Chemo brain is a real side effect of chemotherapy. Researchers don't talk much about it because they don't typically do cognitive testing on patients before beginning chemo so there isn't anything to compare it with (ACS, 2004). Other sources describe memory loss and mood change as commonly reported side effects of chemotherapy. I attribute the mood changes to fatigue but apparently the direct neurotoxic effects of chemo agents (or the metabolites), and hormonal changes induced by the treatment may all play a role. Dose and dose timing, age, genetic factors, and the specific chemo agents may also influence the extent, duration, and the type of side effects each person will experience (Lymphomation.org, n.d.).
What chemo brain feels like to me is being in a fog, Not all of the time, but a good bit of it. Kind of like waking up from a nap a bit disoriented, only this feeling is very difficult to shake and move on. I am not quite myself and definitely not a sharp as I used to be. I have been forgetting little things and it is difficult for me to multi-task. Through in a bit of fatigue and I can't be trusted to remember anything important! Some cancer survivors have report they know it is just something that they need to deal with. As they move further into their chemo cycle, the fog is easier to lift and life gets a bit easier (Sievers, 2006). For now, it is hard to write legible sentences and hard to read anything more difficult than the comics. I have been trying to read a cold war spy novel but had to give up...there are too many characters to keep track of!
What is most difficult for me about this particular side effect is the way it is affecting me emotionally. What if it never goes away? What if I am never able to trust myself and my professional abilities again? Of course, time will tell and other survivors report that the problem gradually disappears.
Chemo #3 was this past Monday. Zander (the oncologist) told us that each round would be more difficult for me. He was right, again. This was the worst so far. I was sick by the time we got home and went right to bed. I was able to get up for dinner and visit with my family but it was short-lived. I was back to bed rather early. Most of the time since then I have been sleeping. I get up to let the puppy out, play with her a bit, try to eat something and I am back asleep. This is difficult for me. I am not a napper and I often equate napping with lazy. Since I am now napping, I am therefore, lazy and I don't like to think of myself that way. The weather is beautiful that I would like to be outside digging in the dirt but the thought of those tasks seems insurmountable to me right now. Chemo redefines the term 'fatigue'.
I did have a big outing today though! I went for a short visit to Children's ED. I really miss everyone there so much! It was very nice to be there, catch up on the gossip and see people. I am looking forward to returning to work on June 1. I hope that I will be able to handle the job, particularly given my chemo brain. Thankfully I work with a wonderfully, caring group of professionals.
References
American Cancer Society [ACS] (2004). Seeking solutions to chemo brain. Retrieved May 3, 2007 from http://www.cancer.org/docroot/NWS/content/NWS_2_1x_Seeking_Solutions_to_Chemo-Brain.asp
Lymphomation.org (n.d.). Chemo brain. Retrieved May 3, 2007 from http://www.lymphomation.org/side-effect-chemo-brain.htm
Seivers, L. (2006). The fog and fatigue of 'chemo brain'. Retrieved May 2, 2007 from http://www.npr.org/blogs/mycancer/2006/11/the_fog_and_fatigue_of_chemo_brain.html
Thursday, May 03, 2007
I have chemo brain!
Posted by M at 3:47 PM
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Referring to previous post about other women who had to face the breast cancer diagnosis...
I was socializing with colleagues who told me of a former co-worker at age 24 found a breast lump as she does monthly self breast exams... She had a lumpectomy but unfortunately some of the nodes were malignant -- this was the most current information.
As a health care provider, I would always work this up and in the same breath know that others would have poohed poohed her, told her to watch the sizing, she's too young etc. In a prior practice, I was browbeat by not only the radiologist but by the MD in the clinic for working up someone else just as young (she was negative). My thoughts: I'm not here for them, I'm here for the women I see ONLY.
Women are asked if there is any family history of breast cancer but the reality is KNOWN history is more important because many women died and causes were not known. MY MOTTO: WORK EM UP!!!!
This lead to thinking of a MD in the clinic that was diagnosed and because of her status she maneuvered quickly through other diagnostics (she ordered most on her own) that many women do not have the luxury of receiving either because of lack of insurance, lack of status or other barriers. Thankfully, this additional work up was negative and her nodes negative.
Women who are age 40 and over, lack insurance and meet the income guidelines may qualify for the SAGE program trough the Minnesota Cancer Program. This program allows for an exam through a desginated clinic that includes a clinical breast exam, pap and pelvic exam. Mammograms are covered. Any abnormality that is found is worked up and cost is covered (i.e., breast ultrasound, colposopies, etc.) CALL THE STATE AND CHECK IT OUT IF YOU BELIEVE YOU MAY QUALIFY. There is the SAGE Gold program that will include some lab work as well (lipids, etc.).
Bottom line: women need to advocate for their care and press their providers for diagnostic beyond a clinical breast exam.
Most importantly, do your monthly self-breast exam and get your mammogram!
Always....
C
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