Taxotere - Round 1 Information

Taxotere is, well, TAXing.  That is my experience, but it didnt start out that way.  This is my first expereince with taxotere and everyone has been telling me it is so much better than AC chemo.  I was a little sceptical, but wanted to believe.  The first couple of days I did feel great.  I felt almost back to normal for those first couple of days . . . I was thinking that everyone who said it was easier was right.  I didnt have the "hangover" feeling like I did from AC.  I also seemed to have a clearer head and was able to get some things done, something that was unthinkable on AC chemo.

The day prior to taxotere infusion I took 16mg of decadron, a steroid used to prevent an allergic reaction that can occur (but also suppresses your immune system).  Then on day 1 I took another 16mg and on day 3 I took 8mg.  I was warned that I would not sleep well, if at all on those days, but I was pleasantly surprised when I did sleep well enough.  It wasnt the best sleep but I did feel it was enough to refresh me and keep me going the next day.  Wohoo I am not even getting that bad of symptoms.

That all changed on the morning of day 4.  I woke up and felt very stiff and as the morning progressed my joints started hurting, particularly my ankles, hips and knees.  I was lying on the couch in incredible pain.  Thankfully the PA had told me that I could take my leftover tylenol with codiene, which after some fretting and debating I did take.  And I was so thankful for those meds.  I thought once I started that I would be popping them left and right in and out of consciousness being loopy as I go in and out of consciousness.  Surprisingly I took very few and was very clearheaded.  I did take a few naps and lay on the couch, but pain is exhausting.  Day 4 and 5 were spent on the couch as much as possible and popping pain pills.  When the pain meds wore off my muscles felt like I had just run a marathon.

During this time I was having a weird taste in my mouth and no food tasted good.  I struggled with eating.  things had a weird creamy/bitter texture to them.  I was forcing myself to eat, but not enjoying it at all.  I also started to develop a weird itchy rash.  I struggled with these for a little bit, but then went to urgent care and got my triple diagnosis . . . Oral Thrush, Shingles and Neutropenia.
Oral Thrush is a common side effect of chemo.  Thrush is an overgrowth of a fungus that is naturally occurring in your mouth anyway.  If you have a "normal" immune system you do not need to worry about it, but if your immune system is compromised due to chemo (or other factors) you are more susceptible to it.    Here is some more technical information on thrush.

Thrush looks like a whitish film all over the tongue.  It is not painful, but I was having a feeling of a hairy tongue and dry mouth and all foods were tasting horrible.  I am now taking clotrimazole troches 5x/day.  A troche is a dissolvable flat tablet?  The size and shape is kindof like some chewable vitamin C things I had a few years ago, but you are not to chew them but rather let them dissolve slowly in your mouth.  I noticed improvement within hours of taking the first dose and while it is hard to take them five times a day it is worth it.  I have to take them for 10 days.  They don't really have a taste, but if I don't spread the dosages out enough I do notice my tongue starts to feel a little raw.  But it is better than thrush.

Shingles

Shingles are not just the tiles on your roof, but a rash that develops if you have been exposed to the chicken pox virus.  I had the chicken pox when I was 16.  After my body fought that off some of the virus remained in my body in the dormant or inactive state.  Then as a result of a weakened immune system and likely stress the virus became active but in the nerves.  The end result is a nasty rash.  The internet says most are painful, but mine has been more itchy and if I scratch it I notice the pain and burning.

I was given Acyclovir to take 5 x/day for 10 days.  These pills are kinda large, but manageable.  The itching has subsided . . . it is a catch 22 - I find the less I scratch the less itchy it becomes, but let me tell you how hard it is to not scratch.  I have been taking the medicine, but I do notice I have been also scratching my collarbone and I hope that is not another outbreak.  Trying not to scratch.

Neutropenia

Neutropenia is a low white blood cell count.  But there are several components to your white blood cells and a change in each of them is indicative of different things.  The doc told me my white blood cell count (wbc) was 1, which is low, but not expected as the day I was tested was day 7 and on taxotere that is the nadir, or low point.  She also mentioned something about my basophils being high because it was fighting off the fungal infection, but I also think my ANC (absolute netrophil count) was low too.  I was lucky enough to be in a room across the hall from the doctors station and could hear the urgent care doc on the phone with the oncologist through the thin doors.  Im sure she would have told me this stuff but she was already giving me so much info already that the extra info ahead of time was helpful.  I was told that someone would contact me about getting neupogen injections and when I got that call they mentioned I had grade 4 neutropenia.  While I am not happy about this, I am happy that my numbers were high enough to avoid hospitalization.

To help my white cells fight off all of these infections I was told I needed 4 days of neupogen shots.  Since I am not comfortable with giving them myself I am going in to the nurse clinic for them to do it for me.

I had the first neupogen shot on Wednedsay morning and feel Ok.  There was a little pain at the injection site but I was told to take the medicine out of the fridge and let it warm to room temp before injection to avoid this.  I have noticed I get bad backaches a couple of hours after the injection.  Thank goodness for leftover pain meds.

I am feeling a little better since getting the shot, but now I have the mouth sore from you know where and a sore/inflamed/partially blocked throat that makes it incredibly difficult to swallow.  It hurts to swallow water but less so if I take baby sips (which means it is hard to drink enough during the day) and eating is downright painful, even after applying some local anasthetic to the mouth sore (which makes eating enough difficult).  At this point I think I would like a feeding tube, but I believe these will improve in a day or two so maybe I can make it through.  Update: I wrote that a few days ago and the mouth sore is still bothering me but is better.  I am still not eating enough (cause it still hurts) but I am gradually eating more every day.

So I have a bunch of pills to take . . . 14 to be exact.  The antibiotic is supposed to be taken 4 times a day on an empty stomach (1 hour before eating or 2-3 hours after), the shingles medication says it may be taken with food to reduce the chance of upset stomach so I have been taking that with food.  And the thrush medication is to be dissolved in the mouth.  I have been trying to do that after eating so as to have the best benefit.  I have a little log sheet of all my pills, when they should be taken and I mark down when I take them, sigh.  It is exhausting just keeping track of them and trying to coordinate taking them at the right time since I am also eating more frequent small meals due to the pain while eating.

All in all I have had better weeks . . . but I am starting to feel halfway human again after being glued to the couch all week.

Cancer sucks.