Side effects

I am not sure this post is of value to anyone but me, when I read this blog again in a few years… there are poems translations at the end for anyone who wants to skip. 

As next week I will go into my hopefully final (pre-transplant) chemotherapy, this post is about chemo. More specifically, it is about the many “minor” side effects of chemotherapy I experienced. I say minor, since by far the major ones (which dominated my life since my first chemo in May 2018) have been exhaustion and fatigue, and I already discussed them in previous posts. These of course will disappear. On the other hand, some of the minor ones seem to recur, and I wonder which of these will stay with me forever. Many of them seem to manifest themselves at random times and for unpredictable length of time, and others are more persistent. Some I actually find amusing, being diversions from others.

If you search the Internet for side effects of chemotherapy you will find extremely long lists, some containing e.g. “other cancers”. Even among most common ones I should say I was luckily spared many side effects on that list, in particular any nausea, lack of appetite, or mood changes. So let me list some which I was not spared and certainly bother me, at least occasionally. Perhaps a natural order is by organs affected. I’ll share my expectations about which will stay with me, and which will slowly fade and be forgotten. I guarantee that nothing below will be gruesome in any way.

Eyes:

One major problem, which occurred mostly during chemo but not in between, is vision problems. Basically, it is blurred vision, regardless on wearing or not wearing the appropriate glasses (and I use both reading and long-distance glasses). I assume that this is really a brain problem, part of “chemo brain”, rather than real eye problems. 

The other problem is watery eyes – basically it looks like I am weeping constantly. This can happen outside of chemo, and usually involves light – bright sunlight or computer screen light (and goes away when I close my eyes). 

Both of these two problems I hope will disappear once enough time passes.

Mouth:

Again two problems. One, which I fear is permanent, is receding gums. As everyone knows, chemo is targeted at fast growing/dividing cells, and many healthy cell types suffer. The most common and visible are hair cells, and like me many lose their hair. This I don’t mind. Other fast-growing cells in the gums and in the digestive system are similarly affected. It is hard for me to feel the effects on my stomach or guts, but with the gums, teeth hurt each time I bite anything cold, and now that cold weather is upon us, even wind or cold air cause some pain. I fear this problem will not go away (despite Fluoride rinsing which supposedly slows this down).

The second, which is very sporadic, is extreme dryness. I could wake up at night with sharp pain in my tongue, feeling like I was in the desert for a week without water. Strangely, even a tiny sip of water (which is now always at my bedside) can relive this immediately. This is again one side effect I hope will completely disappear from my life.

Hands:

A sporadic effect, more focused during chemo treatment, but which recurs at random times, is trembling. One can imagine the effects when e.g. eating soup, or carrying a bowl of soup (for some reason I have been craving soups during this illness). I assume this will go away (and may return for other reasons later in life…).

Fingers:

Toe problems again. The first, combining well (?) with the one above is generally called (focal) neuropathy, which just means “nerve problem” in some group of nerves. For me, it is the nearly complete loss of feeling at the tips of my fingers (it also affects my toes and the balls of my feet, but somehow this does not bother me so much). As  you can imagine, we count on the sensitivity at our fingertips in so many ways that it is strange, and often funny to discover what basic things you cannot do when you want it. It is hard to turn pages in a book, to button a button,… I drop lots of small objects (like the many pills I need to take daily), etc.  Luckily, the cell phone touch screen does not mind all that and responds to the touch of an unsensitive finger! I fear that this neuropathy is here to stay – it has been constant for the past 18 months in my fingers and feet.

A second problem is cramps. I was familiar, like many, with occasional cramps in my feet or legs  (which did increase in frequency and strength around chemo). But it was extremely strange to have all of a sudden, a random finger decides to stick out in a random angle rigidly. This comes and goes at random times (not too often luckily), e.g. while eating or writing or more generally using some of the hand and finger muscles. As usual with cramps (I think), one can force the rebellious finger back, and holding it the cramp goes away. It is just weird, and I hope temporary and will disappear completely when chemos stop. 

Bones:

I guess this is not a direct consequence of chemo, but of something which accompanies chemo almost always, namely steroids, especially Prednisone. I received massive doses of Prednisone over the past 2 years, not only during chemo, but also outside it, mainly to help my bone marrow produce blood cells. Steroids are a kind of a universal agent, which does lots of good things, and lots of bad ones as well, especially if taken (even in small doses) over a long time. In particular, it causes bone loss and osteoporosis. In short, bone become brittle, and this is irreversible. In particular, my orthopedist suspects that the fracture in my vertebrae from 3 months ago (which has been the source of my back pain since) is due to this weakness (and a bad movement). I’ll just have to be much more careful in the future… And apropos that back pain – I should say that my back has been improving and probably healing faster, since I got an orthopedic brace to support it 10 days ago, which I wear most of the day.

OK, this list of side effects was probably not as amusing as I was hoping… let me return to translations. I already posted here two poems I translated of Rachel Shapira in the October 2nd post (Those who were born by the sea, and The rain men). Here are two more. 
I will speak with you - Rachel Shapira 
When your face is pale with sorrow
And your silence’s getting deep
Let my words to you have echoes
Let me walk among your shadows
Just to be with you

I won’t ask for explanations
Won’t disturb your solitude
Choosing, with some hesitation
Signs of grace and of affection
I will speak with you

I have strength and I have courage
Please don’t shield me, dear
Please don’t worry that your thorns
Will hurt, when I come near

When you’re near complete exhaustion 
But in darkness can’t find rest 
When your nerves, exposed and threadbare
Turn a dream into a nightmare
I will stay with you 

By your side I walk and wonder
‘Tween your nightfall and your dawn 
Yes my words are very brittle 
And my hands are very little 
But they’re close to you

When I notice, or you’ll tell me
Softly, barely heard
That your ghosts are congregating
Than I too, will lower my head

I won’t ask for explanations…

  • The second one is Israeli Fall song (שיר תשרי). The Hebrew speakers among you will recognize that I often take liberty in translating not only the poem, but also its title as well. The original title is “Shir Tishrei’’, literally meaning a song for the first month in the Hebrew calendar. In Israel, it happens (roughly) in September, marking the end of summer beginning of fall, the Jewish “high holidays’’, end of summer vacation and beginning of the school year, and the changes in weather, flora and fauna (which of course are different in different countries).  The original Hebrew lyrics are here https://shironet.mako.co.il/artist?type=lyrics&lang=1&prfid=383&wrkid=3037 . My favorite performance is here https://www.youtube.com/watch?v=I166985NY5w
Israeli Fall song - Rachel Shapira

Worried farmers are aware
Of the sky changing its ways 
Righteous neighbors do prepare 
Prayers of Atonement Days

Someone there of you is thinking 
Someone else your actions trekking 
Do come quickly home, do please 
Flying on the chilly breeze 
Do come quickly home, do please 
Flying on the chilly breeze 

Clementines do ripen through
In the orchard just on time 
Coughing, teachers with the flu
Drinking lots of tea with lime 

I just saw a wagtail wagging
Or that bird I just imagined 
And Sirocco broke today 
Ended summer holiday 
And Sirocco broke today 
Ended summer holiday 

What will happen, what will pass? 
All the journalists inquire
While, like children to their class 
Squills report, fill view entire 

Will the evening news astonish?
Will the headlines bring some promise?
Do come quickly home, do please 
Flying on the chilly breeze 
Do come quickly home, do please 
Flying on the chilly breeze 




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