i'm on drugs

someone i know visited the primary care physician yesterday. said physician poked and prodded, questioned and answered, and by the end of the outing, a prescription for antibiotics was in hand and little more was known about the reasons behind the sore throat and cough that has been plaguing the patient for a couple of weeks. "simply wondering what this is has cost me $40 today," said patient. it is true; sometimes doctors hand out scripts like they are going out of style. and visiting the doc is no small matter - it is time consuming, exposes you to all sorts of nasty bugs, and in the end, they often don't know what it is and give you antibiotics just in case. which will, of course come in really handy when you end up on your back in the hospital follwing some mundane procedure (they're all mundane after you've had lung parts removed, thank you) and wham - you're hit with some nasty antibiotic resistant infection doing your insides in. anyway. time is money, and money is money. it starts to get expensive indeed.

i smiled as i thought about my box of drugs at home. the patient told me maybe it is a good idea for a blog post. so, i have to admit, this isn't completely my idea, but i like it. so here goes, the photographic history of me and some drugs.


i have to admit, this is one of my favorite shots. note the allergy medicine, front and center. for a long time i think we thought this thing going on with me was "allergies". i think i thought the drugs worked, sometimes. i went and got more. i took and took. probably for a year or more. in the background is the robitussin i started taking because when i lied on my back and tried to go to sleep at night, i would cough and cough. it got really annoying. so i would down a couple swigs and it seemed to help. too bad it didn't kill cancer. finally, the cream of the crop, the inhalers - albuterol and advair. oh, if only it had been asthma. at the time it was my worst nightmare coming true. asthma! oh, no! i used them right up until my surgery on 10.24.06. then, i threw them in the growing box o' meds.

ah, my frenemy the zofran, the anti-nausea pro-constipation drug of choice, tops this tower. or the generic equivalent. originally i started out on actual zofran, which rings in at about $30 a pill or something ridiculous like that. of course the insurance covered it a couple of times, along with the emend, another anti-nausea pill i took back in the days of the cisplatin/taxotere chemo cocktail. i think i switched to the generic when my insurance started running a zero-copay program on generics. why not? they do the same thing. which is, stop all stomach-related activity. yes, they keep me from being nauseas. which is really, really nice. it is pretty impressive, in fact, that they can keep me from the nausea but as soon as i wait longer than 10-12 hours to take another one, the nausea sets in and then it is doom! time to puke! you can't let the nausea break through. i've got the zofran down to a science (even avoiding the next side effect... which i couldn't avoid the first time around). but anything i eat in the days following the drugs seems to sit in my stomach and go nowhere. which is really, really not nice.

at the bottom of the pile we have premeds of dexamethasone, a steroid i take before, during, and after chemo to give a little extra umph to my day. i was hoping it would enable my pro cycling career, but alas, it just makes me hungry, which is detrimental to the cycling because of the added pounds. the added pounds are good for my chemo career, though, so i'm not complaining. after three days of taking these pills morning and night i have a horrible sweet taste in my mouth that makes me want to avoid any food that is sweet. i have a huge sweet tooth, though, and when trying to think of what i want to eat when i am in the chemo doldrums, i think i want things like doughnuts or cookies or ice cream... but in reality, i don't, because of the taste from these things. i thought it was the chemo for a long time, but recently the taste has been settling in before the chemo, so it must be these. or, i've trained myself to anticipate it.

these bad boys come in to save the day when zofran is coursing through the system... who knew i'd ever want to talk to someone about my poop? well, it had to happen. because when you can't go, its just... shitty.

they're also helpful with these ones, the big muscles of the pain killing world. 2 mg of hydromorphone followed my initial surgery when i was diagnosed. i forget how often. not surprising that i forget - these are serious. seriousssss. basically all i could do is take one, then sleep. 4 mg hydromorphone plus 600 mg ibuprofen followed the thoracotomy. for weeks. i tried to wean myself off them before actually being told by my doc that it was time to do so. withdrawal is terrifying - night sweats and chills, crazy spinny head events, and then, in my case, the pain. word to the wise from the unwise. ask before you start cutting back. i took my last one in florida in march, more than a month later. and it was because i ran out. that's pretty par for the course - i often forget to refill when necessary. at least it isn't as bad as the discharge nurse after surgery. she sent me home with a prescription for the hydromorphone signed by herself. it is a controlled narcotic and every Rx needs to be issued by a doc with a DEA liscense number. little did we know. the hospital gave me one right before i left. this i remember, i took them every four hours at first. mom left me on the couch and went to the pharmacy to fill the prescription with about two hours to go. they refused to fill it, because it was obviously not correct - it wasn't from my surgeon. so, not knowing what in the world to do, mom went to my pulmonary doctor's office and someone there was able to write an Rx for a few of them - enough to get through the night so the prescription from my surgeon could be fedexed to the pharmacy. pain control fail averted. poor mom. i can only imagine what she was going through, thinking i might be at home, writhing in pain with a tube sticking out. in reality, i was stoned, passed out on the couch. beautiful.

soon it was time for radiation and chemo to begin. with these treatments came heartburn. i wouldn't wish it upon my worst enemy. i tried drug after drug, tums, mylanta, sleeping sitting up, not eating... everything. some combination of everything seemed to work in short bouts for dealing with the heartburn. when it wasn't that, and sometimes even when it was that, the nausea would kick in and thus, the puking.


just as with the heartburn meds, i tried almost everything. the ativan, an anti-anxiety drug really seemed to help the most. it was a tiny dose and if i took it before bed i wouldn't wake up in the middle of the night stricken with the urge to empty my stomach. it was a lifesaver, really, because between the heartburn and the nausea i wasn't getting much rest and i was miserable to be around. plus, i could finally eat some calories. i would take a nap, wake up, drink an ensure plus (extra calories) and eat a package of cheese peanut butter crackers. repeat a couple of times throughout the day. i cannot believe i subsisted like that for weeks. is it any wonder i love food these days?


and finally, the cough medicines. radiation made me cough. then i got a cold on top of it. i coughed without control, to no avail. some meds worked, others didn't. i can't do codiene, so we tried it all with that as the exception. sometimes i wondered whether i would cough for the rest of my life. i guess the answer is yes, but i don't cough nearly as much now as i did back then. it really can drive me nuts. the delsym works the best, but doesn't have that delicious robitussin taste. the prescription drugs in this category did little, if anything, to stop the coughing. they basically just made me feel like my head was in the clouds, which isn't such a bad thing when you're lying on the radiation table. it is a bad thing if you're trying to drive.

so, there you have it. all these bottles of goodness, plus empties i've thrown away, and of course don't forget the bags and bags of chemo and fentanyl following surgery and more chemo... i'm fairly certain my blood is synthetic these days. which might not be a bad thing, if the cancer is kept from moving around... hmmm...

who knows the cost of these goodies?! i've lost count. i never counted, really. hundreds, easy, if you don't include the chemo. then we're talking thousands. hundred thousands, maybe. unreal. which is why i silently rejoice when i have my $40 days of seeing my doc and getting my drugs. kind of like paying rent to live in my body a while longer.