Round 4 kicked my ass

By the second morning of my 4th (and last planned) round of chemo, I knew something was up.  Something was simply different from the previous rounds.

Maybe I even knew this earlier, when I complained that I hadn't recovered from round 3 as quickly as from round 1 or 2.  But, I was more tired early on, I had more nausea early, and I just felt foggy right from the start.

One of the barometers I use during chemo, at least in terms of nausea, is coffee.  If I wake up in the morning and I still want to drink coffee, I figure the nausea is under control.  In the first round, I drank coffee through Friday (each round starts on a Wednesday), but by Saturday morning, I was vomiting and coffee was far from my mind.

In rounds 2 and 3, I drank coffee every day of chemo.  Both times, I skipped coffee on the Sunday after chemo, but I was back to it by Monday.  This time, things didn't go well at all on the coffee front.  On Saturday morning, I found myself discussing nausea with the fellow, who happens to be a fellow CrossFitter.  I said it was worse than any previous round.  I'd been taking IV Zofran and Compazine (by pill) every 4 hours since things had started.  Plus, I'd had Emend right at the start of chemo - a multi-day anti-nausea agent.  The doctor suggested another round of Emend and I didn't argue.

I went home Saturday night, feeling just terrible.  For the third straight night, I slept for 11+ hours.  The nausea was no better on Sunday.  My niece and her husband were visiting from out of town and we went to lunch at one of my favorite local restaurants.  It never even occurred to me to order any food.  Food that I'd eaten at this restaurant just a week before seemed disgusting to me.  I did enjoy seeing my niece though, and everyone else seemed to enjoy the food.

Monday morning, coffee was still out.  I went straight to the hospital in the morning, for a scheduled IV hydration session.  I mentioned the nausea, but said it was manageable.  After the hydration, I headed to the office.  In the afternoon, I needed to take some pills.  I deliberately took the most effective anti-nausea medication (zofran) one hour before the other pills.  It didn't help, and shortly after taking the pills, I was vomiting.  Food wasn't something I could even consider.

By Tuesday morning, I think my Saturday dose of Emend had run its course.  When I got to the hospital for more hydration, the nurses remarked one after another that I didn't look like I was doing OK.  I ended up getting another round of Emend and another anti-nausea medication.  That held me for the rest of the day and I was finally able to eat something.  But, for the second straight day, I told my wife I was feeling too sick for her to go to CrossFit.  I simply needed to get home to get some rest right after work.

This morning, I felt a bit better.  I had a few sips of coffee.  The nurses said I looked better when I got to the hospital.  They didn't give me any extra medications today.  I'm far from 100%, but I'm slowly getting better.

I talked to my oncologist briefly on Tuesday and she said that this round is much more typical of how her patients react to these medications on a regular basis.  We both agreed that we were glad I was done with the chemo.

I'm still feeling a bit rough, but gradually returning to normal.  If I'm lucky, I'll be skiing by the weekend.  But first, a nap.  After my wife does CrossFit.