I took another dose of Lasix and potassium yesterday. I think these last 2 doses did reduce the swelling in my left hand, but it's still not entirely gone. It's like a residual puffiness that just won't go away.
I don't think I'll take Lasix again unless my symptoms relapse. Right now, it's just a little swelling in my left hand. I still wake up with "tightness" in my fingers (my joints feel tight when making a fist), plus mild numbness and tingling in both hands. The bulk of it goes away after getting up and moving around, and everything improves during the day, but a mild tingliness persists, and just my fingertips feel numb. Occasionally, I get shooting nerve sensations (not painful) when using my hands. Also, my thumbs feel a little achy. And my left hand is worse than the right.
So today I went in for my monthly Lupron shot. Got my vitals taken, got settled in a bay, then had a bit of a wait. My regular infusion nurse wasn't there, and I was seen by my original oncology nurse. The shot itself took only a minute, but we spent quite a bit of time going over my numb and tingly hands.
I told her how frustrating it has been not being able to identify a primary source for all the symptoms, which means not knowing how best to approach the problem. I think I definitely had pinched nerves from swelling, because reducing the swelling (with Lasix) did help a lot. But why was I swollen in the first place, and how can I eliminate the swelling completely? Or would that be impossible, because it's a side effect as long as I'm on Lupron? Could the remaining numbness and tingling actually be a completely different issue, like carpal tunnel syndrome from the exemestane? Or are they related to nerve-regeneration from my DMX? Could the tightness in my fingers be joint pain from the exemestane? I wish I could know if I'm getting symptoms from a problem that can be addressed and fixed, or if I'm having side effects from medication or surgery that might just go away in time, or won't go away and need to be managed.
In March I have appointments scheduled with both my medical oncologist and my Breast Center NP. Hopefully one or both of them will have some insights. If not, my nurse said it might help to see a hand specialist, like an orthopedist or neurologist. I really hope it doesn't come to that.
I also saw my physical therapist today. Regarding my hands, she said that chemo-induced peripheral neuropathy sometimes feels like numbness in just the fingertips. I didn't have neuropathy in my fingers during chemo, but she said sometimes side effects can be delayed and appear even after chemo ends. Well, that certainly was true about my hair, the way I lost my eyebrows about a month after chemo ended. So, I guess I can add chemo to the list of possible causes.
She worked on my cording and said that if it's not bothering me in any way (not causing pain, not limiting my range of motion), then we can consider the problem resolved, even if the actual cord is still there under the skin. At this point, I can only feel the cord in my right underarm if I go looking for it.
She said I've regained full range of motion. Yay! I'm capable of moving my arms (slowly) any which way, but I still feel a bit of discomfort when driving, and sometimes when I need to reach for something. I should continue with stretching every day (I can feel the difference if I skip a day or two), and can start adding in some strengthening exercises. She gave me a modified plank exercise, using a counter-height surface, to add to my regimen.
Last week she was at a conference for cancer-related physical therapy, and she said she learned a lot about deep breathing, which involves breathing through the diaphram and belly. She said deep breathing can help move lymphatic fluid, which might help with the swelling, which in turn could help with the nerve-related symptoms. She instructed me on how to do deep breathing, gave me a new exercise, and also suggested adding deep breathing to my stretches. Apparently, deep breathing can also help with stress and anxiety, so maybe there will be lots of benefits.
Looking ahead, she scheduled my next appointment for a month from now, which actually made me feel a little nervous. Of course the goal is to be in good enough health to be released from all these medical appointments. But I have gotten so used to going to the Cancer Center that not going as often feels like a big transition. Even when I stopped chemo, I still came in almost every week for physical therapy. Without these weekly physical therapy appointments, there is no automatic time set aside for me to check in with a medical professional about how I'm doing. I feel kind of like a baby bird, not quite ready to leave the nest. My physical therapist was very reassuring, saying these feelings are normal, and she sees it all the time. She said if the cording comes back, or if my existing symptoms get worse, or if I'm concerned about anything new, all I have to do is call and set up an appointment. Well, when she put it like that, it sounds perfectly reasonable and doable.
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