The totally-not-funny-side-of-chemo-brain

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Bev G
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The totally-not-funny-side-of-chemo-brain

Postby Bev G » Tue Nov 18, 2014 2:49 pm

Hi Kids,

SO annoyed that I just lost this message! :twisted: :twisted: :twisted:

Some of you know through FB I was in the hospital last week, 5 days in ICU and 2-3 days step-down. I have been talking about getting my chemo-brain looked into for the past couple of years and promised to share what I found out if I ever did. Here's sort of a combined report. The testing was very complicated and very exhausting, and the results very depressing, but here's the current status. Feel free to ask questions, of course. I'm not writing a lot right now, am still really under the weather from all the stuff last week.

Love to all,

Bev

Copied from my FB:


The non-joking side of "chemo-brain" I have been talking about having my neurologic system checked out on and off over the past couple of years. I had noted some pretty worrisome stuff with my thinking/concentration/memory and felt like I should probably have it evaluated. I have also poked plenty of fun at my "chemo-brain" over the last 3.5 years that I have been off chemo....sort of a sick-irony kind of thing. My beloved dad was my life-long source of Alzheimers jokes, shaming me when I laughed at them, especially when he succumbed to the disease. Certainly some of my motivation in getting my own situation looked in to was to try to be sure I wasn't dealing with early-onset Alzheimer's since I have such a strong family history of it.

Several years ago the University of Rochester published a fairly definitive study about the cognitive effects of the chemotherapeutic drug 5FU. Prior to this, there had been a fair amount of debate about whether or not chemo-brain actually even existed. Well, it undoubtedly does, and I am somewhat f*cked.

I saw a neuro-oncologist at Dartmouth a couple of months ago. She did some preliminary testing then referred me to a neuropsychologist, who did about 7 hours of testing, and all this was followed last week by my hellish hospitalization. It has all been sort of the perfect storm of really bad and really scary information.

I was misinformed/confused about several aspects of the hospitalization, and am still not clear on the whole thing. My blood sugar was not nearly as high as I thought (though high nonetheless ~400) The real issue was that I was "disproportionately" unconscious and wouldn't wake up. I guess I was in ICU for 5-6 days. They went through doing spinal taps, CTs, MRIs, blood cultures and all other manner of torture available, preparing to chalk up my coma as viral meningitis...but it wasn't. Eventually, after every test in the book, and when I regained consciousness (sort of) on the 5th day or so, their best guess was this big time metabolic acidosis AND what they found on my head MRI on that day. Seems I have developed "moderate diffuse" frontal lobe atrophy. CHEMO! So, the synergy between my metabolic derangement and the changes in my brain had my significantly out for the count.

The testing from those several weeks ago show that a lot of my "stuff" is intact (ie verbal IQ and those higher level cognitive skills) but performance stuff is significantly deteriorated. Depending upon the skill required, some problem solving stuff has been messed with. Small motor skills are very significantly deteriorated (so glad I'm not an artist :-) )

There is a lot more information, all of which is depressing, scary and complicated. I have been advised that depression and stress also has a big impact on the manifestation of these issues, so, I am to reduce/eliminate all stress (just kidding)...they are adding another antidepressant to my meds and I'll be thinking about an approach to "stress". LOL. Because of the cerebral atrophy I don't have the "reserve" that I previously did, so I'm going to have to put a lot more effort in keeping myself metabolically stable, not something I particularly have the energy for.

Anyhow, saw my endocrinologist today, and my new PCP yesterday. I like them both a lot, and we're all on the same page. They've both assured me that although I'm still feeling like crap after being discharged almost a week ago, given where I was, and how critically ill I was, it's to be expected. Atypical of me though, I'm scared and do not welcome what this next chapter of my life may be looking like.

Almost 5 years ago I was diagnosed with stage IV colon cancer and was given a 6% chance of being alive today. So, I am. With no sign of cancer. I am grateful for that, especially when so many of my wonderful, beloved friends have not survived. How incredible that the cure has nearly offed me.
58 yo Type1 DM 48 years
12/09 Stage IV 2/22 nodes + liver met, colon resec
3 tx FOLFIRI, liver resec 4/10
9/10 6 mos off chemo, Neg PET&CTC CEA nl
2/11 finished total 10 rounds chemo

9/13 ^17th clean PET/CT NED for now

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juliej
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Re: The totally-not-funny-side-of-chemo-brain

Postby juliej » Tue Nov 18, 2014 4:59 pm

Bev, I wonder how much of this relates to your diabetes - like a perfect storm of diabetes damage plus chemo damage. There is evidence from neurocognitive testing suggesting that cognitive dysfunction should be listed as one of the many complications of diabetes (likely due to damage from hyperglycemia/hypoglycemia, vascular disease, and insulin resistance). Still, just the phrase "frontal lobe atrophy" makes me shiver, especially after all you've been through. Has anyone else in your family besides your dad had Alzheimers?

Love how they tell you to "reduce/eliminate stress" right after giving you the news. Yeah, sure. Hopefully the additional meds will help. And the heaping pile of hugs, support, and love you will get here!

(((((Bev)))))

xo,
Julie
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

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wwroam
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Re: The totally-not-funny-side-of-chemo-brain

Postby wwroam » Tue Nov 18, 2014 5:02 pm

Hi Bev
Sorry to hear about your admission.My question is , as a 40 year T1, how did you get into such a state?
Best wishes
Wayne

Back on topic.
Never really suffered from it, but I worked all through chemo.
Certainly nothing compared to the foggy brain after starting on Lipitor. I can't speak for US but down here it's PX to T2s almost on suspicion. After cutting back to 10 mg a day( or flat out refusing to take 40mg a day) things returned to normal.
Stage 3a DX 25/06/07
Folfox complete 30/01/08
7 years NED
Port scheduled for removal 8/02/10 Gone.
PSA .54 No prostate problems
Diagnosed Type 2 Diabetic
SO diagnosed CC Stage IV Liver Mets 23/03/15

Redtexa5
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Re: The totally-not-funny-side-of-chemo-brain

Postby Redtexa5 » Tue Nov 18, 2014 6:01 pm

Crap Bev as someone who is insulin dependent as well I know how scary not being able to regulate yourself would be, one of my secret fears is getting to mentally out of it to regulate myself. I have been at 400 Mg/dl plus and that is no fun and we all don't want to go there. Have you tried a pump? It might make things easier, and there are some constant glucose monitoring systems out there. Lets face it you know what will happen if you don't get this under control, and blindness is not something you want to add to the mix let alone dialysis.

Oh, and Wayne I am with you on the Statin thing, worse than any chemo brain I ever had.
Start of symptoms 9/08
Dx Stage IIIc/IV CC 2/09
T4bNxM0
Colostomy 2/09
Radiation/5FU 3/09-5/09
FOLFOX 6 6/09-8/09
9/09 Tumor removed Colostomy reversed
10/09-1/10 FOLFOX 6
3/10-2/15 NED
2/14 Colonoscopy NED
2/15 Colonoscopy NED
6/15 PET/CT NED
2/17 7 years NED

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Voxx66
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Re: The totally-not-funny-side-of-chemo-brain

Postby Voxx66 » Tue Nov 18, 2014 6:40 pm

Damn - I have been worried about your situation ever since that odd hospitalization. I am not an insulin expert but it seemed like something else might be going on to me. My hope is that this can stabilized and you won't have any more incidents like that one.

Has there been any discussion of drugs? My mother has been on Exelon as an off label prescription for post perfusion syndrome and it definitely works for her. Unfortunately she has had some unpleasant side effects as the dosage has been raised so still trying to dial that in.

Hoping for the best.
DX and resect 10/2012 age 46
Stage IIa CRC
liver mets both lobes 8/2013
CEA 28
FOLFOX + Avastin 8/26/13 3 rounds
Folfox only 3 rds + rd 8
platelets low round 7,9,10 5FU only
1/14 CEA 1.0 y90
5fu
10/14 mets lung and peri
1/15 Folfiri

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Bev G
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Re: The totally-not-funny-side-of-chemo-brain

Postby Bev G » Tue Nov 18, 2014 6:47 pm

Redtexa5 wrote:Crap Bev as someone who is insulin dependent as well I know how scary not being able to regulate yourself would be, one of my secret fears is getting to mentally out of it to regulate myself. I have been at 400 Mg/dl plus and that is no fun and we all don't want to go there. Have you tried a pump? It might make things easier, and there are some constant glucose monitoring systems out there. Lets face it you know what will happen if you don't get this under control, and blindness is not something you want to add to the mix let alone dialysis.

Oh, and Wayne I am with you on the Statin thing, worse than any chemo brain I ever had.


Hi Redyexas,

Thanks for your thoughts. I have had type 1 diabetes almost 50 years. I have been on a pump for over 25 years. I've used the constant monitoring system and it was way too much of a hassle with the cancer stuff going on---I may go back to that at some point. I have been a Certified Diabetes Educator for >30 years, so I'm pretty familiar with both the disease and the technologies. The probability of me developing blindness or kidney failure at this point (ie with 50 years of disease behind me and no diabetes complications) is essentially nil. That fact doesn't eliminate the risk of acute and severe metabolic disturbances, obviously. The event last week was triggered by my becoming accidentally dislodged while I was sleeping. I hope you are doing well. After careful thought I declined taking any statins (worried about my liver) as my numbers were barely out of range. Sounds like it's good that I did.
58 yo Type1 DM 48 years
12/09 Stage IV 2/22 nodes + liver met, colon resec
3 tx FOLFIRI, liver resec 4/10
9/10 6 mos off chemo, Neg PET&CTC CEA nl
2/11 finished total 10 rounds chemo

9/13 ^17th clean PET/CT NED for now

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meatie
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Re: The totally-not-funny-side-of-chemo-brain

Postby meatie » Tue Nov 18, 2014 7:07 pm

@Bev G

Sorry if this information was previously post on this forum. But, why were you in the ICU for 5 days?
Mother DX @59 8/14
cln+lvr res 9/14, stage 4
FOLOX+Avs 12-rd 10/14 to 4/15
Reoccurrence, KRAS mutant 11/15
Folfiri 18-rds 11/15-8/16
FOLFIRI with Ramicirumab 28-rds 8/17-9/18
Regorafenib 10/18-10/19
Lonsurf 10/19 onward
Folfox rechallenge 05/20
Regonivo (Opdivo+Stivarga) 08/20
External Peace 09/12/2022

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Bev G
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Re: The totally-not-funny-side-of-chemo-brain

Postby Bev G » Tue Nov 18, 2014 7:40 pm

meatie wrote:@Bev G

Sorry if this information was previously post on this forum. But, why were you in the ICU for 5 days?


Metabolic acidosis/coma

PS Your mother won't have this
58 yo Type1 DM 48 years
12/09 Stage IV 2/22 nodes + liver met, colon resec
3 tx FOLFIRI, liver resec 4/10
9/10 6 mos off chemo, Neg PET&CTC CEA nl
2/11 finished total 10 rounds chemo

9/13 ^17th clean PET/CT NED for now

tammylayne
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Re: The totally-not-funny-side-of-chemo-brain

Postby tammylayne » Tue Nov 18, 2014 7:42 pm

Oh Bev.....this is so upsetting!!!!!! I am glad you are doing better, but I cannot imagine how scarey this is for you.

Sending you soooooo many gentle hugs xoxox
51 F
'06 Stage 1 CC,
'10 Stage 3 Rectal

"You never know how strong you are until you have to become your own hero."

cmrl
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Re: The totally-not-funny-side-of-chemo-brain

Postby cmrl » Tue Nov 18, 2014 7:59 pm

So glad you're feeling better. Do you have any pets? Great stress reducers, unless you have a high energy minipin like I do. Just wondered if you would be a candidate for one of those Service Dogs that can detect changes in your blood sugar.
Resection of splenic flexure 7/24/13
T3N2BM0, Stage 3c,12/29 nodes
Folfox x12 9/13-3/14
CT scan 4/14, enlarged spleen, otherwise clear
CT 4/15, spleen WNL.
6/17 3 cm benign polyp at ileocecal valve, awaiting removal

peanut_8
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Re: The totally-not-funny-side-of-chemo-brain

Postby peanut_8 » Tue Nov 18, 2014 8:11 pm

Wow Bev, that is some scary stuff. Glad you are out of the hospital and have a plan regarding the chemo brain. Good luck.
peanut
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

skypup
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Re: The totally-not-funny-side-of-chemo-brain

Postby skypup » Tue Nov 18, 2014 8:48 pm

Whoa, Bev, I had no idea! Thank goodness you have stabilized and are out. Thank you for sharing what you are finding out about chemo brain. The adventure continues! Equal parts "argh" and "thank goodness"!

michelle c
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Re: The totally-not-funny-side-of-chemo-brain

Postby michelle c » Tue Nov 18, 2014 9:30 pm

A huge hug for you dear Bev. Sending you love and warmest wishes across the miles.

Michelle xox
May 25 2009 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
Jun 3 2009 LAR - Stage III 3/10 lymph nodes
Jul 6 - Dec 10 2009 - 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 2012 port removed & hernia repair

bitchslapped
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Re: The totally-not-funny-side-of-chemo-brain

Postby bitchslapped » Tue Nov 18, 2014 9:54 pm

Glad you are safely back at home & gracious enough to share what you have learned with the rest of us. I hope you can compartmentalize the understandable fear while recuperating until you are better able to process all of this information in what has happened. Your body & mind are busy healing.

Best wishes

Bitchslapped
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp, diverticulitis
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07, lvr, billiary tree fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia

Danieljt
Posts: 309
Joined: Sun Aug 10, 2014 10:32 pm

Re: The totally-not-funny-side-of-chemo-brain

Postby Danieljt » Tue Nov 18, 2014 10:28 pm

Bev, nothing but best wishes and hugs to you. Hope your felling better soon and keep fighting the fight. God bless.

Dan and jackie
70 male stage 3b cc
Dx 5/9/14
Resection 7/1/14
dx 9/14
65 yr wife DLCl
Sct 3/21/19 Ned last 8 mo.


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