Yes, We Have Too Many Bananas (number-crunching kvetch edition) in Here Be Dust

The good news is that, on balance, my side effects following my second chemo infusion have been less severe and more short-lived than they had been following my first infusion. Part of the difference is likely due to the fact that my first infusion had also occurred two days after surgery to install my chemo port.

1. Fatigue, what I would call my most debilitating side effect, decreased by 31 percent when comparing the first five days of Cycle 1 and Cycle 2, as measured by naps. My naps (on top of overnight sleep) during the first five days of Cycle 1 totaled 13 hours, compared with 9 hours during the first five days of Cycle 2. In addition, I had napped for an additional two hours on Day 6 of Cycle 1. I write this on Day 6 of Cycle 2, so I have yet to see whether I'll need a nap today.

2. Constipation has decreased in two measures: time between BMs and Bristol Stool Type. A BM delay of >48 hours is considered mild constipation; my longest delay during Cycle 1 had reached 56 hours 50 minutes. In contrast, my longest delay during Cycle 2 has been 42 hours 25 minutes. My Bristol Stool Type (I was so excited to find this metric!) had taken nine days to reach a normal type during Cycle 1 and six days to reach it during Cycle 2.

3. Edema in my feet and legs had been mild during Cycle 1, but my right calf had swelled to 14.75 inches from its baseline of 13.5, while my right foot (circumference measured at the arch) had measured 9.5 inches with no baseline for comparison. My right calf had taken 15 days to return to baseline, while my right foot had taken 8 days to drop to 9 inches (which I now consider my baseline). In contrast, edema during Cycle 2 involved less swelling and faster resolution. My right calf swelled to 14 inches; my right foot swelled to 9.25 inches. Both returned to baseline after five and four days, respectively.

4. My total calorie consumption increased by 21 percent when comparing the first five days of Cycles 1 and 2. Net calorie consumption (total calories consumed minus exercise calories burned) increased by 20 percent. In addition, my exercise intensity has increased by 23 percent over the first five days of Cycle 2 as compared with Cycle 1, as measured by calories burned. I do not exercise on the day of chemo infusion. I resume exercise on my mini-bike the day after infusion at a lowered intensity and gradually build back to my baseline intensity.

5. Between constipation, edema, and steroids, I had gained five pounds overnight after both my Cycle 1 and Cycle 2 infusions. It had taken me six days to lose the gain during Cycle 1. Four days after the gain in Cycle 2 I am down two of those five pounds. That said, I am currently only 1.5 pounds over my target weight (I had gone from 150 to 155 after my first infusion and from 148.5 to 153.5 after my second). These days, my main priority is to make sure I eat enough.

6. I've had a gaggle of transient side effects. A brief bout of all-over-body tingling and a later two-hour spell of peripheral neuropathy had occurred during Cycle 1. (I could tell it was neuropathy because it had occurred in the wrong fingers for my usual carpal tunnel syndrome.) I've experienced brief spells of vertigo, once while sitting during Cycle 1 (relieved by lying down) and once while lying down during Cycle 2 (relieved by sitting up). Mild sweats and hot flashes during Cycle 2 are a new addition. So far, Cycle 1 and Cycle 2 have each come with a short bout of hiccups.

7. Nausea (confined to queasiness) and heartburn have occasionally interfered with my eating during Cycles 1 and 2, especially during the first week, and they are present throughout the day and night. Sipping water, taking small bites of food, and moving help to alleviate my queasiness. And burping helps. Lots of burping.

Chemo destroys cells in the digestive tract, including the stomach. My "chemo food" for the start of Cycle 1 had been heavy on soft, sweet, and bland. Peanut butter on soft bread. Bananas and applesauce mixed with yogurt in a smoothie. Eventually I switched to saltier foods, which helped relieve the heartburn. Trying to swallow bites of banana had become physically painful. In contrast, melted cheddar on whole wheat bread was heaven.

Eating plain Greek yogurt now becomes a discipline, and I am careful not to make it too sweet. Drinking organic ginger tea settles my stomach wonderfully but can ramp up my heartburn, which can make even swallowing sips of water painful. Calorie consumption becomes a balancing act.

I've got a bunch of eight bananas that are now mostly brown. I'll have to do something creative with them soon. :-)

Dry mouth is also a 24-hour constant. I might be awakened by it, rather than by an unsettled stomach. It's another reason why my water bottle is my constant companion.

Before I started chemo I bought one of these:

I didn't need it during Cycle 1, but it has been crucial to my sleep during Cycle 2 because I now need that upper-body elevation. I stand my regular head pillow on its end and nestle it between the short arms.

If Cycle 1 is any indication, most of my side effects will be gone after the first week, leaving only mild queasiness and dry mouth -- and baldness. My overall strength will continue to increase until my next chemo infusion at the start of Cycle 3.

I'm curious to see what the next infusion will bring. On the one hand, I've heard that fatigue and other side effects become progressively worse with each cycle because the body does not recover fully back to baseline between infusions. On the other hand, Cycle 2 has not hit me as hard as Cycle 1 had, all things considered. On the third hand, I have more fully recovered from my port surgery, which explains some (but, I believe, not all) of my lessened side effects from Cycle 2.

All in all, my side effects are quite manageable -- and are in fact minor compared to the severe dysmenorrhea that I had endured for 18 years.

Meanwhile, this arrived in the mail yesterday:

I am at lifetime risk of lymphedema following my lumpectomy and sentinel lymph node biopsy. Here I model my newly-arrived compression sleeve and gauntlet set from Lymphedivas ("Irises" design). I had learned of the company through Xeni Jardin's blog on BoingBoing.

"All women who are at risk for lymphedema or who have mild to moderate lymphedema should, at a minimum, wear their sleeve and gauntlet during air travel and while exercising," says Lymphedivas's catalog.

Medicare currently does not cover garments and other lymphedema compression supplies. I have written to my Representative asking him to cosponsor the Lymphedema Treatment Act (HR 3877). This site has more info. "Although this legislation relates specifically to a change in Medicare law, it would set a precedent for Medicaid and private insurers to follow."