Tag Archives: bone pain

Another Call of Duty

cancer call of duty

I’ve spent the day writing apology emails to the people I blew off this week after being called up for active duty as a Breast Cancer Conscript. While I expect to battle this disease for a very long time, learning to manage it is another matter entirely.

The battle requires aggressive medicine that’s guarranteed to stop working at some point, which means moving to another aggressive medicine with its numerous side effects that seem to play out differently in my body than those who have gone before me.

As a Breast Cancer Conscript, I patrol cancer’s parameter under mostly peaceful circumstances until I come under fire. The higher ups (that would be my doctors) move in new artillery (that would be the new drugs), allowing better targeting of the enemy. But getting used to using it is a bit like a sniper who ends up battered and bruised from the recoil of the high-powered rifles he’s using until he gets used to the way it fires.

That’s been me this week, as I juggle my non-cancer life (and believe me, I do have one) with my cancer tour of duty.

In my non-cancer life, I am a freelance writer, which suits me well, both because I enjoy the vocation and because I can adjust my schedule when I need the downtime to acclimate to new meds and their side effects or for a day’s worth of scan’s or tests to see if they’re working. My current goal is to shift from selling the stories I write to becoming a published author, so that instead of getting paid one time for my work, I can generate residual income. That’s not a lesson of cancer, but of the financially successful. It’s just that cancer makes it all that much more necessary.

I’m no longer a new recruit to this war, but I am new to the warfare tactics. So when I started having side effects from the Ibrance – namely bone pain – I shrugged it off and decided to just grin and bare it. When it got intense, I went out and exercised, which kicked up enough endorphins to make the pain unbearable.

With normal pain from aging or overuse, your mind wraps around it and can tune it out, so the intensity fades and you can get on with your day. Or you know or have learned how to manage it with an ice pack, laying off of it for a while or downing a pain reliever like an aspirin or Ibuprofen.

With cancer medication side effects, it’s a whole new world. Sometimes the pain will disappear after a few minutes. Then, it will crop up in another body part, from say the leg to the arm or shoulder, a sort of Whack-A-Mole of pain surges. Sometimes it will be a dull ache, other times an intense burning. Sometimes something as simple as an allergy relief tablet such as Claritin will take it away. Other times, even doses of a high-strength painkiller like Oxycodone don’t work.

And there’s no rhyme or reason to it. I can go a day or two with no pain, then suddenly a flare up, which can bring on nausea and irritability. I’m amazed at how pain affects my moods.

My doctor has been sympathetic and liberal when it comes to offering drugs to counter the pain. The problem is, those drugs are addicting. In my age group the leading cause of death isn’t cancer, but overdose from opiods or suicide because of dependency. A few in my circle have suggested medical marijuana, which can alleviate pain, nausea, act as a mood booster – and most promising – is a possible cancer killer. Of course, our puritanical medical and political establishments frown on this. I have yet to have the conversation with my doctor. For now, he’s agreed to lower the dosage of the Ibrance. We both agree it’s too effective – bringing down my tumor marker numbers quickly, but obviously doing damage to the healthier parts of my body.

Yes, there are many promising drugs out there that give me hope for a long, healthy life. But I’m learning they all come with a price tag, each one heftier than the last. And while I win the battles, it’s still a long, draining war.

 

 

 

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Ibrance Romance

clinking glass

AS GOOD AS IT FEELS, LIFE’S ABOUT TO CHANGE AGAIN

An oversized brown box arrives on the front porch. Inside is a plastic bag. Inside that, is a small bottle, maybe three inches big. Inside that are 21 Ibrance capsules which will take me through the next month of this leg of my cancer treatment.

The bottle of pills cost $10,000 a month, so I imagine it doesn’t seem indulgent to the specialty pharmacy to send it out overnight in this oversized package. The plastic, resealable bag is thick. I can think of a million reusable ideas for it if it didn’t contain the ominous skull and cross bones and a warning that reads: Dangerous. Toxic. Chemotherapy drugs. Do not handle.

I wonder what my trash men will think of me. And I realize I now live in a toxic world, one where I can no longer recycle or repurpose. One where there’s no turning back.

According to my first pathology report five years ago, my cancer cell was an estrogen-hungry fool, making her easy to decimate. I agreed to an aggressive IV chemotherapy treatment that shrunk my tumors to mere slivers, and the surgery and radiation that followed erradicated them entirely. I endured baldness, bone pain, nausea and weakness that I thought I’d never recover from.  For my efforts, my doctors were sure I was cured, free of the pernicious cells.

AND THEN THERE WAS THE ONE THAT GOT AWAY

But it turned out, one survived. My onocologist would later explain that tumors are like jars of pebbles and the first pathology report told of a larger rock in the jar. What was left was a grain-like piece of sand. This cell didn’t eat much estrogen. She was very slow growing. I called her my Crack Whore cell, because it was amazing she existed, let alone thrived in the Country club setting that’s my body. My Muffy and Buffy cells were outraged that she’d gained admittance. They want her banished.

I agreed, of course. And so we sought to oust her with a combination of drugs. One, called Xgeva, fortified my bones, which is where she took residence, relegating her to a cardboard bed existence outside a barred –bone entrance. The other, called Faslodex, filed the edges off the estrogen the Crack Whore feeds off of so she couldn’t grasp them when they floated by her. The third, called Arimidex, leeched the estrogen out of my body, in an effort to starve the Crack Whore completely.

SO WE ROCKED HER WORLD

In the beginning, the new hostile environment worked. The Crack Whore stopped having babies and Muffy and Buffy filled in with their own children.

Then after about six months, the Crack Whore realized she didn’t need as much food, didn’t mind the cardboard bed and started pimping herself out again. Judging by the CT scans I had last month, she hasn’t given birth, but she’s likely pregnant along with her other Crack Whore offspring.

So last month, I started  a new approach. Nix the estrogen leeching drug and replace it with the Ibrance, a drug that blocks proteins the cancer cell needs to replicate. A Crack Whore cell tubal ligation of sorts.

THE MARRIAGE DILEMMA

I call it the Ibrance Romance. When I started taking the drug, it seemed so much better than anything else I’d been on. I was in love. Three weeks into it I crossed the matrimonial threshold and suddenly thought  to myself “What have I gotten myself into?”  Now I wonder if I can endure living with it the rest of my life or if I’ll scratch its eyes out.

While my doctor told me I shouldn’t experience any side effects from the Ibrance, he explained that the drug suppresses my bone marrow – that’s the place where red and white blood cells are made – so I will likely see my blood counts go down. I need to go in for tests to be sure they don’t go too low, in which case I’ll need to take a break from the drug or go off it completely. For that reason, I can only be on the drug for three weeks at a time, with a week off to give my body time to replenish the damaged bone marrow.

It’s a bit like going into Muffy and Buffy’s den and messing with their Netflix streaming. But knowing that Muffy and Buffy are the Country Club set, I kept them preoccupied with activities. I make lots of dates with friends – many who are in the same boat – to run, bike, swim, walk. Keep our endorphins up, the dopamine pumping, the serotonin flowing. For Muffy and Buffy, it’s a cocktail party and they didn’t miss NetFlix.

PARTY’S OVER

Then came the hangover. Searing pain in my bones that were rebuilding themselves, from a restless aching in my toes up through my long, leg bones to a burning in my rib cage and pounding in my head like I’d been hit with a baseball bat. I took a pain reliever, which didn’t much help.

I decided to respond to pain with pain, longer runs that inflame my hip flexors, cancelling out the bone pain, which works until I have to go to sleep.  And then, even that stops working.

The pain is so great, I call my doctor for an answer, something stronger to relieve the pain. And while I wait for him to return my call, I begin to cry. I cry because it hurts. I cry because I know I now live in a toxic world where I can’t recycle or repurpose and there’s no going back. I cry because my body has to work so hard to heal itself and there’s nothing I can do to change that. I cry because I know this is the tip of the iceberg, that I’m in the rabbit hole and down is the only way I can go.

I cry until I hear a knock at the door. I wipe my eyes, as I hear giggling and clinking glasses on the other side. It’s Muffy and Buffy.

“Cocktails anyone?” I hear them yell on the other side.

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