Karen decided she wanted to have her chemotherapy with Arizona Oncology. She says the staff is very nice, which is important to her, and it came highly recommended. So earlier in the week we had a visit with the physician's assistant to schedule the chemo treatment - FOLFOX 6 - and to go over things like side effects and precautions.
Starting on November 18th, she will be receiving chemo every other Monday, leaving with a pump which delivers more chemo for 46 hours, and returning Wednesday to have it removed. She asked about having chemo Friday and the pump removed by a home health nurse or nurse at another location, but was told they couldn't do that. She seems quite eager to return to work, so hopefully the chemo won't prevent that. However, if it does, she says she'll certainly reconsider taking chemotherapy at Mayo Clinic.
There's the possibility of all the usual stuff you hear about: nausea, vomiting, diarrhea (or faster output for people with a stoma), constipation, and fatigue. We're told they are able to manage these side effects quite well. When you see someone with cancer who is bald, it's usually not from this kind of chemotherapy, but other kinds of chemotherapy or radiation therapy. It's possible there will be some hair thinning, but even then, it's not usually that bad, and might not even be noticeable.
And, of course, she will be immunocompromised once again. Just in time for the holidays! They say if she catches anything, if anything happens, no matter how small she might think it is, to give them a call right away. For example, even if it's just a cold, they wouldn't want it turning into an infection, and would preemptively prescribe antibiotics. Seems reasonable to me.
It's also likely she will have numbness and tingling in her fingers. This is suppose to go away shortly after each chemo session, but it sounds like everyone is different as to how long after. It's even possible that the loss of sensation could start to become permanent, lasting from one session to the next. This would indicate that she's heading towards permanent nerve damage. However, if that starts to happen, they'd just switch the chemo drugs around a bit.
One of the more unexpected side effects will be cold sensitivity. It will last from the start of chemo, to 72 hours after the pump has been removed, possibly longer. The cold sensitivity not only be to things like food and drink, but to things she touches, such as cold car keys or objects in the refrigerator or freezer. She has freezers at work, but she says there's special gloves you use for that anyway. So this shouldn't be a big deal.
Another one that surprised us was the taste of metal in your mouth, and a sensitivity to the taste of metal in foods. The physician's assistant suggested we get plasticware and glass or stone cookware to help avoid that metal taste, and suggested chewing gum to get the taste of metal out of your mouth. She's also expected to have a change in taste buds. She might dislike things she normally likes to eat, and may start to like things she didn't like before. Tastes usually goes back to normal after treatment ends.
I think the scariest sounding possible side effect was short term memory loss. It doesn't sound incredibly common, but I never like to hear about things messing with your mind. We were told even if it happened, it's generally not debilitating, and you can learn little tricks to work around it. So far all of these side effects are temporary, but I wish I had thought to ask if this one was potentially permanent.
Afterward Karen told me she's actually excited to start chemotherapy. Not because it sounds like fun or anything crazy like that, but because it's one more step towards being through with cancer.
