July 22-26, The Week After Treatment

As the doctors predicted, this has been the worst week, by far.  Monday (July 22) I woke to a profound sense of fatighue and exhaustion.  Much more intense and real than what had come before.  But this was minor compared to other difficulties.

My last radiation was Thursday, July 18.  My esophagus continued to get more painful every day after that.  I went into work on Monday and Tuesday morning, but had to leave around 11:30a Tuesday, as the pain was dominating my thinking.  My radiation doctor had prescribed a general pain medication which I began taking as soon as I got home (Lortab).  This made me pleasantly drowsy so I slept through the afternoon.

As the esophagus pain got worse, it seemed to make me more queasy and eating became impossible.  I would only force down enough calories in the evening so I would not have a headache.

Wednesday morning I had an appointment with my medical oncologist (chemo doctor).  As I drove over, I started having abdominal cramps.  He told me to take a liter of IV saline right then.  I also mentioned to him that I had not had a bowel movement since Friday.  So he had me get a stronger laxative, Miralax.  The nurse administering the saline IV told me you take Miralax every 3 hours until something happens.  I took it at 3:30p, 6:30p, and 9:30p and nothing happened, except I had intense abdominal cramps the entire time.  I finally called the office around midnight.  The doctor sleepily said to stop taking Miralax, rest, come in for saline IV Thursday.  I did not sleep very much Wed. night.

Thursday I went in for another IV and they told me to get a suppository and if that did not work, a bottle of Magnesium Citrate.  The suppository did not work.  Magnesium Citrate comes in a 10oz bottle and is a very strong laxative.  I was supposed to take 5oz and if nothing happened within an hour take the other 5.  I took both and about an hour after the second dose I one diarrhea BM and an hour later one more.  Then nothing till Thursday night, when I had 3 or so more diarrhea BMs.  I may not have slept at all Thursday night.

The nurse who explained the dosage of Magnesium Citrate also told me that constipation and abdominal cramping seemed to be the two most severe effects of chemo.

Cramping Explained?

Most of Wednesday, Wednesday night, Thursday, and especially Thursday night were dominated by abdominal cramps. These are very uncomfortable.  Add in esophagus pain and queasiness, and I am hardly eating or drinking anything.  I think around 4:00am Thursday night, as I lie there in pain, one fact hit me.  Both on Wednesday and Thursday, before getting the saline IV I had abdominal cramps, but after the IV, the cramps were gone.  Maybe a big contributor to the cramping was dehydration.  I got up right then and forced down a big glass of water.  I think the cramping subsided a little soon after.

Friday morning the diarrhea subsided and there were no abdominal cramps and I was drinking lots of water.  My esophagus still hurt and queasiness was still there.  I started making sure I was getting more nutrients.  A nutritionist had given me a bottle of Boost and Ensure, two high-calorie, high-protein drinks.  I drank one Thursday night and another Friday.  Martha bought me some more on Friday.

I tried to work from home on Friday, but after sitting in front of my monitor for about an hour, I got this bad pain in both my lower front ribs that made me stop.  I have no idea what that was, but it was not the first time it had happened.  I'd had it last Sunday also.

It has been a difficult week for me.  I think I may be turning the corner now.  I'm still weak and light headed and my esophagus hurts, but it doesn't hurt quite as bad.  I'm able to eat more normally.  Hopefully this next week will see a big rebound.