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Tuesday, July 7, 2015

This is your brain on chemo drugs...any questions?

It's been awhile. Things have certainly been happening. Big things, and little things, too.

Cancer is full of gifts; there is such a universe of caring and kindness during the treatment, and so much pain and confusion and despair that everyone involved in the process works to resolve.
But what happens after the treatment rolls to a close? Not many people talk about this, or maybe they do, and it is too hard to hear during the crisis.

Once I began to feel physically better, more like my former self, the more I began to notice the cognitive effects of the whole process: chemo brain.  I've never experienced anything so frustrating, or real.

As a hard-working college professor, I have some baselines in place: how long it takes to learn all my students' names, how efficiently I respond to their emails and questions, giving grades and feedback, and being sure each student feels like I'm paying attention. Can I make spontaneous leaps in sharing content because I know it so well? Do I support my colleagues as a department chair, finishing the myriad of tasks efficiently?  I have the before-cancer baseline, and then, the spring semester of 2016  2015 (see?) benchmark revision: not good, sometimes shambolic, especially learning names. And it goes beyond my work; gradually it became a daily struggle to think of words, names, why I came into a room, what I meant to do next. My typing is scrambly and I burn myself on the hot stove, putting me somewhere between being geriatric, and a toddler.

Now couple this with the opportunity to spend a year on a breathtakingly exciting project, working with ed-tech pioneers, a project that rallies all of my energies, instincts, experiences, and interests. Imagine the fear of diving into a project like this, not knowing if your trusty brain would be there to support you.

I decided to do research, and approach my doctors with ideas from only the best sources: Mayo Clinic and MD Anderson Center. For the first time, my cancer treatment became a bit wacky. A call to the oncologist's office turned into over-the-phone-nurse-advice resembling a game of "Telephone" from childhood. I started all over again, and booked an appointment (more co-pay) to discuss this in person. The Oncology NP thought it was worth a shot to try a medication. The next day, when I saw my internist, she seemed shocked that the NP prescribed that drug, and implied that it would probably make my head explode (she didn't use that exact term, but...) and she thought a different drug would be better. I filled that prescription, too, only to have her nurse call two days later and say that it might interfere with the Tamoxifen I take to prevent a recurrence of cancer. She put me on a drug similar to the one the NP put me on in the first place.  So far, my head has not exploded, and the meds may be making things considerably better.

The new job is so filled with learning curves, every day is a winding road, and sometimes my brain responds to this and cooperates with stored knowledge and muscle memory. Everyone here (well, there - they are in Portland, I'm in VA) is younger than I am, so I've cultivated the sage-like slow answer (madly scrambling in my head for thoughts) and other times, it seems I can coast a bit on my instincts. I do think that jumping into a new world, given the past year, is pushing my brain back into shape, along with medication. I'm loving the adrenaline of challenge. Maybe the adrenaline, along with the prescription, will bring me to an even newer baseline, one well ahead of my pre-cancer self.

I'll keep you posted.



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