Tuesday, November 2, 2010

Side-effect roulette

I had my first nearly sleepless night last night.  Turns out that the anti-nausea drug that was making me foggy was also helping me sleep.  Now my head is happily perched on the hillside, overlooking the fog in the river valley that is my digestive tract.  All night I was in total sphincter failure, from heartburn on down.  I took my non-brain-fog-inducing anti-nausea medicine at 11:00, ate some frozen yogurt at 12:15 (microbes unite!), but neither of these helped.  We don't have any heartburn meds in the house, but that will be corrected before sundown today.  All of what I'm calling river valley fog was included in chemo 101, but I'm guessing that the reason it hadn't surfaced before was because one of the side effects of the anti-nausea medicine was constipation; therefore, the two opposing forces cancelled each other out.  Now I seem to have traded the brain fog for digestive tract fog.  Boo!  

This makes me wonder what effect chemotherapy is having on my gut microbiota (gut microbiota:  all of the microbes that live in a digestive tract.  Fun fact: there are more bacterial cells associated with your body than human cells!)  Is anyone studying this?  Are my gut microbes going crazy because they too are affected by the chemotherapeutics, or are they going crazy because my immune system is no longer keeping tabs on them, or are they not going crazy at all?  Would probiotics help me to feel better, sooner?  I can think of at least 10 of you who have already launched Pubmed to answer these questions for me.  I can think of at least five of you with whom I would like to collaborate on a grant to ask, and then answer, these questions.    

Let's keep the science rolling, shall we?  Thanks to my friend Dr. Jason for explaining what neulasta (aka bone cuddle) is in his comment:  "neulasta is a colony stimulating factor- it stimulates precursor white blood cells (granulocytes) to grow, divide and mature more quickly to help your bone marrow keep up production during chemo. It is also covalently bound to polyethylene glycol so it hangs around in your body longer."  My delightful oncologist elaborated on this yesterday and said that neutrophils (a type of white blood cell) are specifically upregulated.  Neutrophils are your body's first defense against infection (shout out to Rose and her neutrophil-studying splendor).  And this is when it dawned on me how neulasta got its name:  Neulasta, helping your NEUtrophils LASTA bit longer.  Oh yes I did.



  1. Neulasta, helping your NEUtrophils LASTA bit longer. Oh yes I did.

    LOL - and you call yourself a doctor :)

  2. In case no one has indicated this, ginger is supposed to help with the nausea - ginger ale, ginger snaps, ginger bread, Ginger from Gilligan's island (sorry that last one is only good for what ails me :0 ), and fresh ginger.

    Here is an interesting link.

  3. Haven't done a search yet, but I already had van Vliet et al. 2009 Clinical Infectious Diseases (49:262-70) in my store of references on my computer. They looked at pediatric patients with leukemia before and after chemo and with and without antibiotics, and assessed the community with DGGE and FISH. It indicates that your gut community may be reduced 100-fold by chemo with unpredictable consequences (and antibiotics won't help things). I think lots of probiotics would be a good idea.

  4. Fecal transplantation works for clostridium difficile patients.

  5. There's a lot of science up in here - it's tough for my English teacher brain.

    Frozen yogurt sounds good...

    Coooome on white blood cells!!!!!!

    Love ya! Beck

  6. Oh Heather, only you could make science sound fun and cute!

  7. Remember the Sheep's milk yogurt with Ginger. Everything wrapped up in one!!!! Find it at the CO-Op.

  8. Oh yes you did, like you always do, and like you always will. Ginger tea to the rescue this weekend my dear.

  9. Haha, I got to the end of the post and was like "bone cuddle? huh?" But I like the big hug for your bone marrow and neutrophils, and it makes me happy...neutrophils will protect you!

    It never occurred to me to think about the microbiota, but I bet chemo does crazy stuff! What kind of probiotics can you get, other than yogurt with active cultures? They actually have all kinds of products on the drug store shelves here, but I'm always skeptical of their efficacy.

    Love the new haircut, love the blog, and love you! Sorry about the stomach troubles. Xxx