pain during premeds and determined that I must be "special." She offered to stop the infusion, but I didn't see much point in that, as I'd already experienced this same pain 4 times before, so it would probably go away shortly after Taxol started. And it did. 

port-a-cath bulb

Tuesday of this week, before my 8th infusion, I met with the oncologist and told her about the pain during premeds happening again. She checked the medicines and confirmed that they were all the same as during weeks 5 and 5 (when I had no pain). She said there was no reason for pain during premeds and asked if I was feeling anxious before the infusion. I can honestly say that I was feeling really calm and cheerful, unusually so, before the last infusion. So she said it must be the Taxol causing the pain. 

twin port-a-cath bulb

I reiterated that the pain consistently happens before the Taxol begins and thus I really don't think the Taxol can be the cause. With kind of a shrug of not knowing what else to do with me (I am clearly a wierdo patient on this), she decided to put some anti-anxiety medicine in my premed. I felt a bit like this was by way of telling me I was imagining the pain, but what else could we do? My husband thought I shouldn't read this as her saying my concerns were imaginary, just as a different way of approaching the problem.

new earrings from Like the Moon (Ellensburg artist)

So the next day, while I was getting my premeds, I asked what all was included this time. As usual, they started by giving me a Benadryl pill, then started a series of syringes of pepcid, anti-nausea and steroids, into my IV machine. So, knowing that I've been having trouble with pain during the premeds, did they give me something for that first? Nope, they gave me all the regular premeds, THEN the anti-anxiety medicine. Because? Cause and effect? No? What do we think is the point here, folks?

my IV stand

While the saline rinse was running between premeds, I walked to the bathroom with my cool rolling IV stand and on the way back felt a sudden stab of pain low in my left chest and in my sternum (this pain has usually been in my sternum). I told the nurse who seemed a bit alarmed and asked if I'd had an EKG or echocardiogram. I said I had an ultrasound of my heart, which seemed to alarm her more and she asked why. I'd had it before the A/C because the adriamycin is supposed to be bad for my heart, which seemed to calm her down. 

still trying to get a photo that captures the soft little white hairs all over my head

So the upshot is that they gave me the premeds, which I think are the cause of the chest pain. The premeds appeared to cause the chest pain again, as they sometimes do, and then, after the pain started, they gave me the preventative anti-anxiety meds. Now, what is, I think, relevant here is that the pain, though significant, usually lasts just 20 -30 minutes. So I would probably be roughly as happy if I were told to just deal with it because it isn't causing damage and it will be over soon. I can live with 30 minutes of pain as long as I know that it has a fairly quick end time and as long as I don't need to worry that the pain is a sign that something is breaking inside me.

the IV tube during chemo

But instead, once I got back to my chair, the nurse gave me the anti-anxiety medicine and told me it would make me feel woozy, so just be prepared. Hoo Boy! did that stuff make me feel loopy. I'm still laughing at myself from Wednesday. It's been a long time since I've been drunk, but that stuff got me quickly and gently drunk. 

the part of the IV tube that goes in the machine

Exhibit A: My camera roll from Wednesday. I've been thinking about how to incorporate cancer and chemo imagery into my sculpture, so I decided to take some pictures of the IV stand and related parts. 

the part of the IV tube where the syringe can go in (I think)

The tube that goes from my chest to the stand has sections that split off to allow a syringe or different tube. There's a flat thing that goes in the machine, and there's a lot of extra tube that curls up and gets caught in the arm of the chair when I move around. So I figured I'd take some pictures of this.

the little drippy things that I can watch to see the Taxol bag is lamost done (it isn't)

I took a whole bunch of pictures of the tubes and of me. Ok, no big deal. This is research and I'm bored, to boot.

more silly selfies

But then, for some reason that I no longer remember, I decided to take a whole bunch of pictures of the bag of ice that I used to ice my fingertips during Taxol to preven neuropathy.

icing

No idea why I was taking all these pictures, but these don't appear to be "oops dropped the camera" photos. For one, there are 7 separate pictures of the ice bag, with and without my hand in the photos. For another, they aren't all in a row. I took a break to take pictures of the IV stand and then came back to the bag.

not icing

I must have been intereested in the spot where I'd been gripping the ice and the way the ice bag stayed clumped in a hand shape when I let go. 

more ice

Then I started taking selfies from inside the ice bag. There are five of these, plus more selfies with the IV tube coiled up in front. I'm ridiculous.

peek-a-boo

Now I find this hilarious. I'm not sure what I was thinking then. This anti-anxiety medicine is pretty fun. By the time my husband came to pick me up, I had forgotten how to tell time. My text to him says "I think I'm 15 mins from done but I've forgotten how clocks work" Except I misspelled clocks. I was having some trouble distinguishing the minute hand from the hour hand. I also texted my friend Carli, though the next day when I woke up I thought, "I better text her" (and was surprised to see the evidence of the conversation we already had on my phone).

why am I doing this?

When Sean picked me up, I honestly considered whether I was going to make it to the car. I did just fine (I think), but I did use the wall to help me down the hall. At home, I was stumbling a bit and figured it was safer to sit down. It was shortly after lunch time, so I put some food in the microwave and came in to sit with my daughter. She showed me a game they were doing for her social studies classs and asked if I wanted to get my lunch from the microwave as it had beeped. I said I'd get it in a moment and about 15 minutes later finally got up to get it.

trying out some different impressions

Except by then somehow not 15 minutes but more like an hour and a half had passed. I had no idea so much time had passed, but my daughter seemed to think it was funny. By then it was about 4pm, and we had someone bringing food at 4. I was still wobbly when I walked and still feeling pretty great, really. 

port-a-cath with spikes

The anti-anxiety meds were really quite delightful. I felt absolutely calm and relaxed and cheerful. I had no hint of worry or anxiety about anything all evening. Granted, my daughter had to tell me all her stories again the next morning because I hadn't remembered them (she says she told me twice on Wednesday, but had to tell them again on Thursday), and I'm not sure I should have been allowed access to email in that condition. I even had a convesation with my boss, which now does worry me just a bit (her email follow up makes me think I passed myself off tolerably well, but I think it could have gone either way. The person who got an email from me just thought I'd meant to send it to someone else). 

twin twins

That night, as I was getting ready for bed, the effects having started to wear off, I kept catching myself thinking, a little sadly, that the next day I had to go in for my chemo infusion. Somehow the idea that I had already done chemo was feeling a little slippery. 

more tubing

So, I am left with a puzzle for next week. I should probably tell them that if they want the medicine to help, they might want to give it to me before the premeds that cause the pain. Giving it after the pain seems, well, ridiculous. The anti-anxiety medicine did feel delightful, but all in all, I'm not totally sure whether 30 minutes of pain needs to be counteracted with an entire day of being a total goof followed by mild amnesia the next day. On the other hand, it was a fun day.