Break, round two

I had the same painful inflammation start Saturday morning as with the first break. On Sunday, I talked to the nurse about it when I went to get my Neupogen shot: she thought it was a withdrawal symptom from the steroids. She called my oncologist, and he approved me for 20mg of prednisone Sunday, and 10mg on Monday (my dose Monday through Friday had been 200mg a day).

Tapering off the steroids helped tremendously with the pain. It brought the swelling down on the days I took it, although it ended up lasting longer: I couldn't button my pants until the next weekend. (The first cycle, the swelling had receded to the point where I could button my pants by Thursday.) I didn't mind too much, though: having the pain significantly reduced was wonderful. Monday I only had a little bit of achy from the Neupogen and felt overall pretty good.

The Neupogen shots they give me daily, starting the Saturday after my chemo, stimulate my bone marrow to make white blood cells. The first cycle, that whole first break week was largely a haze of pain and I wasn't sure how much of it was due to the shots. But having Monday be so good pain-wise made the aching and sometimes stabbing pains later in the week obviously due to the Neupogen: Tuesday and Wednesday every large bone in my body hurt so, so bad. Taking the max recommended amount of acetaminophen and ibuprofin (4000mg/day and 800mg/day) only took the edge off. Taking two at a time of Tylenol #3 (which has codeine) relieved the pain for a few hours - but taking large amounts of narcotics is a bad idea while fighting constipation.

I don't think it helped anything that my white cell count was double what it was after my first round of chemo. It's nice that my bone marrow wasn't as damaged by the chemo this time, but, ow. Ow ow ow. One of the nurses said my counts were high enough this time the doctor might reduce the dosage of Neupogen next round. Literally every bone in my body is hoping he agrees to that suggestion.

Other side effects were much more minor. Again, I had jaw cramps Saturday through Thursday, though they seemed less severe this time. The inside of my mouth, which had toughened up during my chemo round (likely due to the steroids), re-sensitized. (Although I found the sensitivity was really not bad if I refrained from trying to eat jalapeno flavored potato chips.) My eczema came back again, although much less severe: the first cycle we had record low temperatures - and dry air - during my break weeks, while now we're having record high temperatures.

My heart rate went back up over 100 the first break week, then this week dropped down into the 90s. I think this may be a reaction to the chemo drugs, or to my anemia, or some combination, and not completely due to the tumor next to my heart. Laying on my right shoulder is also still uncomfortable; that was my very first symptom of this cancer, so it seems reasonable it will be the last thing to clear up.

My energy level has been better these two weeks than it was during my first break, even though I caught a cold and had to make friends with a couple of boxes of Kleenex over the weekend. Feeling so good is very encouraging; still, I'm nervous to see the results of the CAT scan I had today. Hopefully the radiologist report will be ready tomorrow, so I won't have to be in suspense too long.