Almost immediately after hitting the publish button on last week’s post I started getting that upper right sided abdominal pain again and by the time I left work for home was chilling.  My temperature went up to an even 102 by the time I went to sleep.  I have had fever every day since then until yesterday.  While this makes me feel much less than fair for a few hours every day, I think this is a good thing.  The fever and abdominal pain started on exactly the same cycle day as it did last cycle.  I talked to my oncologist and told him he could collect cultures and counts, but no antibiotics, no IV fluids and no hospital.  Why?  I think this is the Alimta working and causing tumor necrosis, which releases all kinds of nasty chemicals that do all kinds of nasty things.  Tumor necrosis factor alpha, specifically, causes fever and what’s call anorexia-cachexia syndrome.  Basically no appetite and weight loss.  I certainly have the fever and I have both no appetite and early satiety so that I feel full after only a few bites.  But only during cycle days 9-16.  Exactly the same during the last two cycles.  I don’t remember it happening this clearly with the first cycle, but I was miserable and on fairly good doses of Ibuprofen (which suppresses fever and takes away my abdominal pain) due to the radiation pharyngitis that was still bothering me.

Once again, my oncologist and I are not in quite the same place.  I called my personal friend who is also an oncologist last Wednesday evening because my guy was not on call and I did not want to be sent to the emergency department or hospitalized by the on call doctor who doesn’t know me.  My friend agreed with me about my interpretation about what the symptoms mean.  I did see my doctor last Thursday for cultures and counts - all of which are fine.  I called him Monday to check the culture results and update him on the fever.  He asked me if I wanted to stop the Alimta due to the fevers.  I have managed to control/time the fever and abdominal pain with alternating Ibuprofen/Acetaminophen so that it is usually late afternoon/evening when I am burrowed under seven layers in my bed so I have been able to work this time and had a wonderful weekend at Canyon Ranch with my daughter.  So my thought is that, no, I don’t want to stop the Alimta.  If these symptoms are from tumor necrosis factor released by tumor necrosis caused by Alimta I really don’t want to quit.  I know they could be from progressing tumor all by itself, but the timing related to Alimta makes me think that’s not the case and the chest CT angiogram done on January 30th doesn’t suggest wild, out of control growth.  So we agreed on one more cycle and then another scan.

This is feeling bad that I can get behind if it’s because the Alimta is working and working well.  So I’m imaging cancer cell apoptosis, taking medicines to ease the symptoms and putting one foot in front of the other.  Hope with me that all of this is my cancer having a temper tantrum because it’s getting beaten into submission.