Green Thumb - 7/6/11

My oncologist is not happy about my green thumb. She says that she has never seen the nails turn green. Sure, Taxol does a number on the fingers and toes and causes neuropathy, but my situation is so serious that she makes the hard decision to take me off of the Taxol. To be clear, the whole thumb is not green. The nail and the skin closest to the nail are lime green. The thumb is very sensitive to the touch and is swollen. My other nails are undergoing the same fate. They are all in some shade of brown, indicating the nails are dying and starting to separate from the nail bed. All of my fingers and toes are neuropathic - tingling, painful, or numb. I had long ago cut down the nails as close to the skin as possible to lessen the pressure on the nail beds, but it appears that this action has done little good. Because of the chemo, the nails aren't growing as fast as they would normally, which is a blessing.

I have mixed feelings about stopping the Taxol. My last CT scan showed continued regression in one of my liver tumors. It's down to 10 millimeters from 16 millimeters. Initially, it was 19 millimeters, so that sucker is really shrinking. The lung tumors are stable, and there doesn't appear to be any new bone lesions. That means that seven months of chemotherapy is working. I really don't want to stop just because of neuropathy. I've been in so much pain from the mets in my spine and hips in the past four years that the pain in the fingers and toes is minimal in comparison. I do drop things because of the numbness, and I need to go shopping for pants with no buttons. Anything that touches the fingers and toes causes pain, or in the case of the numb digits, a tingling sensation travels through the nerves. And the green thumb is really grotesque. Even with all of that, I would still rather be on the Taxol. What if the tumors start spreading or growing again? Technically, Taxol has not failed me yet, so as soon as the neuropathy is under control, maybe I could go back on it. In the mean time, however, my treatment options are so limited that my oncologist offered no replacement for the Taxol.

I'll still get all of the other drugs: Avastin (chemotherapy drug that enhances the effects of Taxol by cutting off the blood supply to tumors); the clinical trial drug, Everolimus (I still think that I'm getting the placebo); Zometa (helps to build new bone tissue); Lupron (injections to keep the ovaries shut down); and Aranesp (injections to help build up the red blood cells). Without Taxol, I no longer need the IV bags of steroids and Benadryl. Eliminating the steroids should allow me to finally calm down enough to get some quality sleep during the night. Of all of the drugs, Taxol is the most important, and as proven from the neuropathy, the most toxic. Because of the green thumb, I'm back on more antibiotics. My oncologist also wants me to soak the nails in warm water and baking soda several times a day. I'll lose the nail on the thumb, but maybe by stopping the Taxol, starting the antibiotics, and soaking the nails, I'll be able to save the others. The real reason for stopping the Taxol, of course, is to save the nerves. Having permanent nerve damage in the hands and feet would really suck.

Avastin is still spiking my blood pressure. I am now on a double dose of the blood pressure medication. By eliminating Taxol, my blood counts should start coming back up so that I'll be less tired and breathing better, and the eyebrows and eyelashes should finally start to grow back. Avastin is used as maintenance and doesn't really attack the tumors like Taxol. The best we can hope for is stability with no progression. Regression is almost impossible without the Taxol. The best thing about all of this is that I now only have to go to the cancer treatment center twice a month instead of three times a month.

As a side note, I'm down to essentially no running. I just can't get enough oxygen into the lungs to sustain a run. Trying to breathe in too much oxygen too fast only results in dizziness. My stamina is gone. I could literally fall asleep while I'm walking. A power walk is a struggle, but I've been moving my legs every day. I hesitate to say walking because three miles an hour is really pushing it for me. I'm hoping that working this hard has some kind of training effect. Maybe when I'm able to get back to running, it won't be too difficult to get back into shape. Regardless, I do what I can, and I try not to stress about what I can't do. I am still "racing", but it's all for sanity reasons now. I'm sick and tired of being sick and tired, so I need some type of normalcy in life. Racing does that for me. I am so grateful to all of the race directors who put on timed events or who have very, very generous cut-off times for the distance events that allow me to finish.

I've also tried to decrease my calorie intake, losing about five pounds over the last couple of months. I'm not running, so I really should have made adjustments some time ago. Hopefully, I'll be able to shed a few more pounds throughout the summer. I have several cute little sundresses that I would love to squeeze back into. My face had become so bloated from the steroids, so when a good friend of mine recently commented that my face was thinning out some, she really made my day. It's the little things in life that are so special.