Yet Another Health Update

I promised another health update last night, so here it is. I know that some of you are interested in this, while others find it tedious, so I’ll put it all below the fold. Here’s the nickel summary: There’s a good chance I’m going to continue feeling lousy for a couple of weeks or so, but I should start to improve after that.

Here’s our story so far: My chemo regimen ended four weeks ago, but this week I’ve been feeling terrible. Monday was a very bad day. Tuesday was little better, but not great. Wednesday was very bad again. Thursday was so bad that I checked myself into the emergency room.

The ER docs did what ER docs do: they gave me a bed, drew some blood, ran a bunch of tests, and gave me IV fluids. Then they waited to see how I was doing. The result was a little surprising, and I now have dueling theories about what’s going on.

My main symptom over the past few days has been enormous fatigue, far worse than usual. I’ve been pretty much just lying in bed all day, and on Thursday I felt so weak that it seemed as if something really serious might be going on. So off I went to the ER.

But all the tests came back negative. No infections. No electrolyte imbalances. No fever. Etc. The ER doc came by in the afternoon and spent quite a bit of time with me, and he was also skeptical that this was a result of chemo recovery. It’s been four weeks since my last session, after all, and while some symptoms of chemotherapy can linger for quite a while, overwhelming fatigue shouldn’t be one of them. So we talked. And as we talked he eventually suggested that my problem was….

Depression. This is normally a diagnosis I’d push back against, but it actually made some sense to me. I have a lifetime history of chronic mild depression. I obviously have a bunch of objective reasons to feel even more depressed lately. Many of my specific recent symptoms are fairly classic signs of depression. And because our brains often create problems where no real problems exist, it so happens that I’ve been feeling enormously guilty for the past few weeks because I’ve felt too lousy to really be there for Marian following her surgery in January. I really thought I’d be in good enough shape by then to do for her what she’s been doing for me all along, but I wasn’t.

So now I have a prescription for an antidepressant. And there’s an interesting backstory here, which makes me open to trying it regardless of whether this diagnosis is correct. About 15 years ago, I decided to see if I could do anything about my moderate depression. I ended up trying seven or eight different meds, and at the time I concluded that none of them had any effect. Years later, though, it occurred to me that I was probably mistaken. One of them really had made a difference, but I hadn’t quite noticed it at the time because it wasn’t a huge difference. As absurd as it sounds, I had chalked up my improvement to normal mood changes, not to the drug.

But I have reason to believe that it really was the med, and for some time I’ve been noodling around with trying it again. So when the opportunity presented itself yesterday, I took it. If it doesn’t work, no harm done. If it does work, my life will be better.

Plus there’s an unexpected bonus. It turns out that my drug of choice, Effexor, also helps treat neuropathy. My neuropathy will almost certainly go away on its own within another month or two, but anything that helps it along is more than welcome.

Of course, this is still a speculative diagnosis. One of my readers, for example, writes to say: “My husband is a clinical oncology pharmacist and says what you’re experiencing is totally expected. Basically your body is directing all of its energy to rebuilding all of the cells the chemo killed. It’s the biggest complaint among chemo patients. He said most doctors are terrible at this sort of stuff.” I haven’t yet had a chance to talk to an oncologist to see what they think of this, but in any case, the odds are that I’ll never know for sure. You see, if depression really is my problem, it will take 2-4 weeks before the med kicks in and I start feeling better. If it’s actually chemo recovery problems, it will probably take 2-4 weeks before I start feeling better. So when I start feeling better, it’s going to be hard to tell what the real reason is.

But I’ll say this: If my symptoms really are a result of depression, I have a new respect for moderate vs. severe depression. This was no mere case of feeling bluer than usual. It had all the feeling of a genuine, concrete physical problem. I was simply too exhausted to do much of anything. Just walking downstairs was about all I could manage. If this is severe depression, it’s a whole different beast from the moderate variety I’ve had since I was 25.

So we’ll see. I’m still pretty tired today—in fact, I’m going to go lie down as soon as I finish this post—but nowhere near as bad as earlier this week. Perhaps this is because my health goes up and down these days and today I happen to feel better. Or perhaps it’s simply that I’m responding to getting a diagnosis, regardless of what the diagnosis is. Time will tell.