Chemo Brain

I thought I would share with you the after-effects I feel after having chemo. These usually stick around the 3 days that the chemo is in my system, and then I return to normal afterwards.

One thing that doesn't happen: I never feel sick. Though it is one of the side effects of the chemo I'm on, the anti-nausea meds I'm on ensure that I never feel it.

Day 1
This is the day that I get chemo. After my first session, I felt like I could run a marathon. I had a ton of energy and even took a 1+ mile walk with a friend that evening. That level of energy has not returned after my subsequent chemo sessions. In fact, just the opposite has happened. My chemo starts in the morning and it takes several hours after I've had blood drawn, visited with my doctor, received my anti-nausea injections, and finally received my two different types of chemo injections. Everything is administered slowly. The anti-nausea meds are adminstered over about 20-30 minutes. The first chemo drug is administered over about 15-20 minutes. The second is administered over an hour in an IV drip. (By the way, all the drugs are administered through IV.)

It is usually as I'm receiving the drip of the 2nd chemo that I start to notice chemo brain. This is when my brain gets a little scrambled. Not so much that it's scary. It just becomes more difficult for me to think of specific words when I'm trying to express an idea. I find myself "stumped" a little more frequently. It is this particular phenomenon that makes it particularly hard to work (as a writer) on the days that follow chemo. It's much harder to make my brain make connections that are ordinarily pretty easy. I don't turn into a stammering idiot or anything. I can still carry on a conversation, but every once in a while, it just goes blank. It's kind of standard. Nurses and patients alike have nicknamed this phenomenon "chemo brain."

Afterwards, I usually go grab a bite to eat with whoever has accompanied me to chemo. I'm usually pretty hungry by this time... and so are they. After they drop me off, I begin my at-home anti-nausea regimen. I immediately take some compazine. I want to ward off any nausea before it starts. With the exception of my first session, when at this point I decided to take a walk, I usually start getting pretty tired about this time. If I've got a good book, I'll lay down on the couch with it, but within half an hour, I'm into serious nap mode. This nap usually lasts about 4 hours. I wake up from this nap feeling like I could go to bed. I usually don't. I putter for a couple of hours, maybe watch some TV, clean my kitchen, or just read some more. But within 2 hours, I'm in bed... right after I take my ativan.)

Day 2
Already my energy is starting to return. I'm still on a nurse-recommended anti-nausea regimen, (1 Emend in the morning, 1 compazine in the A.M., 1 compazine in the P.M., 1 ativan before bed). The Emend is the super-drug that comes highly recommended by my doctor that they were worried my insurance might not approve. They did. Apparently, this is a very good thing, as I have yet to really feel sick through this experience. On the second day, I get up, take an Emend, take a compazine, take a prilosec (I like spicy foods and heartburn seems to come with them during chemo), take a senocott (constipation is a lovely side effect of all the anti-nausea meds), and a one-a-day (just to keep my body healthy).

Yesterday, I actually forgot to take everything. That's a good second day. I remembered to take my Emend around noon... and, yes, I took it. I wasn't messing around with the magic that is Emend. I took the prilosec just before I ate... and took the senocott at the same time. I'm not messing with constipation either. Unnecessary. I can't remember if I took a compazine then, or if I skipped it. I think I took it. But I know I didn't take another one yesterday. I skipped straight to ativan as I was crawling into bed. Now, before anyone scolds me about messing up my regimen that has been working so well, my nurse had actually recommended it. She said that if everything is working so well, I was welcome to start experimenting with it to see how things go. Maybe I won't need as much. I like a nurse who pushes fewer drugs rather than more. That's my kind of nurse! ;)

I did sneak in another nap yesterday. I got about 2 hours. I love the naps. I wake up from them feeling energized. These naps are especially good on days that I'm feeling low energy to begin with. It's nice to wake up from one of these naps feeling refreshed.

Day 3
When the day begins, I'm starting to feel pretty normal. Actually, day 2 started for me that way yesterday. However, day 3 feels even moreso like normal. Today, I've taken my Emend and my compazine right away. I don't want to mess with fate. I have rehearsals (for my film) on Saturdays and don't want to feel poorly during that time. I have enough energy that I can even do a little housecleaning before anyone arrives. (I'm so my mother's daughter.)

By the end of my rehearsal, however, I'm feeling the energy drain. Particularly because I've had to be "on" for 3 or more hours. When rehearsal is over, I want to curl up on the couch and take a nap... and frequently do. Last time I had rehearsal on a chemo week, I took a 4 hour nap. We'll see how it goes today.

The rehearsals take place at my condo, by the way. Because the other way that chemo brain affects me is when I'm driving. I learned after my first session, that I absolutely should not get behind the wheel of a car the three days around chemo. The connections in my brain are much slower (and, hence, my reflexes) and all the meds make me just sleepy enough that driving is very difficult. So, I don't attempt it now. I don't know if it affects everyone that way, but it definitely affects me that way. And the good thing about that, is that it forces me to slow down on chemo days and take care of myself.

Okay, I've got to go eat some breakfast and clean my bathroom before my cast arrives.