Fairly productive for a while yesterday, and a good GI day by my current standards, but most of what happened yesterday was swept aside by pain.
Neulasta is a drug given to me (at $7,000 per dose, retail price) the Monday after each chemotherapy session to bolster my immune system. The reason I had to delay a chemo session last month was because we’d omitted the Neulasta in hopes of spreading it out to every other session. We all know how that turned out. This stuff works.
I’m not clear on the pharmacological mechanism of Neulasta, but basically it gooses the bone marrow. One known side effect of Neulasta is so-called “Neulasta hips”, pain in the hips that occurs some days after the injection. The hips, pelvis and thighs are the largest concentrations of bone marrow, so whatever Neulasta is doing, it’s doing the most of it there.
Frankly, they may as well call it “Neulasta inquisition”. Or “Neulasta red hot poker up the ass”. Because calling it “Neulasta hips” makes this pain sound kind of cheery and cute. A minor affliction, on a par with a regrettable spread of acne across an adult face.
This was pain on a level I’ve rarely felt outside of surgical recovery or ER-grade trauma. Much, much worse than prior Neulasta cycles. It begins as an sharp ache in the lower back and hips. The ache is positional, and if I remain fairly still, doesn’t bother me much. This feels a bit like a combination of osteoarthritis and classic lower back pain.
Yesterday evening I passed beyond that. The back-and-hips ache flared to a 6 or 7 on the pain scale. The muscles across my lower back spasmed continually. My thighs felt as if they’d been beaten with a broomstick. I got sympathetic pains in my biceps, as if a very strong person were clamping their hands on my arms. I was both sweaty and chilled, and experienced a headache as well as pain-induced nausea. It didn’t matter what position I sat or lay in, or how still I held myself, this pain pulsed through my body over and over and over. The pain was so overwhelming I could not read, could barely think, and kept weeping and moaning from the intensity. At one point my lower GI insisted on a trip to the toilet. You can imagine the sensation of passing stool while all this is going on. Two Tylenol Extra Strength didn’t even begin to touch it. I went to bed, but of course could not sleep for the pain.
After about two hours of this, it faded sufficiently for me to fall into an uneasy, difficult sleep.
Oddly, pain is rarely a feature of my cancer experience. I’ve never had any pain at all from the disease directly. With the exception of the drug-mediated post-operative environment, the treatments have produced all manner of sensations and difficulties, but never pain.
Except for this. Neulasta hurt me so much yesterday it was frightening. I have five more of these to look forward to. Skipping Neulasta is not an option, as my immune system crashes out. I need this to stay fit for chemo. But good God, it hurt. Pain, crying, please-I’ll-do-anything-you-say-just-sto