Better Living Through Chemistry?

Happy first day of autumn.
Out here, we’ve taken a trip back into summer — gorgeous day, 80 degrees.  Last night, we refilled the hummingbird feeder, hoping to prolong the little guys’ visits. We had four this year and the kids named them: Fred, Bob (or Bobette, we’re not sure of the sex), Noodle Neck and Clementine.  So now along with begging for a cat, a rabbit, a snake, or another pet, my son also wants a hummingbird to keep.  Too bad.  He’s stuck with just a dog. Unless he wants to make pets out of the spiders. It’s spider season here.

The Popsicle Report:  Yesterday’s flavor — purple.  Not grape.  Not raspberry.  Just one of those popsicles whose flavor is its color.  Purple.

We weren’t sure what to expect with the infusion yesterday.  The cold my son brought home last week he shared first with my husband and then with me, and I’m still coughing. We weren’t sure if they could do the infusion under the circumstances, but since I haven’t been running a fever and the white cell count looked “beautiful” as the doc put it (I’m sure he meant that in the scientific not the aesthetic sense), the routine continued.  I talked with Dr. L at length about the rollercoaster pattern of the white cell count.  He said it’s not unusual during chemotherapy, and not necessarily something to worry about, unless it forces a significant delay in the schedule.

So we’ve figured that 2 shots of Neupogen a week are sufficient — 3 being an overabundance and 1 being obviously not enough.  We’re trying not to be “wasteful” (as the doc put it) with the Neupogen — given that a month’s dosing (at 3 shots a week) is $6,000.00.  (Yes, that price is right.  There’s no generic version.)  Thankfully, our insurance coverage brings our co-pay down to $25 per order. We’re not sure if I’ll still need it after the switch to Taxol in a couple weeks, so I have to call in a refill order that’s as precise as possible. The pharmacy doesn’t take back leftovers, but the doc says if we don’t use it all, he can pass the extras on to those who need but can’t afford the drug.

As I was thinking about all these drugs I’m taking, I decided to do a little research. Not into the side effects, since I was overloaded with information about those at the beginning, but into the genealogy, so to speak.

Adriamycin caught my attention primarily because of the name (Its generic name is doxorubicin; Adriamycin is the brand name).  The -mycin part gives it away as an anthracycline/antibiotic, and it’s used to treat a variety of cancers: prostate, breast, lymphoma, ovarian, and others. It works by short-circuiting the DNA of cancer cells so that they die. The drug was developed in the 1950s in Italy from soil microbes, and got its notorious cherry-popsicle color from the red soil the microbes were taken from.  The prefix Adria-, as it turns out, indicates the geographic region of Italy where the microbes were found — near the Adriatic Sea.

Now isn’t that a lovely image for a drug whose nicknames are “red devil” and “red death.”

Cytoxan, the drug I take daily in pill form (generic name: cyclophospamide), is also used to treat diseases besides cancer:  autoimmune disorders like lupus and rheumatoid arthritis, something called Minimal Change Disease (a kidney disease in children), and multiple sclerosis. It too works by stopping cell growth, and was first developed and tested in the 1950s.

Neupogen (generic: filgrastim) is the magic drug to build white blood cells, specifically neutrophils.  It’s used primarily for patients undergoing cancer treatment, but also for anyone exposed to dangerously high levels of radiation. On the box, it says the drug is a recombinant granulocyte colony stimulating factor (rG-CSF) derived from (can it be?)  E. coli. This is the first I’ve ever heard of E. coli being a useful thing.  Think of that the next time you contemplate your spinach.

My “happy drug” — the steroid I get just before the infusion — is dexamethasone (brand name: Decadron). It prevents inflammation and suppresses the immune system, and they give it to patients like me to prevent any reactions to the Adriamycin infusion and enhance the effects of the antinausea med.  But it’s used for a wide range of situations, anything from dental work to altitude sickness and even ear infections in dogs. With prolonged use, it can make you gain weight (though those shots of olive oil might be the better choice), and has a host of other nasty side-effects with long-term use. I haven’t noticed any “‘roid rage” on the minimal dose I get, but I sure can get grouchy a couple days after the infusion as the drug flushes out of my system. A friend of mine said that, if she had only 6 months to live, this would be the drug she’d take because of its mood-enhancing effects.

The one other drug I take (besides the Ativan at night for sleep) is Zofran (generic: ondansetron). It’s strictly an anti-emetic, meaning it prevents vomiting, and is a fairly new drug, being patented in the 1980s and FDA-approved in the ’90s.  The first generic appeared in 2006 (which maybe explains why I’ve taken 3 different versions of this drug — one round and yellow, one oblong and white, and the flavor-coated, fast-dissolving one they give me before the infusion). Other, off-label uses include treating schizophrenia, sleep apnea, Parkinson’s disease, addiction to opium, and alcoholism.

With all these drugs and the supplements the naturopath suggested (probiotic, fish oil, CoQ10), I rather wonder how much of my blood is really blood. Advertisers did once promise us “better living through chemistry.”  I wonder if this is what they had in mind.

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