Drained, But Less Than Expected

It seemed like forever, but after 5 days of ifosfamide, etoposide, and IV fluids round the clock, I am finally through the chemo part of cycle 6. Now the recovery begins. I feel quite drained right now, but pleasantly surprised by the amount of energy I do have -- I was expecting to feel a lot worse, like the crash weekends I had during my first three cycles. I have had to lie down and rest quite a bit, yes, but not for the entire day.

I must emphasize that I was expecting to feel a lot worse. Cyclophosphamide, a drug related to ifosfamide, did a number of me during the first three cycles. But that wasn't the only "tough" drug in there -- when I'd mentioned the side effects doxorubicin before, I focused on the risk of heart damage, but it is also a potent nausea inducer. Etoposide is not a big nausea inducer, so I had that going for me. Still, I needed the fluids to keep flushing my bladder like I did for cyclophosphamide during the first three cycles, and that was of course no fun.

As for nausea, it started to kick in Monday afternoon during my first dose of ifosfamide, but thankfully a very aggressive course of anti-nausea meds beat it back. And I mean aggressive. As soon as one wore off, time for another. There are actually four total anti-nausea meds that can be used during treatment, three that I have at my disposal in pill form. The one I don't have is dexamethasone, a steroid. I get that by IV in the clinic. Funny thing -- a skier received a 2 year ban for using it as a performance-enhancer. Well, if it takes steroids to beat cancer, so be it. Though before anyone thinks I'm going to turn into one of those hulked-up athletes, dexamethasone is not that kind of steroid. The others I have available as pills are ondansetron, hydroxyzine, and lorazepam. Lorazepam I'd mentioned in a previous post; it addresses "anticipatory" nausea (i.e. you get nauseous thinking about food). Hydroxyzine targets motion-sickness style nausea. Ondansetron is a general-purpose anti-nausea medicine. At the clinic, I get these by IV, and take pills when I'm out.

With medicine schedule in hand, getting the needed IVs during the day and waking up at prescribed times for pills at night, I hardly ever felt nauseous. But there was a catch. Lorazepam and hydroxyzine cause drowsiness, and lorazepam has made my brain "crash" before (cycle 4). Continually taking them left me in a zombie-like state for much of each day. I'd be in a fog upon waking up, which would clear a bit by mid-morning, and I'd have some useful brain functionality until after lunch. Then, it was a slow descent back into the fog, which of course reached its worst at bedtime. But I could actually eat decent amounts of food without feeling sick! So yes, I'll take being a zombie over being nauseous. I was in a fog much of today too.

I'll start backing off the meds a bit tomorrow; hopefully, I will recover quickly to a more normal state. Now I have to brace for the period of very low immunity that comes over the next few days and do my best not to get sick. My rehab and other plans for this month depend on it. I'm doing my best to be careful, taking inspiration from noted television germophobe Sheldon Cooper. I find myself reaching for the Purell a lot these days as well...