Saturday, September 8, 2018

Jagged little pills.

Prior to starting chemo, I did a lot of research about side effects of taxotere and cytoxan and neulasta. And I was careful about which websites I visited. So when I found a publication on the NIH website about the amino acid L-glutamine and its apparent protective effects, I read it throughly. Particularly the section on glutamine supplementation in chemotherapy. The study showed some neuroprotective effects for both cyclophosphamides and taxanes. The studies conclusions included this gem:
"Supplementation with this inexpensive dietary supplement may have an important role in the prevention of gastrointestinal, neurologic and, possibly, cardiac complications of cancer therapy. These complications often negatively affect the quality of life and may also lead to changes in therapy, which potentially alter efficacy. Glutamine may also improve the therapeutic index of both chemotherapy and radiation, increasing cytotoxicity while concurrently protecting against toxicity."

Additionally, women on a chemo support board recommended biotin for nail changes (the hair is going regardless). I went searching again. Another NIH study said antioxidants and vitamins don't decrease the efficacy of chemo. The evidence is unclear about whether biotin can actually help but it does not seem to hurt.

So did I rush out and buy the two supplements? No, I did not. I sent a message to my oncologist about what I read and asked if he was on board with me taking them. When I got an affirmative answer, THEN I bought them. Glutamine was trickier to track down, so I ended up at a health store, with shelves stocked with all manner of pills and mystery potions. When the woman behind the counter found out why I wanted them, she pushed pamphlets on me with information about some supplement combo. She told me that "No matter what they tell you at the chemo center," everything in it was safe. Well, that sounds to me like practicing medicine without a license. I left with just the glutamine, the pamphlet with its crazy ingredients and wild claims, and a vow never to go back.

Cat's claw, sheep sorrel and slippery elm, anyone? Yeah, I'm not taking the word of a shop clerk over an oncologist either.
So the first couple days after chemo weren't bad. Even the infusion from the onpro neulasta delivery device on my belly only stung a little for about 15 minutes of the 45 it took to empty into me. When I rolled through the next day without a hint of bone pain, I was optimistic. And then day 4 kinda sucked. No nausea, ever, but they are really good these days with medicating that. But fatigue, and an upset stomach, and headache. That night I didn't fall asleep until after 4 am. Day 5? It didn't kinda suck, it really sucked. Now I felt like I was slogging through mud, my belly twisted into knots, mouth sores developing, and my thigh and hips bones began aching as they started to churn out new white blood cells. I'll be honest, it was a pretty weepy day for me.

Fortunately, I turned a corner the next day and I'm learning. I have my own little pharmacy now, both prescription and oncologist-approved OTC meds and next time I'll know what to take in advance. Like doubling up on my usual loratidine and throwing in aleve ahead of the bone pain. But the effects are cumulative and I already feel myself bracing for the next round.

Swallow it down (what a jagged little pill)
It feels so good (swimming in your stomach)
Wait until the dust settles
You live you learn, you love you learn
You cry you learn, you lose you learn
You bleed you learn, you scream you learn
You grieve you learn, you choke you learn
You laugh you learn, you choose you learn
You pray you learn, you ask you learn
You live you learn

- Alanis Morissette

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