Treatment 2

Treatment 2 was much better than the first time. The dream team of Dana Farber experts that I'd hoped for has materialized and is helping me figure out how to better manage side effects from many angles. Stephanie the nutritionist gave me some key, empowering nutrition tips, nurse Barbara battled the insurance companies for me to get me the right drugs at the right price, and Dr.LaCasce was stunned and very pleased at the amount that my lymph nodes have shrunk already (she also complemented me on my shoes!). My dear brother David came up for the weekend from Miami and he and Adam kept me laughing the whole afternoon of the treatment. My second mother, Judith Morris, arrived from DC on Friday and gave me some valuable information on diet and coping tips that she'd developed during her own fight with cancer. Lisa Cohan, who was rowing in the Head of the Charles on Saturday, came by for lunch and spread sunshine with her firecracker personality. Nora Foster and dear little Evan also stopped by with soup which was great to have on hand with so many visitors!

I am definitely not looking forward to the next step of side effects which is most likely going to be losing some or all of my hair, but even here, sometimes you just have to laugh through some of the pain. Dave and I kind of thought we looked like twins when he donned my new hair piece (to be worn with hat). My stomach hurt Thursday night, but more from laughing than from any drugs.

Here are more details from David's perspective:

Saturday, October 21, 2006

So far, so good. Lil's second treatment went smoothly and she appears to be coping pretty well. She's waiting for the other shoe to drop when substantial fatigue sets in a few days after the chemo but her energy level is still high as of Saturday evening.

A couple of good things came to light on Thursday that should have positive long-term effects. First, the port that they inserted into her chest shaves a significant amount of time off the treatment. Lil did experience some discomfort when they stuck a line into it for the first time; but that was offset when her nurse, Melissa, told her it shouldn't really hurt and was lightning quick at swapping out different drip bags, syringes, and needles. She can draw a vial of a blood sample in about two seconds from the port.

Second, Lil's blood work revealed that she was mildly anemic (http://en.wikipedia.org/wiki/Anemia), which helps explain some of her lack of energy. Her red blood cell count was a 28 when it should have been a 35. Fortunately, Dr. LaCasce had a remedy: a booster shot, which Melissa administered immediately after the chemo treatment.

Last, and probably most important, a nutritionist, Stephanie, came by to counsel Lil about how to manage her diet during chemo to help alleviate the side effects. Here are some important factors that Lil needs to be aware of:

- Water. Apparently, chemo leaves your body dry as a bone. For example, Lil wakes up with cotton mouth in the middle of the night and again in the morning. The medical professionals agree: it is virtually impossible for Lil to drink too much water, and she should be hydrating constantly.

- Vegetables. Lil needs at least 5 servings of approved vegetable a day. Much like water, there is really no upper limit on the amount of vegetables Lil consumes. Vegetables have the added benefit of containing phytonutrients, our new buzzword. Apparently, plants themselves have internal immune systems and, when a human eats them, he or she benefits from the added immunity. Since the chemhas weakeneded Lil's immune system, the phytonutrients found in vegetables can be instrumental in helping to rebuild her body's defenses. Some examples of plant-based foods on the phytonutrient list: asparagus, broccoli, brussel sprouts, okra, apples, mango, cranberries, cilantro, garlic, flax seeds, soy...

- Protein. Stephanie says that, since Lil's body needs to be regenerating cells that are destroyed by the chemo, her nutritional needs are equivalent to those of a high-performance athlete (which is a positive spin on things that Lil appreciated). Therefore, consuming an elevated level of protein is of the utmost importance. Protein-rich foods should also help with anemia and iron-deficiency. Normally, Lil should be eating about 46 grams of protein per day. Now, however, she needs 58-70 grams. On Thursday evening, we made a big meal of steak and vegetables which was right up my alley! And last night, she ate a whole haddock at a restaurant; tonight we doubled-down on the steak. For protein-rich snacks, she can supplement with things like yogurt, soy milk, flaxseed, soy protein powder etc.

- Spices. Lil finds just about anything spicy irritating, primarily because the cells that line her mouth and esophagus have perished in the chemo. She gets horrible hearburn with too much acid or spiciness. Therefore, she needs to eat relatively bland, uncomplicated, digestible foods.

Having all of this detailed information is very empowering for Lil. She now feels like she has a measure of control over her side-effects and, as a result, her overall physical well-being and comfort. Her friends and family can help by suggesting recipes and preparing meals rich in lean protein and vegetables, and devoid of spices, fat, starch, and sugar (cancer loves sugar). Some days, she is going to be too tired to prepare a meal, but she still needs to be constantly vigilant about her water, vegetable, and protein intake. So having something diet-compliant that she just has to microwave would be very helpful.