Guy's Gotta Talk -- About DIABETES; breast cancer, Azheimer's: November 2011

Saturday, November 26, 2011

A Big Hairy Deal

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

It’s been my experience that men don’t usually care that much about their hair. It’s also been my experience that hair is VERY important to women.

That’s why the most obvious result of chemotherapy – alopecia – has such a profound impact on women and the men who love them. Women who lose their hair are OBVIOUS to everyone who looks at them. They are noticed; they stand out in public in a way a bald man will never stand out. We admire it even – Kojack, The King of Siam, Captain Jean-Luc Picard are all heroes and we don’t even notice their shiny heads. But bald cops, Queens and starship Captains would be so odd that most of us wouldn’t even remember the rest of the record, reign or voyage.

As men with wives, girlfriends and mothers who will or who have lost their hair because of breast cancer, we stand in an unusual place.

We have to be honest encouragers.

“Honey, how does this wig look on me?”

“Is the scarf the right color for my skin?”

“If I wear a baseball cap every day, will you still think I’m sexy?”

“If I don’t wear anything on my head in public, will you be embarrassed?”

The first response to each question is initially: “It looks fine, dear”, “It looks fine, dear”, “Of course I will”, “Nothing you could wear or not wear would embarrass me”.

The problem with the response is that our loved ones are our loved ones and a diagnosis of “stupid” does NOT go hand-in-hand with a diagnosis of breast cancer. They know when we are patronizing. I learned the hard way not to patronize my wife. When she asked one of the questions above, I had to take my time and think. I had to consider my answer not because I wanted to be right, but in order to battle the deep-seated desire to avoid inflicting any more pain on a person worn out from the constant fight against cancer.

So I studied her as she modeled the wig, scarf, hat or bald pate.

Honestly responding, I gave my opinion. When it was honest, it gave her FEEDBACK and while the ultimate choice was still hers, she most likely felt that my response – especially before her hair started to grow back – was honest and another data point in her effort to decide what to wear that day.

Ultimately, I could do nothing more important that to be consciously HONEST!

Images: http://i536.photobucket.com/albums/ff323/MSBrady78/charpics/picard.jpg

Saturday, November 19, 2011

Neulasta!!! What’s It DO???

Hey! I'm back! And yes, I WAS in Portland, Oregon during Occupy Portland! I DID see the marchers and took pictures of them and watched them...occupy Portland for several days...and now, back to our regularly scheduled blog:

Though I talked very briefly some time ago about what the various chemotherapy drugs that my wife was treated with were “for”, I never really went into any kind of detail.

Now that chemo is “over”, I wanted to explore what some of the long-term and lasting effects of the treatment are. Because she reached that time – what with the odd numbing of her upper lip, the incision pains, swollen ankles and dry skin, I’d like to know which of those things is chemo-derived and which ones are not.

So we’ll g0 here next:

What’s “neulasta” and what does it do?

Chemically, “neulasta” is N-(3-hydroxypropyl)methionyl, 1-ether-alpha-methyl-omega-hydroxypoly(oxyethylene).

Looks like the picture up top. Complex. Lots of chemicals.

But what’s it DO?

“Neulasta”, is a special protein that’s based on sugar (an oligo-saccharide, meaning that the molecule has only a few small units, in this case a sugar ) that’s attached to a protein to form a glycoprotein.

The glycoprotein is a very important part of a cell wall – the cells that are being targeted are white blood cells. The white blood cells are also called neutrophils, granulocytes and stem cells and are the main part of the blood that destroys microscopic body invaders like bacterial infections, viruses or other germs. The glycoproteins help the white blood cells recognize the germs.

Neulasta makes the marrow in bones produce more white blood cells to replace the ones killed by Cytoxan, Adriamycin and Taxotere (which I talked about above) while they are busy killing cancer cells that are growing out of control.

The “colony” in the “colony stimulating factor” is the white blood cells in the bone marrow.

So – “neulasta” is injected just under the skin and gets into the bloodstream. It goes along until it reaches the bone marrow where it forces (also known as “stimulating”) the growth of new white blood cells to take the place of the older ones killed off by the chemicals in chemotherapy.

Side-effects? Sure. Any one of us who’s seen the Red Devil injected in his wife, mother or girlfriend knows what I’m talkin’ about here. With stuff like THAT going into a human body, to expect NO side-effects would be the crazy thing! There are “minor effects” – did any of the researchers experience any of these symptoms? If they had, would they have called the effects “minor”? – of the injection, things like hives; difficulty breathing; swelling (face, lips, tongue, or throat) as well as bone pain; pain in your arms or legs; or bruising, swelling, pain, redness, or a hard lump where the injection was given.

More serious side-effects (though according to the test trials, these rarely happened: sudden or severe pain in your left upper stomach spreading up to your shoulder; severe dizziness, skin rash, or flushing; rapid breathing or feeling short of breath; signs of infection such as fever, chills, sore throat, flu symptoms, easy bruising or bleeding (nosebleeds, bleeding gums), loss of appetite, nausea and vomiting, mouth sores, or unusual weakness.

My wife didn’t seem to experience any of the side-effects. In fact, though we expected WORSE, the chemotherapy (while horrible in its own right) only threw us a few curves. Because of the neulasta injections, she didn’t seem to catch any sort of germ at all and stayed (on the chemotherapy scale of things in our “new normal” world) pretty healthy.

References: http://en.wikipedia.org/wiki/Pegfilgrastim, http://www.drugs.com/neulasta.html,

Image: http://molecules.gnu-darwin.org/html/00150001_00175000/164419/164419.png

Saturday, November 12, 2011

Cytoxan!!! What’s It DO???

Though I talked very briefly some time ago about what the various chemotherapy drugs that my wife was treated with were “for”, I never really went into any kind of detail.

So we’ll g0 here next:

Cytoxan is the “third” drug of the cocktail she was force fed through the tubes and into her port every three weeks for six months. “Cytoxan is a cyclophosphamide that has been converted into a non-toxic ‘transport form’. This transport form is a ‘pro-drug’, subsequently actively transported into the cancer cells. Once in the cells, enzymes convert the drug into the active, toxic form that kills the cancer cell.”

Plain English, please!

OK – first stunning surprise is that Cytoxan is a cytotoxic chemotherapy agent similar to mustard gas.

Although used today as anti-cancer drugs, they can theoretically also be used for chemical warfare. Nitrogen mustards add chlorine atoms to the DNA of cancer cells, in effect poisoning the cancer cell.

Mustard gas was stockpiled by several nations during the Second World War, but it was never used in combat. Mustard gas and its related compounds are strong and long-lasting blister agents. Production and use is restricted.

How did we get from WWII mustard gas to anti-breast cancer drugs? During WWII nitrogen mustard gases were studied at Yale University and classified human clinical trials of nitrogen mustards for the treatment of cancer started in December 1942. Also during WWII, an incident during the air raid on Bari, Italy led to the release of mustard gas that affected several hundred soldiers and civilians. Medical examination of the survivors showed a decreased number of white blood cells. After WWII was over, the Bari incident and a Yale study came together prompting a search for other similar compounds. The nitrogen mustard became the first chemotherapy drug mustine.

Many people taking cytoxan do have serious side effects. Side-effects life nausea, vomit, bone marrow suppression, stomach ache, diarrhea, darkening of the skin/nails, hair loss or thinning of hair, changes in color and texture of the hair, and lethargy. Cytoxan can cause cancer, it can lower the body's ability to fight an infection as well as an unusual decrease in the amount of urine, mouth sores, unusual tiredness or weakness, joint pain, easy bruising/bleeding, existing wounds that are slow healing.

Image: https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmeUaW2nD_OBX9leZ30RBz_aWK0gF7QrwVFEDhJ2NrwplzaUmaVSVIUkELu_KkQyTNkg0iQ4kFr2BHrsklZUd2lf5lqnvT82BH5dWfhcTtsKkNVVBmLcAG9ZB2yOsrEbasbuo39giIv0fX/s1600/WW1-mustard-gas-attack.jpg