The New Meds

I called Dr. Lunin today to see if I could book an appointment. Scott could not see me so we spoke by phone. The long and short of it is that we don't know what may be causing my discomfort, but Scott believes it could be several things. It could be shingles or it could be the onset of neuropothy or it could be something else. I got the sense that Scott is inclined to think it may be the start of neuropathy, but he has not ruled anything out.

Shingles (the chicken pox virus) would make sense. It is common for cancer patients to develop shingles because of a run down immune system. If you have had chicken pox as a kid (and I did) the virus lays dormant in your body. Most people don't get chickenpox a second time. However, anyone who has had chicken pox has the potential to develop shingles, because after recovery from chickenpox, the virus settles in the nerve roots. According to an article on shingles that I found "at risk for shingles are people with leukemia, lymphoma, or Hodgkin's disease, and those whose immune systems have been weakened because they are HIV-positive, or have undergone chemotherapy, radiation, transplant surgery with immunosuppression, or treatment with corticosteroids." The later category would apply to me. In fact, I put out on the Lung Cancer Alliance Survivor Website a description of my symptoms and someone came back to me almost immediately and said it could be shingles. I guess shingles is fairly common among cancer patients. We don't know that this is what I have, but it is possible. From what I have read, shingles is no picnic and can become serious, depending on what nerves the virus attacks. Scott has given me a prescription of Valtrex (an anti-viral), which I will take three times a day for the next seven days. If it is shingles, the Valtrex should give me some relief.

The other possibility is neuropothy. This is perhaps more common and why Scott seemed more inclined toward this possibility. I have not been able to discern much about neuropathy, other than that it is very common is chemo patients. Neuropathy is characterized by sensations of pain, tingling, burning, numbness, or weakness that usually begin in the hands or feet. It can be caused by certain illnesses, for example, diabetes. It can also be a side effect of treatment with platinum-based chemotherapy drugs. The MD Andersen Cancer Center is currently doing clinical trials on how to treat patients with neuropathy, which is an indication of just how common this side effect is. Scott has also prescribed a drug for me called Lyrica, which is an anti-seisure medication often used for patients with fibromyalgia or diabetic nerve pain (DNP). Lyrica is also used for nerve pain after shingles.

Chemotherapy-induced peripheral neuropathy can be either acute or chronic. Acute peripheral neuropathy may begin during or shortly after administration of a platinum-containing drug and usually goes away on its own after several days. Chronic peripheral neuropathy may arise weeks or months after chemotherapy treatment and may be very difficult to treat; in some patients, it may be irreversible. Let's hope that is NOT what I have...I think I would rather have shingles!

Tomorrow I go to a new ENT (Dr Moss); Wedesday I go for an audiology exam (Dr Walden); Thursday I see Dave Rice and Friday I see Dr Lunin... Sometime in between all these doctor visits I may find time to work!