Drink, drink, drink

I'm gearing up for chemo tomorrow. I've already started to concentrate on getting the required 10 cups of liquid into me by sipping on some chocolately Carnation Instant Breakfast this morning. It not only helps meet the liquid requirement, but gives me all those vitamins, nutrients and protein my body desperately needs.

Next I'll move on to Gatorade, a staple in my diet since I've developed the nasty habit of throwing up. This beverage replaces electrolytes and adds the potassium my body likes to expel when it vomits or develops gastrointestinal issues, which I've luckily avoided over the past week or so. I've taken up a new habit of eating an Activia with a liberal dose of Bran Buds sprinkled in for breakfast and my bowel movements are easier and more regular. My doc said natural ways might tax my already overworked gastrointestinal system, but this seems to work better and be less painful than the meds, so I'm sticking with it.

My homecare nurse also made a suggestion to help my sleep issues, and it seems to be working. I'm now splitting my lorazepam in two, taking half at bedtime. Then when I first wake in the middle of the night, I swallow the second half, roll over and return to sleep. I've done this for three or four nights and I've managed to get between six and eight hours of sleep in a row! Now I'm still waking up at 4:30 a.m. because I'm so tired I fall asleep around 8:30 or 9 p.m. If I could just shift the schedule a little, I'd be closer to my normal. (I know, some of you work really early and this is your usual schedule.)

And yesterday, I tried something else new to see if I could prevent my vomiting in the evening. I noticed most days, I seemed to process my food fairly well (as long as I didn't overdo the amount I ate) during the day, but if I ate dinner, my stomach seemed to say, "Whoa, too much!" and I'd vomit up the top layer of food. So yesterday, I ate my dinner at about 2:30 p.m. and consumed only small snacks in the evening. And I didn't throw up last night for the first time in about a week.

This could have been a fluke or I may be onto something. But I'll continue to experiment to see what I can do to keep as much food in me as possible. (Or should I say, prevent me from vomiting any more than absolutely necessary?)

It's all trial and error. I know some of my stomach problems stem from the fact I'm round and full of ascities. I once again look eight months pregnant. I called my nurse, B, yesterday and she's put in a request with interventional radiology for paracentesis. Not that I really want to have the giant needles stuck in my belly again to drain the fluid, but I'm sure it will make me feel much better. In addition, if the chemo doesn't have to work on drying up this fluid, it can attack the cancer cells with more gusto.

Since my abdomen is full of scar tissue and pockets, the fluid doesn't flow through freely. Usually for paracentesis, an ultrasound technician identifies and marks the biggest pocket of fluid to drain, then sends the patient back to the cancer clinic for the doctor to conduct the procedure. Due to my unique situation, Dr. W worked with interventional radiology so I can have the procedure done by the radiologist, who will identify the biggest pockets via ultrasound and drain them right there. It sounds like the most logical approach with a blocked up abdomen like mine. As a result, I'm hoping this procedure will be far less painful and far more productive than drawing 1 L of fluid from my poor swollen body.

Speaking of swollen, my face is all puffy from the steroids. I have chemo acne and I get flushed red sections covering my cheeks. My nails are brittle and breaking from the chemo. My tastebuds aren't cooperating to savour the full pleasure from food and drink. I get tired and breathless easily and often, and my legs sometimes feel weak from climbing stairs or walking too much. My hair is thinning and I find a good 50 strands in the tub and sink after I get ready in the morning. My skin and lips are dry, my muscle tone is disappearing and I'm losing strength. Yup, I'm a bit of a mess.

But it could be worse. These side effects - and even the ascities and vomiting - are tolerable. Or have I sadly just gotten used to them? They've been worse and I'm hopeful they'll get better. I just need to get more chemo into my body tomorrow so those ninjas can work.

As long as I keep moving forward and finding the good in my days, I'll be okay.

Tina