1/6/14 - What I Did to Combat Chemo Side Effects

It took me forever to write this blog. This is what I did, and in some cases am still doing to eliminate chemo side effects. You should always check with your oncologist before trying any remedy. Not all of us are the same and what worked for me, may not work for you.

Here is a list of side effects, that I was told by my doctors, could happen during chemo:

Constipation - By far, my biggest side effect. In fact, if I didn't have this side effect, I think I may have become a chemo queen. I've been prone to constipation all of my life so I knew it would be a challenge. My oncologist had me take two Colace capsules in the morning and two Senna tablets at night. Unfortunately towards the end it stopped working and I ended up in the ER with impacted bowels. I was also encouraged to drink 8-10 glasses of water a day. My bowels were back to normal (meaning normal for me) about 4 weeks post chemo. To combat it now, I eat a bowl of Fiber One Cereal every morning along with a glass of Plum Smart Juice, which seems to keep me pretty regular. I've found pears to work really well too. I'm not a water person, but I've become one since chemo. DRINK, DRINK, DRINK - it really does help flush out all those chemo toxins.

Intestinal Pain - Primarily caused by the constipation and blockage. The ER doctor prescribed a powder  (GoLYTELY) that I mixed with Crystal Light. It didn't taste too bad and it worked within an hour. I camped out in the bathroom all night, but boy did it work. I think they should change the name though - GoQUICKLY or perhaps Go-A-LOTLY. In fact, you may want to install a seat belt on the toilet if it's ever prescribed to you. My intestinal pain went away after clearing out my bowels. 

Diarrhea - Not a side effect I experienced. My oncologist told me to take Imodium A-D  if it happened.

Fatigue - This was a cumulative side effect. I was pretty used to fatigue because of my RA, so it wasn't awful. But for a healthy person, I imagine it could hit pretty hard. I did sleep a lot during certain times - it usually hit me about the third day after an infusion and lasted about a week. After my last infusion it lasted a lot longer. Walking seemed to help a lot but it was difficult for me to get motivated. My fatigue started getting better right before my lumpectomy. That would make it about four weeks post chemo. Eight weeks post chemo and I'm pretty much back to normal. That will probably change once radiation starts.

Hemorrhoids - I was really concerned about hemorrhoids for obvious reasons (read my history). They stared to bother me after my first infusion but they seemed to get better as I went along. For this I used Preparation H wipes which work very well for irritation and inflammation. After my second chemo they were pretty much under control, just a little bothersome. Every little flare up made me a little wacky.

Muscle & Bone Pain - Caused by the wonderful Neupogen and Neulasta shot. The doctor switched after my first chemo from Neupogen to Neulasta. I had slight pain with the Neupogen but it really got bad with the Neulasta. My limbs felt like tree trunks and I came to dread every shot. At the same time, I was thankful that it eventually increased by blood counts. It was a love/hate relationship. Giving myself the injection was pretty easy. When I injected the Neupogen, I alternated from different sides of my abdomen. When I injected the Neulasta, I switched to the upper portion of my leg. I would alternate from one leg to the other. The upper portion of my leg was much easier for me to inject and didn't bother me as much. For pain I took Claritin which seemed to help a little. The muscle and bone pain got better about 2 weeks post chemo but has recently returned. It was pretty bad after my first Herceptin only infusion and has slowly been getting better. I actually broke down and took a pain pill (Norco) and that seemed to help. However, the pain pill did cause a slight rash and itching. For the rash I took Benedryl.

Rash and Itching - I developed a severe rash after my surgery. Before calling the doctor I tried Benedryl at night and Claritin during the day. That didn't help at all. Next I tried Aquaphor which was unsuccessful. As a last resort I tried Calamine Lotion which seemed to help right out of the shower. The relief was short lived though. The doctor prescribed Triamcinolone Acetonide 0.1% topical cream. It did nothing for me. Then she prescribed Betamethasone, Augmented 0.05% topical cream which worked much better. With the new prescription it took about one to two weeks to fully clear up.

Loss of Hair - I wish I had a magic potion for this side effect. I know many people use cold caps which can be controversial. I never really lost my hair completely. I had a light fuzz all around my head. I lost the hair under my arms and eventually the hair on my legs. Also lost the hair down south - I'm sure you get the picture. I kept my eyebrows, and my eyelashes thinned just a bit. I eventually lost all of my nose hair.

Eight weeks post chemo and my eyebrows are actually starting to thin - very strange. The hair on my head is starting to fill in a bit more. My leg hair is back - I have to shave about once a week. The hair under my arms has grown a tiny bit - I've only had to shave once. Down south hasn't grown at all and my eyelashes are about the same. My nose hair hasn't grown back.

Nausea - It was rare that I felt any nausea. When I did, the doctor prescribed Zofran and that seemed to do the trick. He also prescribed Compazine which I used once. I didn't like the way it made me feel - it made me dizzy. He also prescribed Marinol which is supposed to help with nausea and appetite. Because Zofran worked so well for me, and I obviously didn't have any problems with my appetite (gained 13 pounds), I never used the Marinol.

Vomiting - I vomited one time after my first infusion, which was caused by the pain pill I took on an empty stomach. Before and after every chemo I tried to eat small meals.

Dry Skin - Shortly after my first infusion I started getting these big dry patches on my face. I tried all kinds of creams and lotions and nothing worked. After a lot of experimenting I finally found a great regimen that actually improved my skin. At night I would wash my face with CeraVe and after that I applied Cetaphil (in a jar). Now here is where I made a wonderful discovery - in the morning, instead of washing my face with CeraVe cleanser, I washed my face with CeraVe lotion. I'd put it all over my face and wet a wash cloth. Then I would go in a circular motion with the wash cloth and wipe it off. When I did that, it would take all the dry skin off.  At that point, if I wasn't going to wear makeup that day, I would apply more Cetaphil. If makeup was going on, I would apply Lancome Bienfait Multi-Vital Sunscreen Cream which I got in the makeup class given by the American Cancer Society (Look Good... Feel Better). My skin is better than it was before chemo. I'm hoping the Lancome product isn't too expensive because I would really like to continue using it. 

Acne - I developed horrible acne after my first infusion. Look under dry skin (see above) and see my routine. It worked for acne too. Cleared it right up.

Neuropathy - I've always had a bit of neuropathy from past surgeries. A couple of the toes on my left foot would get numb and tingly and I have a portion of my left leg where they removed tissue for my reconstruction which is completely numb. I did fairly well during chemo, until I had my last infusion. At that time my whole left foot went numb and tingly and it affected my right foot but not as bad. I also had problems with my hands. It really affected my fine motor skills making it difficult to button my shirt. Luckily it only lasted  about a week post chemo. I'm not sure how it would have been, if I had continued with all six infusions they originally wanted me to have. I didn't find anything to counteract the neuropathy. It went away before I could address the problem with my oncologist. Eight weeks post chemo and I just have the same neuropathy I've always had.

Mouth Sores - Before chemo I made an appointment with my dentist and had a thorough cleaning. During chemo I brushed and flossed after each meal. I used, and still use Biotene toothpaste. I also made sure to always have water on hand, and kept my mouth moist. I carried a water bottle with me wherever I went. I was fortunate not to develop mouth sores. My doctor prescribed, MW: Diphen-Lido Visc-Maalox-NYST Oral Susp. - where do they get these names? Fortunately, I never had to use it so I can't say whether it works or not.

Low Blood Counts - This is a side effect I did have all through chemo. To counteract I used Neupogen which didn't work too well for me, so I was switched to Neulasta.

Low Ejection Fraction - Ejection Fraction measures how well your heart is pumping. This can be a side effect of taking Herceptin which is a targeted therapy for HER2+ tumors. The doctors keep a pretty close eye on your heart during treatment, ordering a Muga Scan every three months. My ejection fraction did drop but came back up pretty quickly after skipping a dose of Herceptin. The research I did indicated that 30 minutes of exercise a day can help improve your ejection fraction. I started walking 30 minutes a day and it seemed to help mine. Lowering your salt intake can also help.  I have another Muga Scan scheduled for the end of January.

Abnormal Liver Enzymes - When my ALT test was elevated I got really concerned that either my liver was damaged or the cancer had metastasized. Then I learned an elevated ALT could be a side effect of chemo. I immediately stopped taking Norco because it contains Tylenol, which can damage your liver. When I had my next blood test, it was back to normal. It got slightly elevated again during chemo, but always came right back down.

Fingernails Turn Black or Lift - I never had this side effect. Throughout my treatment, I kept my toenails painted and I put Sally Hansen Hard as Nails on my fingernails. I also had a pedicure during chemo, making sure my counts were up before I went. I let them trim my toenails but didn't let them cut the cuticles. I kept my fingernails very short. Eight weeks post chemo I have a slight line in the middle of my fingernails. It's barely noticeable. If you look closely, you can see the new growth is a slightly different color than the old growth. You've really got to be looking closely to notice.

Watery Eyes and Blurred Vision - This is a side effect I did get. It seemed to be worse right after an infusion and it lasted about a week. My oncologist told me to use Restore Tears. I bought the product, but never used it. I hate putting things in my eyes. I had it on hand in case it got unbearable - which it didn't.

Bloody/Cracked Nose - Got this one. I think because everything dries out so much, your nose gets bloody and cracked. I read on various support sites to use aquaphor. I asked my oncologist about it, and he wasn't too keen about me putting stuff in my nose. He said you have to be careful because it can be absorbed into your lung and cause problems. That's all I needed to hear. I lived with the bloody/cracked nose. I tried to moisten it with water in the morning and that seemed to help. It took about one week after each chemo for that to subside.

Runny Nose - Another side effect I have. I've read on the internet that it's caused by the Herceptin. That remains to be seen. Right now it seems that it's caused by lack of nose hair. There really isn't anything there to stop it. I'll have to report back on this one once the hair in my nose starts to grow. Then I can tell you if it's the Herceptin. In the meantime, I carry a tissues. It's not a constant drip for me - it's occasional.

Chemo Brain - I'm not sure I'm experiencing this or not. Occasionally I will be doing a task and start another task ,while in the middle of the other one. That could just be old-timers disease - I'm really not sure. I don't feel like it's much different than before I started chemo, except for the fact I'm more aware of it. I guess the jury's still out on this one.

Infection - I'm happy to report I've experienced no infections while on chemo. Yipeeeeeeeeeee! Must be the antibiotics they pumped in me after every chemo infusion or it could be I'm a neurotic nutcase when it comes to spreading germs. I wore a mask when I entered any type of medical facility while my counts were down. I also used a ton of hand sanitizer. When I wasn't using hand sanitizer, I was washing my hands. I stayed away from crowds and kids when my counts were down. I bathed daily and dried my skin gently. I carried Neosporin around in my purse and used it on all cuts and scrapes. I wore gloves when I washed dishes (didn't do that too often because Robyn was home - thank you Robyn!!). I kept my whole body moisturized so I didn't develop any cracks or sores. I didn't eat fresh vegetables when my counts were down, and I monitored my temperature daily. I also didn't share a bathroom the whole time during my treatment. In the infusion room they have you flush twice when you use the restroom. I did that at home as well, with the lid down. My doctor also said to stay away from pet droppings - no problem!!

Fluid Retention - I got a slight amount of fluid retention. I tried to limit my salt intake so it never got unmanageable.

Appetite Changes - Yeah right. I had a few days after every infusion where I didn't eat a whole lot but I always made up for that. I would lose two pounds and gain back four. It's got to be that Italian eating gene I've inherited.

Taste Changes - This I did have, but obviously it didn't affect my appetite. I had a slight metallic taste which was caused by the Taxotere. Water starts to taste really yucky when this happens. I found that cold water tasted much better than warm water. About three weeks post chemo my taste buds were back to normal.

Bleeding Problems - Never had this one.

Urination Changes - Didn't have this one either.

Chemo Pause - This one has been a challenge and eight weeks post chemo nothing has changed. I was pretty close to being in menopause before my diagnosis. I had already gone through the night sweats and also had hot flashes on and off. I went almost a year without my monthly visit from Aunt Flo and then she returned for a couple of months and went away again. Once chemo started the night sweats and hot flashes got so much worse. I spend most of the time freezing one minute and burning up the next. This also contributes to my insomnia. There has been no sign of Aunt Flo and I don't expect a return. I haven't talked to my oncologist about this, but it's on my list for the next appointment. For now, I try to dress in layers. I feel like a chemo version Mr. Miyagi from the Karate Kid - hats on, hats off. Sorry, bad joke.

Insomnia - I suffered from insomnia long before chemo started. But I must admit, it did get worse. Usually on the nights right after the Neulasta shot and also the few days pre and post chemo when I had to take steroids. Another thing keeping me up lately has been the hot flashes. As mentioned above, chemo pause makes sleeping uncomfortable. I'm hot one minute and cold the next. I have a special hat for sleeping that's made of cotton. It's green so I call it "my little green giant hat". I spend most of the night taking it on and off. Occasionally I will wake up in a cold sweat. I've tried so many things. Luckily I don't require a lot of sleep but it sure would be nice to get a good night's rest. This is one side effect I haven't solved. I guess it deserves a chat with my oncologist. My oncology nurse said something about melatonin, but I've never tried it. I'm cautious about sleep aides because I don't want to become dependent. Thinking too much will also keep me awake. I really need an on/off switch installed on my brain. I will report back on this one when/if I find a solution.

Emotional Effects - This was also a big one for me due to past health issues. It took me awhile to wrap my head around the fact I was facing another health crisis. My doctors were very honest and told me it's possible to get Flesh Eating Bacteria again during treatment. That was/is my biggest fear. My doctor prescribed Ativan, which I took before every infusion, and sometimes before a procedure. I also took it occasionally on the nights I was stressing about treatment and possible side effects. Eight weeks post chemo and now I just take it before my Herceptin infusion. I've weaned myself off of all the prescribed cancer medications and I'm back on my RA meds. That may change once radiation starts.

It's a long list of possible side effects and it can be quite overwhelming before you start treatment. When I started chemo I was terrified. I was sure I would get every side effect - but I didn't. The ones I did get were typically pretty mild. In fact, if it wasn't for the dreaded constipation which was exacerbated by my other health issues, I think I would have come through chemo very well. Even taking that into consideration, I still think I did well. My RA pretty much went away while on it, which was wonderful. Was chemo easy? No, of course not. But it wasn't as bad as what I had envisioned. So if you're facing chemotherapy in your lifetime, it is doable. Once it's behind you, the memories will fade, and life will get back to normal. I'm eight weeks post chemo and I'm feeling pretty good. I can't speak for the long term side effects, but I'm hopeful there won't be any.

I will add to this blog post as I think of more side effects. I'm sure there must be some that I have forgotten. HMMMMMM - Chemo Brain?? :)

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