The Challenges of Taking Xeloda

Xeloda is an interesting drug..it is given in tablet form and the patient takes it at home...twice a day, with meals.

Back when I was researching this, I thought that it was probable that although it is much easier for the patient (you don't have to drive to a chemo center, sit and wait to be called in, then sit and wait for the IV to deliver the chemo), it is also easy for the patient to make mistakes in taking the drug.

For instance, one thing I noticed is that although all the manufacturer's information say to take the drug within 30 minutes of completing a meal, some of the women taking it have waited for an hour afterward to take it.  This is problematic because the drug is metabolized and if it isn't taken with a meal and plenty of water, it isn't likely to do what it is supposed to.

In addition, it is easy to forget to take it after your meal...I have had guests and I've forgotten to take the tablets with me when we went out to dinner.  Even after they were gone, I forgot tonight to take them, and then had to eat something else in order to take the tablet.  If I gain weight with this, it won't be because of any steroids, rather that I am eating when I am not hungry in order to take the pills appropriately.

The last thing which happened is that I thought I understood the directions on how to take it.  I was told to take 2,000 mg twice a day within 30 minutes of eating.  Well....for the first session (two weeks) I took a total of  4 pills, when I was supposed to be taking four pills in the morning, and four in the afternoon.  I realize that it is possible for mistakes to be made in dosing when one is getting an IV, but I suspect that this kind of mistake (either taking too low a dose or missing a dose) is far more prevalent when taking drugs at home.

I'm not sure what the answer is for this...You'd think having a huge pill box with 7 days worth of "slots" with "AM" and "PM" on it would jar my memory...in fact, I set the box in front of me tonight with dinner....and promptly forgot to take them.  Thank goodness for apple pie. :)

So, double check your prescriptions and make sure that you are taking the appropriate amount....at least I took my medicine....even if it was only a half dose.

Holding on and watering our gardens

Recently, a friend of mine told me about an essay which Alice Walker (the author of The Color Purple) wrote.  He thought of me largely because of quilts and gardens.  Yet, as so often happens, when I read it I see something which applies to life in general and to the live of someone living with Stage IV cancer in particular.

In her essay, "In Search of our Mother's Gardens: The Creativity of Black women in the South (1974), Ms. Walker writes this:

Like Mem, a character in The Third Life of Grange Copeland, my mother adorned with flowers whatever shabby house we were forced to live in. And not just your typical straggly country stand of zinnias, either. She planted ambitious gardens - and still does - with over 50 different varieties of plants that bloom profusely from early March until late November. Before she left home for the fields, she watered her flowers, chopped up the grass, and laid out new beds. When she returned from the fields she might divide clumps of bulbs, dig a cold pit, uproot and replant roses, or prune branches from her taller bushes or trees - until it was too dark to see.

Whatever she planted grew as if by magic, and her fame as a grower of flowers spread over three counties. Because of her creativity with her flowers, even my memories of poverty are seen through a screen of blooms - sunflowers, petunias, roses, dahlias, forsythia, spirea, delphiniums, verbena . . . and on and on.

And I remember people coming to my mother's yard to be given cuttings from her flowers; I hear again the praise showered on her because whatever rocky soil she landed on, she turned into a garden. A garden so brilliant with colors, so original in its design, so magnificent with life and creativity, that to this day people drive by our house in Georgia - perfect strangers and imperfect strangers - and ask to stand or walk among my mother's art.

I notice that it is only when my mother is working in her flowers that she is radiant, almost to the point of being invisible except as Creator: hand and eye. She is involved in work her soul must have. Ordering the universe in the image of her personal conception of Beauty.

Her face, as she prepares the Art that is her gift, is a legacy of respect she leaves to me, for all that illuminates and cherishes life. She had handed down respect for the possibilities - and the will to grasp them.

I know that Ms. Walker is writing about the particular trials and struggles of black women living in the south, but I would offer that in many cases the same could be said about other struggles which are peculiar to the human form.  In particular, what she writes resonates with me as I struggle through cancer and the general lack of understanding what it means and the knowledge that my body is slowly failing me as I fight my own cells gone awry with toxic drugs.  

We all have to have respect for the possibilities, and tend our gardens passing on what we can...sharing and giving...no matter if our "garden" is the ability to make good meals,  paint a picture, frame a house, or write a letter.  We all have burdens and struggles, but there is so much more than that.   We are so much more than that.

I would encourage you to read the whole essay as it appeared in Ms. Magazine in Spring of 2002.  Here's the link

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     Sometimes I am amused by how my battle with cancer changes my perspective.  I recently finished a novel, An Echo in the Bone by Diana Gabaldon.  Sometimes I'm embarrassed to admit that I read her, although I do have to say that her writing has improved over the years..and they have always been a good romp even if a bit light....

However, I thought I'd share this with you...I suspect that it reflects Ms. Gabaldon's viewpoints on the topic....The conversation is between Claire Beauchamp Fraser (a time traveler from the 20th century who was trained as a surgeon in the 20th century and continues to practice her craft in the eighteenth century after traveling through time) and Benedict Arnold (who was an apothecary in New Haven, CT prior to becoming the revolutionary war figure and eventual traitor).  Claire begins this conversation begun about a bottle of laudanum, an opiate available in the 18th. century):

"...But relief of pain is one of the more important things I can offer some of the people who come to me--God knows I can't offer many of them cure."
     His brows went up at that.  "That's a rather remarkable statement.  Most persons in your profession seem to promise cure to nearly everyone."
     "How does that saying go? If wishes were horses, beggars might ride;?" I smiled, but without much humor.  "Everyone wants a cure, and certainly there's no physician who doesn't want to give them one.  But there ar a lot of things beyond the power of any physician, and while you might not tell a patient that, it's as well to know your own limits."

"You think so?"  He tilted his head, regarding me curiously. "Do you not think that the admission of such limits, a priori--and I do not mean only in the medical way but in any arena of endeavor--that such an admission in itself establishes limits:  That is, might that expectation prevent one from accopmlishing all that is possible, because one assumes that something is not possible and therefore does not strive with all one's power to achieve it?"

I blinked at him, rather surprised.

"Well....yes," I said slowly.  "If you put it that way, I'd rather think I agree with you.  After all"--I waved a hand toward the ten flap, indicating the surrounding army--"if I didn't--we didn't--believe that one can accomplish things beyond all reasonable expectation, would my husband and I be here?" (serving on the American side in the Revolutionary War).


(Diana Gabaldon, An Echo in the Bone. New York: Delacorte Press, an imprint of the Random House Publishing Group, 2009.  ISBN:  978-0-440-338871).  Page 565.

So, yes....do what we can to alleviate pain, but don't sell yourself short.  Much in the world cannot be explained...including the tenacity that some of us have to hold onto life and to persevere even though the odds seem against us.  Each day is our own...each day we can chose to look backwards, or forwards with worry...instead, the trick is to claim each day unto itself and make the best of it that we can....living every moment with whatever gusto we can muster.