In a few days, I will begin a new phase of chemotherapy. Halfway through my chemo treatments, the medicine is being changed to a new concoction for the remaining three cycles of infusions.

The new chemo drug is Taxotere (or Docetaxel), which was originally produced from the needles of the European yew tree and is now created in laboratories. “Taxotere Tuesday” will see me undergo treatment with this new drug. As with other chemo cocktails, this one will likely produce some side effects.

It starts off differently than the chemo of my first three treatments. With Taxotere, I will be taking steroid drugs a day ahead of time to minimize side effects, which include allergic reactions to the chemo drugs and nausea. But unlike the first round of chemo (“FEC”--Fluorouracil-Epirubicin and Cyclophosphamide), this new drug is supposed to have less nausea associated with it.

The downside is that Taxotere has the potential to affect finger and toe nails. I could lose nails, or may experience numbness, tingling, and burning in fingers and toes. It may even change how I walk. Part of my treatment will result in having ice packs placed on my hands and feet to try and minimize these side effects.

Other side effects may include fluid retention, hair loss, and the ever-present chemo fatigue. Taxotere also has the potential to create muscle or joint pain within a few days of treatment.

I can’t use Aspirin or Advil for pain relief due to blood thinners, so Tylenol is the usual drug of choice to alleviate pain. For me, taking Tylenol or Tylenol 3’s is akin to swallowing Smarties-they don’t work. To manage pain, I have been prescribed a narcotic painkiller to have on hand if needed.

My doctor warned me that I would need to fill the prescription within three days of issue otherwise it would be void. As I understand it, this requirement has something to do with controls on issuing of narcotics, which also resulted in me having to sign off on receiving my prescription when it was picked up. The pharmacist that filled the prescription advised that I will be quite dopey with the drug and that I should not drive while using it. It will be interesting to see how my body reacts with this drug when added to compounding chemo fatigue.

The chemo fatigue phenomenon still puzzles me. After nine weeks of treatment, I continue to learn and listen to the fatigue signals in my body. With chemo, there is an undercurrent of fatigue that is always present. You learn to live with being tired, otherwise you would never do anything or have a sense of normalcy in your life.

However, it is a different kind of tiredness than when I’ve been healthy. My experience with chemo fatigue has had fewer warning signs when my body is getting more tired vs. feeling tired when I have been healthy. It’s only after I have done too much in the course of a day that I recognize what chemo fatigue feels like. After a few episodes of doing too much, I am now starting to read the chemo fatigue signals more readily.

These days, my activities are lessening because of the fatigue. The only major activities I may do in a day is a handful of laundry, grocery shop, or prepare dinner. When doing any activities such as these, I get tired more easily and have to rest when they’re done. After dinner visits with family and friends have to end by 9 p.m. as that’s when my body starts powering down rather quickly.

As anyone who knows me will attest, I tend to have a lot of energy and a reputation of carrying on “non-stop” for hours at work and at home. With treatment, I struggle with how little I am able to do each day because of chemo fatigue. I often wonder about the times when I was well and how much I did in a day. I got up early each morning, multi-tasked in a demanding job all day long at work, fit in lunch hour exercise three times a week, and ran a household. I can’t even imagine maintaining this kind of schedule now.

I’m also still learning about other less mentioned side effects of chemo from members of my cancer care treatment team. One of them recently told me that the chemo steroids can affect one’s body in ways other than weight gain and fluid retention. They can make you restless (“More restless than normal?” my husband queried) and they can affect your overnight sleep. Its fairly common with chemo steroids to only get a solid block of three hours of overnight sleep and then fall in and out of sleep until morning. My poor sleeping habits are now starting to make sense because of the effects of chemo.

The chemo journey continues and enters a new phase this coming week. Like with the first three cycles, I say “bring it on.” I will continue to fight cancer with Strength, Courage, and Determination.