Breast Cancer in the time of COVID-19 Series Part 1: Side Effects

The introduction to this series is here.

My side effects from Adriamycin (generic name is doxorubicin) and Cytoxan (cyclophosphamide) include nausea, fatigue & dizziness, changes in the color of my nails, intestinal upset, changes in taste, hair loss, and dry eyes and skin. These have continued to various degress under Taxol and Carboplatin. So let's take these one at a time. Please remember that side effects are different for each person. My experience may be completely different from yours, or your friend's or loved one's experience.

Nausea

The nausea during my A/C treaments kicked in pretty hard by Friday night or Saturday morning. I have two prescription anti-emeticss, Zofran (ondansetron) and Compazine (prochlorper) which can each be taken every eight hours, so you can alternate them every four hours to give constant coverage against the nausea. This worked pretty well during my A/C treatments. During my current treatments, with Taxol (paclitaxel) and Carboplatin, the nausea is not as bad when I just have Taxol, but the Carboplatin makes me feel really sick. This past weekend I had not felt sick at all on Saturday, so I didn't take any anti-emetic, and I woke up at 6:15 Sunday morning feeling really nauseated. It was too late to take a pill, and I threw up. A lot. Once the vomiting stopped, I waited about 30 minutes and took a Compazine pill. Zofran has to be dissolved on the tongue, and it tastes weird to me, so I chose the pill I could swallow with a sip of water. At 9:30 I started throwing up again. Again, I waited a while after I stopped puking, about 45 minutes this time, and then took a Zofran. Once I began alternating the two drugs, keeping both in my system, the nausea was under control. But I was exhausted from the vomiting, worried about dehydration, and unable to eat without feeling sick. I spent the day lying on the couch, sleeping and sipping on ginger ale, Powerade, and then Pedialyte that a friend brought over. It was a rough day. By late in the evening I was able to eat and keep down some thin mashed potatoes and a piece of toast with cinnamon sugar on it. Monday I kept alternating the anti-emetics, and was able to eat more normally, but still felt extremely tired.

Fatigue and dizziness

Using the word "fatigue" for how I feel these days just doesn't seem strong enough. The tiredness from chemo is a deep, bone-tired feeling, where you feel like you're carrying around half again of your body weight and your muscles don't respond correctly to your brain's commands. At least mine feels like that. I usually "crash" like this on Saturday afternoon, Sunday, and Monday, so Days 3-5 of each round (the day I get chemo is Day 1.) It makes me feel like all I want to do is sit and watch something, or play a game on the computer or my phone. Along with the fatigue comes dizziness when I stand up too quickly or bend down to pick something up and then rise up again. It's like how you feel when you've been terribly sick and are recovering, trying to regain your strength. Maybe you've never felt that way; I hope you never have. By Tuesday the fatigue lifts considerably and I start to feel more energetic again. But I usually don't feel totally normally physically anymore, not even by Wednesday or Thursday, and then I have more chemo.

Nail changes

One weird thing is that some of my nails have turned dark purple at the base or over most of the nail. It isn't very dark, but it's noticeable. My fingernails have also gotten sort of ripply and ridged. Apparently this is all normal and to be expected.

Intestinal upset

I'll forgo discussing the intestinal upset and just say that it can go two ways: the Immodium way, or the Colace/Miralax way. You can figure that out. 

Changes in taste

The first thing I noticed was that fruit tasted like soap. Then many other foods began to taste metallic or like chemicals. Many foods that I used to like now sound unappetizing to me. For a while, toward the end of my A/C treatments and while I had the sinus infection, I lost my sense of taste entirely, probably because I couldn't smell anything at all, and nothing sounded good to me to eat. (And before you ask, NO, they did not test me for COVID-19. I did not have a fever, sore throat, or deep cough in my lungs. I still wonder, though....) A few friends who are cancer survivors suggested I switch to eating only with plastic utensils, and that has helped tremendously. Since I've been on the two new chemo drugs, my taste buds have revived considerably. I am able to taste food better and enjoy eating again.

Hair loss

I lost most of my hair two weeks after I started chemo, back in March. On Day 13 after Round 1 it started coming out in handfuls. I decided to take control of it, and cut it short, in a pixie cut:

Then Eric helped me shave it into a mohawk:

But it was falling out horribly as I put stuff in it to spike it up, so I only kept the mohawk for about 15 minutes. Then we shaved it all off. I started wearing comfy chemo hats;

At that point, I hadn't started losing any eyebrows or eyelashes. Now that I'm on Taxol and Carboplatin, my scalp hair has begun to re-grow, and my brows and lashes are falling out. My lower lashes are almost totally gone, I have about half of my upper lashes, and my brows are seriously thinned out. I was using a lash serum the whole time on my lashes and brows, but they just can't hang on. I'm having to use an eyebrow pen to fill them in now. 

Dry eyes and skin

Finally, chemo has dried out my skin, even though I try to stay hydrated internally. My feet flake and peel, and my face, hands, and legs are horribly dry. Even my eyes are dry! I had to call my ophthamologist to get recommendations for eye drops, eye gel, and eye ointment that I can use during the day and at night to relieve the dryness. The eye dryness was worse on the A/C protocol, and has abated somewhat during T/C. But it's still there. I'm applying facial moisturizer multiple times a day, and body lotion on my arms and legs several times a day.

Well, there you have it. My side effects.