Sunday, April 29, 2007

Wait, what was I going to say again?

At long last, someone is finally willing to admit that chemo can make a smart person act kind of dumb. Here I was thinking that I might have a vata imbalance - you know, airy, spacey, flighty, forgetful - or maybe even a touch of Adult A.D.D., when really, it's just the lingering effects of chemo, also known as "Chemo Brain". According to this article in the New York Times, some 15 percent of patients who had been treated for cancer with chemotherapy never fully regain all of their faculties, even years later.

See, now that barely even made sense. Let me back up a moment. Many chemo patients experience some level of cognitive dysfunction while they are ON chemo. This cognitive dysfunction can feel a bit like senility - cracking an egg onto a plate instead of into a frying pan, driving away from a parking garage with the rear door open, looking for your cell phone while in the middle of talking on it. I did all of those things. And it was embarassing, and it was disconcerting. At no time did I think that it was anything serious like a brain tumor/metastasis, even though the airy/spacey/forgetful stuff was accompanied by other even more potentially scary neurological symptoms, like the unexplained and uncontrollable shuddering that I used to experience at times, or the full-body jerking I used to experience right before falling asleep (akin to what many people experience right before falling asleep, except that it would happen 10 or more times in a period of five minutes). I guess it was some pretty hefty AND healthy denial that kept me from worrying about it.

And it was a slippery slope of getting used to the symptoms that kept me from worrying over time that my chemo brain wasn't significantly improving. I've shied away from going back to work in the law not only because I find the notion of working as a lawyer so distasteful now, but also, and quite significantly because I don't think my brain could handle the multitasking that being a lawyer requires, and I KNOW that my brain couldn't handle being required to concentrate for such long periods of time as being a lawyer requires.

Back in the summer of 2006, I was called upon by my insurance company to defend my chemo brain. How could I still be experiencing chemo brain three years after completing chemo? How was it possible, they wondered. WAS it possible, they wondered. And so, they put me through a battery of tests, two days' worth of tests, I think, although, haha, I can't exactly remember. No, seriously, I really can't remember. I do remember crying to the psychologist who made me sit through these tests that I couldn't take anymore testing and begging her to let me walk around the block for a few minutes. And I do remember suggesting to her that perhaps there just aren't enough clinical studies out there on the cognitive effects of chemo on YOUNG women who survive their cancer, or particularly, YOUNG women who not only did a course of chemo but also were put through sudden and irreversible menopause, thus depriving their bodies of estrogen, which is a hormone associatd with cognitive function (think of the image of the doddering old woman, frail, bent over from osteoporosis; what you're seeing is the effects of estrogen deprivation, and yes, men have estrogen in their bodies, unless, of course they have had hormonal treatment for, say prostate cancer, in which case, they too might experience cognitive problems...as described in another article I read recently in the New York Times...unfortunately, I cannot remember what section it was in or even in which month the article appeared...I rest my case).

But anyway, FINALLY!!! FINALLY it's there in black and white:

"About 15 percent, or roughly 360,000 of the nation's 2.4 million female breast cancer survivors, the group that has dominated research on cognitive side effects, remain distracted years later, according to some experts. And nobody knows what distinguishes this 15 percent.

Most oncologists agree that the culprits include very high doses of chemotherapy, like those in anticipation of a bone marrow transplant; the combination of chemotherapy and supplementary hormonal treatments, like tamoxifen or aromatase inhibitors that lower the amount of estrogen in women who have cancers fueled by female hormones; and early-onset cancer that catapults women in their 30s and 40s into menopause."


Incidentally, I never heard from insurance company again about my cognitive issues after they received the report from the psychologist who tested me. And anyone who knows me will attest to the fact that I can NEVER purposely perform poorly on any test. I really tried to repeat those number sequences. I really tried to remember what I saw in the little drawings. I really tried to answer whatever other questions the test posed, questions which, predictably, I cannot friggin remember. But I guess I didn't do such a good job. I try not to beat myself up about it. It is what it is.

And I try to look on the bright side. Apart from the obvious, there is this: a bad memory can do wonders to help you forget bad memories. I have become an incredibly forgiving person, and I am sure it's not just the yoga. A large part of it is that I often tend to simply forget things that I don't try really hard to remember.

And on that note, um.....

YC

1 comment:

sally said...

Hi YC,

Yes, I have heard of this too - in fact, here in Oz U heard a podcast which was all about this topic. The transcript and all the info is here:
http://www.abc.net.au/rn/allinthemind/stories/2007/1841207.htm
It was really interesting show, and might resonate with your experiences...

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About Me

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Northern Westchester, New York, United States
I live by a duck pond. I used to live by the East River. I don't work. I used to work a lot. Now, not so much. I used to teach a lot of yoga. Now not so much. I still practice a lot of yoga though. A LOT. I love my kids, being outdoors, taking photos, reading magazines, writing and stirring the pot. Enjoy responsibly.

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