Wednesday, August 20, 2008

My Bowel Shut Down with Chemo

One year ago in July, following the collapse of my spine, it was clear that it was time for me to start chemo (see post from June 7, 2008 on "Spinal Collapse" and from July 18, 2008 on "So Grateful for Where I Am Now -- Chemo Began 1 Year Ago").

So it was on Friday July 20, 2007, that I began taking the 3 different chemo agents prescribed for treating multiple myeloma -- daily Thalidomide, weekly Dexamethasone, and Velcade every 3 days for 2 weeks followed by a week off. The Thalidmoide makes one sleepy, so I was told by my oncologist to take it around 10 p.m. each night. In fact, it was given to pregnant women in the 1950's to help them sleep, after which it was discovered that Thalidomide causes horrible birth defects. So now there is tight control over who takes Thalidomide, and who can even touch the medication. But the good news for those with multiple myeloma is that Thalidomide helps kills the cancerous plasma cells in the bone marrow, and it also helps one sleep in the process. Other side effects from Thalidomide, besides sleepiness, can include constipation and numbness or tingling in the fingers and toes. The numbness never bothered me...

At the hospital on Friday July 20, I was given a 3-second long IV of Velcade, along with other drugs to reduce nausea, and then at home that night I took the weekly dose of Dexamethasone and nightly dose of Thalidomide. In addition to the Thalidomide being constipating, I was informed that both the Velcade and Dexamethasone are also.

So the weekend went by, and each evening I took Thalidomide. I continued my habit of drinking plenty of liquid (over 80 ounces per day) to maintain kidney health, including water, juices, herb teas, no alcohol, and only 1 cup of Earl Grey tea with caffeine in the morning. As Saturday went by, I didn't poop. My daughter's future in-laws came into town to visit us over the weekend. My roommate from college came to stay, too, so I was showered with lots of love. My future son-in-law was also in town for the weekend, and we had fun playing all kinds of board games. And by the end of the weekend, still I hadn't pooped.

Monday came and it was time to go back to the hospital for another IV of Velcade. The ambulance arrived at the house at noon to pick me up, since I had great difficulty getting to the hospital in a car due to severe back spasms every time we went over tiny bumps in the road. Unfortunately, the ambulance was no better. When I arrived at the hospital and was wheeled on a gurney into the infusion center for treatment, the nurses told me I was a kind of greyish color. They also said the only alternative to getting the ambulance rides to the hospital was to be admitted to the hospital as a patient, and I thought that was not necessary. I didn't realize at the time how close I was to being admitted to the hospital, how sick I really was.

After treatment on July 23, an ambulance took me back home from the hospital, and again I took Thalidomide that night. I didn't poop that day, so it was 4 days since I had emptied my bowel.

When Tuesday came along, it was a beautiful summer day, and my partner's and my 15th anniversary. I still remember having visits from 2 very dear friends, one in the morning and another in the afternoon, as well as having a visit from the secretaries of the Astronomy Department, who brought lunch to share. It was a wonderful day with friends, and still no poop.

By late afternoon, I started to realize that there was a problem. I had been eating food for 5 days since chemo began, and nothing had come out. I was feeling very full inside, with not much room for anything new until I emptied some of it. So I asked my partner to go to the drug store to buy the stuff I had drunk before my colonoscopy 1 year before -- and 2 hours after drinking it nothing had happened.

We ate dinner, and I had room for a little food, so I joined in the festivities. But still no poop came out, so afterwards I sent my partner back to the drugstore, this time for an enema. That didn't work either, and by 11 p.m. I realized that I was in trouble, literally in deep shit. If all of the things I knew how to do weren't helping my intestines move food through, I needed to go to the hospital.

So shortly before midnight on July 24, 2007, we called the ambulance to take me to the ER for an obstructed colon. I still remember being taken from the house down the front sidewalk, looking up at the stars in the clear sky and exclaiming, "It's so beautiful. I haven't seen the stars all summer!"

I was close to death that night, although I didn't know it until later. But even though I was in very serious condition, I still found joy in the beauty of the Universe.


Beth said...

Hi Judy,

Was anyone able to tell you if there's any way to prevent this from happening again such as prophylactic use of stool softeners? I don't think I've heard a worse story than yours. :( I've been on almost every MM drug, but not all at once like you were.

I hope you won't have this trouble again.


Joyous Judy said...

Hi Beth,

The next part of the story, which I will post in a few days, is that I was admitted to the hospital and it took 5 days of treatment by doctors there for my bowel to become unclogged. Before I was sent home, I learned about Miralax, Colace, and prune juice (which does wonders for me), and I have had a smoothly functioning bowel ever since.

I hope my experience can help someone!

Joyous Judy