Sunday, March 22, 2009

EPOCH+R break four: side effect round up

While my bone marrow tolerated the increased dose in cycle three very well, this doesn't appear true for the further dose increases in cycle four (dose increases were for the E,C, and H drugs). Hemoglobin is a component of red blood cells: levels of less than 12 are considered anemic, less than 8 require a blood transfusion. I've been between 9.5 and 10.5 since my first chemo cycle; on Friday my hemoglobin was 8.4. Neutrophils are a kind of white blood cell needed to fight bacterial infections; absolute neutrophil counts (ANC) below 1000 are considered dangerous. My first cycle, I dropped below 1000, but not in cycles two and three. Friday, though, my ANC was 144. I don't think my oncologist will be increasing my dosage for cycle five.

Despite a reduction in dose of vincristine, the O drug, the tingling/numbness in my fingertips came back the Sunday after my fourth round. It's still here a week later. But, it has not spread any further up my fingers, and they don't hurt nearly as easily.

Also on Sunday, I got a tingling sensation at the very top of my breastbone when I ate. With each swallow, the tingling sensation would spread out to a larger area. Not that the tingling was particularly unpleasant, but for some reason I developed an aversion to swallowing, especially liquids. And the underside of my tongue hurt - the pockets where you stick a thermometer. Chewing was fine, but extending my tongue to clean food from the outside of my teeth was extremely painful (so I've been using my fingers to get food out from in between teeth).

On Wednesday, that area at the top of my breastbone hurt all day, especially when taking deep breaths. Wednesday night, by the time I finished dinner, the tingling had spread to my ears. My aversion to swallowing was strong enough I only managed three or four 8-oz glasses for my fluid intake that day. All these symptoms have gradually improved; by Friday only the tongue pain remained. Today (Sunday) my tongue hurts just a little - I can even use it to get food off my teeth again.

I'm guessing all of this is caused by the same kind of nerve damage that is causing the fingertip issues. When I told a nurse about my breastbone pain, she had one of the doctors come talk to me - his best guess was also neuropathy. I think being so bothered by my issues with swallowing has made me not be bothered by the weird sensations in my fingertips. I'm glad everything seems to be resolving fairly quickly. I hope next cycle isn't any worse.


Becky (CanadianMaple) said...

I'm hoping you're feeling even better now. Thank you for sharing your story in this blog. I'm thinking about you.

Andrea said...

Praying for you and thinking about you.

Jennifer @ Conversion Diary said...

Wow, that sounds like it would be difficult to deal with. Ugh. I'm glad to hear that the symptoms are getting better. I hope they continue to improve!