Monday, February 21, 2011

Side Effects: Can You Say Peripheral Neuropathy?

I have been relatively lucky when it comes to side effects from chemotherapy.  Although I’ve had the expected big ones – hair loss, low red and white blood cell and platelet counts, and some intestinal troubles, I have been fortunate to be treated in a time when there are very effective anti-nausea drugs.  These are delivered to me through an IV on the same day that I receive my chemo treatments. I consider myself doubly lucky because some patients still experience this most unpleasant side effect despite the use of these meds.  I have also been spared the intense fatigue I hear other people speak of. Some patients write that they can barely lift a finger without needing a rest and they spend much of their time sleeping. Yet I have had to take only a few naps along the way during the 16 weeks since I started this regimen. That is not to say that I haven’t had my share of side effects, but they have been manageable and relatively minor, and most have lasted for only a few days.  Below are a few of the more annoying or persistent ones.

Peripheral Neuropathy:  Until this last round, I’ve only had brief encounters with numbness and tingling in my fingers and toes, or peripheral neuropathy. In rare cases, once you get it, it never goes away, but my experience with it has been fleeting, until now. Round 5 brought on a longer lasting and more significant case of numbness.  I was not able to feel my big toes for a few days, and haven’t been able to feel any sensation in my left thumb for quite a bit longer!  It is truly an odd sensation to touch or poke your thumb and not feel a thing!  I’m confident this will pass.  In the meantime, caution is required when using knives or dealing with hot items because the nerve endings can’t sense and communicate to our brains that we should let go of a hot skillet, or whatever may cause a burn.

Taste:  My sense of taste has come and gone. After each round of chemo I go through a period of 4-5 days when things are tasteless or downright yucky, and I resort to a very bland diet.  During these periods, chocolate doesn’t taste like chocolate at all and is totally wasted on me.  This was the first time in my life that I tasted one M&M and I didn’t even want another – a clear indication that all was not well with my taste buds.  The only foods that are palatable during these taste bud blahs are those with that special quality the Japanese call “umami” or a savory taste.  Umami is now considered by many to be the fifth basic taste, along with sweet, sour, bitter and salty.  Somehow it can break through the blandness and provide some satisfaction.  So when the taste buds go south, I switch from turkey sandwiches to roast beef. We also make a wonderful slow cooker stew with oven-roasted beef, barley and roasted root vegetables. This experience makes me think of my poor mother, who, in her later years lost her sense of smell, and therefore her sense of taste. She found it really hard to bring herself to eat much and she became a little slip of a thing. Food, often the centerpiece of family events, gave her no pleasure.

Tears:  I have cried only a couple of times since learning that I have cancer, and I’m not even sure those tears were related to my own situation.  However, I now shed tears like nobody’s business, especially for the first few hours of the day. The doctor feels that one of the two chemo drugs I receive is the culprit, causing clogged tear ducts. The odd thing with this side effect is that it, like my neuropathy, is a very one-sided problem. My tearing is pretty much restricted to the right eye, and causes some significant vision problems. It is perhaps the most annoying of my side effects. The past couple of days it has been an all day, all night event and I get tired of dabbing at my eye and face as the water overflows onto and down my cheek. After awhile it almost makes me want to cry for real!

Skin: Winter is never a friend to my skin, and despite my best efforts to keep the house humidified, and to lather myself with the dermatologist recommended skin cream, Cetaphil, it is still an uphill battle. Add to that the fact that chemotherapy causes some strange changes to the skin on my fingers and I have a bigger problem than usual. The skin at the tips of my fingers splits and I have had as many as four bandaged digits at time. Talk about a decline in my typing accuracy!  It’s a real challenge to hit the right keys with bulky fingertip bandages on. This nuisance, and sometimes-painful side effect starts with a hypersensitivity to heat. Washing my hands in hot water burns for a couple of days before that sensitivity abates. Then the skin on the affected digits hardens, reminding me of elephant skin. No amount of moisturizing softens it up, and ultimately it starts to split and peel, like an insect shedding it exoskeleton. My thumb looks like a patchwork of layers at the moment.



So, although I consider myself quite fortunate, I will be most grateful when these all passes. It will be good to cry only when I’m experiencing emotions that warrant it!

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