Thursday, April 17, 2008

Temodar, so far

I am about to take a capsule that cost my insurance company $240.90. (Fortunately, it cost me 95 cents.) It's a big capsule, aqua blue and white, emblazoned with a couple of thick fill lines that make me think of a bee's belly. To resolve confusion, the top reads "TEMODAR" -- such service for 240 bones. I'm sitting here trying to find something remarkable, noteworthy even, in the capsule, but it's just a capsule, and I'm just stalling. The remarkable things are the cost, hope and fear; and I'm not feeling qualified to comment on any of those just yet.


The first dose is always like this. The first time I received chemo -- a fairly toxic old-school combination of cisplatin, mitomycin and adriamycin -- I was terrified. The event felt momentous, and yet there I was sitting in an armchair in a big room looking at other people feeling various unknowable degrees of sadness or boredom or optimism. I worried about throwing up when the drugs hit me, movie style. I worried that the nurses had missed the vein, or that the vein would fall apart allowing caustic chemicals to spew painfully into my body. I worried, ridiculously, that one of these so-called vesicants (scary word) would get loose and I wouldn't realize it quickly enough. The actual event, of course, was efficient and routine: no hurling, not much of anything in public. But one thing felt momentous: Adriamycin is delivered through a "push." A nurse connects syringe to line and looks intently at watch or clock to squeeze the drug in over 90 seconds or so. I sat there staring as the bright red drug moved by infinitesimal degrees into my body. A couple of minutes can seem like a very long time.


I swallowed the Temodar after L. gave the capsule a little pep talk ("Go get that cancer!") and now I'm waiting to see what happens. Like always, I'm inordinately paranoid about side effects. (The pharmacist didn't help. While we were working out our version of the hot dog/hot dog bun conundrum -- I was authorized for 21 Temodars at a time, but only six Zofrans -- I allowed that I hoped I would move on to a less badass anti-emetic. "Yes, but you don't want to throw up a pill that expensive," she said. "Zofran is one thing; losing a dose of Temodar is another." I don't actually want to throw up cheap pills either, but never mind.) My stomach feels jumpy, but it did before I took the drug. Nothing new develops. Eventually, I get bored and decide to sleep. Another first dose finished.

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