My appointment began, as always, with a nurse asking a standard list of questions. When prompted, I explained how I was in bed last Tuesday, Wednesday, and Thursday. I detailed the pain, sweats, and chills with my normal, matter-of-fact delivery.
I was holding it together when my doctor and nurse practitioner entered the room. With their first question, “how have you been feeling?”, I started crying.
I had finally broken.
We talked about my past experiences with steroids, and how they affected my sugar. We discussed the possibility that decadron might be causing a sugar spike, making me feel like crap, only to plummet a day later and make me feel worse. And we also acknowledged that it could be, as we’ve been assuming, Gemzar punishing my body.
To see what role the steroid plays, we reduced it from 20mg to 4mg as part of my pre-meds. There are three possible outcomes. A) I don’t get hit so hard with side effects because the steroid was causing some of them. B) I get hit harder because the steroid helps to buffer the Gemzar. C) Nothing changes.
After we sorted out my steroid questions, I moved on to the other ones I had readied for my appointment.
> What is the maintenance schedule for Gemzar?
If this chemo is working (TBD) and we can find a way to improve my quality-of-life, the schedule will continue as 3 weeks on / 1 week off OR every other week. Gemzar cannot effectively be given once every three weeks.
My eyes welled up once more.
My doctor assured me that after Gemzar there are still “plenty of drugs on the shelf.”
“No,” I said through tears, “right now I’m not afraid of dying. I just don’t know how I can live through this.”
He understood. “There are two reasons to discontinue a treatment,” he explained. “Either it’s not working or there is a quality-of-life issue.”
I nodded, tried to gather myself, and moved on to my next question.
> What is after Gemzar?
After all, Gemzar’s days are numbered. He rattled off three possible drugs, one of which was Taxol, popular in the treatment of many types of cancers.
I told him I didn’t have any other questions. And then I started crying again. “It’s just really wearing me down.”
“I know,” he said quietly. “I know.”
I’m supposed to call him later this week with an update. If I do better, I’ll continue with Gemzar. If I have another bad week, we’ll try something new on Monday.
I just have to get through the next few days. Maybe they won’t be so bad.