Atypical Multiple Sclerosis

Well the first two months of a twelve month treatment with Cytoxan were unremarkable or so I thought.  After the second treatment, I became extremely dizzy.  Vertigo is a symptom I struggle with and was a presenting symptom.  For several years I struggled to keep my world still.  Now, I take the moment as it comes.  I realize that vertigo is part of my life.  For right now I cannot do anything about it so I live with it.  

Turns out the Zofran (nausea meds) given during the Cytoxan infusion causes dizziness.  Great!  We increased the Meclizine hoping to get the vertigo under control while changing the nausea meds.  The vertigo I dealt with is fully disabling.  I mean make my way to the couch and sit.  If I got up to move it felt like I was walking through an amusement park fun house that spins.  I flew off my feet, crashed into walls, fell to the floor.  This didn’t really help that nauseous feeling.  

We substituted Compazine for Zofran because it was a different class of meds whose side effects didn’t include dizzy.  Interestingly,  Zofran stops the stomach from producing an enzyme that induces vomiting. Why dizziness is a side-effect, I do not know.  Just interesting how Zofran works in your system.

Compazine; however, works in the brain.  It stops the messages from your stomach that says, “Hey, some strange substance in our system!  Quick, vomit!  Get rid of this!”  Again, no dizziness.  Good stuff.  Well, by now you know what’s coming.  Other side-effects. Also gem #4:  When you deal with chemo, or really any hard core meds then it really is about tolerating the side-effects.  I don’t think at this point there is ONE med that doesn’t have some kind of side-effect.

Compazine put me to sleep.  I mean sslleeepppp!  I was barely able to make it to my car so hubby could drive me home.  That third month, the first time I took Compazine, the sleep was not restful.  As I hit a REM cycle, horrible dreams and images woke me.  Not like a regular nightmare, where you sit upright in your bed breathing heavy, WIDE AWAKE, glad you’re awake.  I woke up only to realize it was a dream then off to sleep again.  The nausea was better.  The dizziness wasn’t quite as bad, but still not good.  I was able to move around my house without flying into walls.

The fourth month was even worse.  Not only was I unable to stay awake at all, still plagued by horrible dreams and nightmares, but I felt like my skin was crawling.  I laid in bed wishing I could take off my skin, just for a moment.  And the dizziness, yes still there.  Seems I went from the frying pan to the fire as they say.  Of course, this was only for the four days or so following the infusion.

The fix to this situation.  As it turns out the bladder med they give you during the infusion (once before the bag of Cytoxan and once after-see Cytoxan post) causes dizziness too!  In addition, the side-effects from Compazine was not normal.  So my docs and I decided to discontinue the bladder meds.  Although the official “literature” cites bladder cancer as a possible development with Cytoxan infusions, no one had ever actually developed it at this clinic.  And the docs at this clinic had twenty-five years of experience with Cytoxan.  Good enough for me.  Remember from above it is all about tolerating side-effects.  I took my chances (SPOILER ALERT:  I did not develop bladder cancer).

The nausea was a bit trickier.  Most of the nausea medicine when dealing with Cytoxan cause dizziness. Compazine was bascially in a class by itself.  My treatment became Decadron (steroids) and Ativan (anit-anxiety).  Ativan is used in the short-term for suppressing the central nervous system.  Which is what I needed for the few days following the Cytoxan infusion.  Decadron is used in the short-term to Decadron is also used in the short-term treatment of nausea caused by chemotherapy.  How it does this is not fully understood.

I certainly didn’t fully understand how they would work.  So the fifth month was nerve-racking until about four days later when I began to feel better.  Yes, I vomitted my brains out, spent days and nights praying to the proverbial porcelain god. but I felt better afterwards.  I felt better even when I was vomitting. And the best part: the vertigo stayed under control.  

From treatment five through ten I took Decadron (pill form) during the infusion and at home.  I also took Ativan at home.  My routine was this:  Get up at 5:30 am on the day of the infusion (a Friday).  Get son and hubby up at 6:00 am.  Have coffee – two cups.  Get son breakfast.  Get dressed.  Grab a coffee and breakfast to go.  Leave the house by 7:00 am.  Drop son off at school.  Hubby and I would drive the 1 1/2 hour to clinic.  Register.  Pick out chair in infusion center.  Pee in cup.  Get IV.  One bag fluid for about an hour (after bout 1/2 hour take six Decadrons).  Bag of Cytoxan for about an hour. Vomit. Another bag of fluid for about an hour. Vomit a few times.   Done in only three hours.  Take Ativan.  Walk back to car and drive (hubby drove) the 1 1/2 hour back home stopping a few times to vomit.  Be sick for about four days.  Then take two weeks to recover.  One week to feel better.  One week to prepare for it all over again.