I am writing directly today to pass along a bit of information. One of the reasons chemotherapy agents affect memory and learning ability is because our brains constantly produce new neuronal tissue. When we are exposed to anything novel or challenging the hippocampus and limbic systems (the areas that also regulate our general mood/motivation/energy/attention) go into production mode and create new synapses and cells to adapt to the new stimulus coming in. Thus the value of taking on new jobs, tasks, hobbies, languages, etc throughout our lives.
However, these new cells are only transient in nature because the brain keeps what is pertinent and useful to our lives. Not much more. We need to persist in our exposure to the new to cement the gains. Additionally, we must get good sleep, nutrition and exercise so that the machinery of cell creation in the brain is well oiled and efficient. Bad habits...drinking, probably hypnotics (like prescribed sleep medications eg Ambien, Lunesta, Sonata, Restoril, etc) irregular sleep and even worse behavior can wash away or, at least, sharply reduce the brains capacity to learn and adapt.
Many Chemotherapy agents work by killing cells that are rapidly dividing IE being born. Thus, the process of memory creation and neuronal adaptation in the brain are arrested with every treatment Mother gets.
Sigh...everything has a price. Some prices we pay are considerable.
The effects of Mother's ongoing chemotherapy treatments, in various forms, accounts for her "chemobrain". Her recent confusional state was something more and mostly unrelated. The opiates used for pain control are a double edged sword as is chemo. But these agents can act more to scramble the coordinated flow of neurochemical reactions in the brain in a more widespread fashion if the dose is too high. Result: varying degrees of delirium*
Dr. Muldoon, just to be on the safe side, is looking into mother's brain via scans to be certain that her cancer has not spread to the brain. He actually believes this to be unlikely but better safe...
I was not present for his conversation with Mother last Monday but her reproduction of its contents seems plausible. In other words, I think her memory was a better than usual and there was no evidence of any lingering confusional state now that her mediation dosing has been reduced. Also great news is that her pain has not returned on the lower dose of fentanyl (the pain patch) and stopping the oral pain medications. Her appetite is better as well.
All of us can only hope that the Gemzar she is now on is truly having more impact than former treatments. Reading the tea leaves and assuming Mother's memory of her conversation with Dr. Muldoon is accurate he really thinks this is the case and is not giving a doctor's usual reassuring murmurings.
I am delighted that more order has been brought to the problem of organization and consistancy in Mom and Dad's medications. This issue just had to be dealt with and that appears to be what has happened. The St. Joseph's Home Health Care program gives early evidence of being efficient, thorough and offers a wide-range of services. A rarity in our medical system today. Mother has struck it very lucky, indeed with the excellent quality of her doctors and the ancillary services they have recommended to her.
Of course, she is such a charmer she could get a King Cobra to give her a kiss and run errands for her.
I will be out there again very soon and then Janet to follow me. Dad wants us to stagger our visits. Mother mentioned the stress of paying bills which, I agree, should be removed from her shoulders. If I had her ongoing problems in concentration and memory would be very daunted at trying to carry out something so important. Dad could, of course, do this but he does have quite a bit on his plate and Mother has, historically, always done this task so he does not have the habits in place to take care of it well right now.
Mother constantly talks about how very considerate, thoughtful and concerned Dad is. I have certainly noticed this on my visits as well. Cudos to the great man!
Sorry that I have not had the opportunity to speak with Mother yet to day so that I could gather up some of her wonderfully droll comments and observations to further embellish and render onto the page here.
Jeff
* Delirium: http://en.wikipedia.org/wiki/Delirium
An article you might like the development of cancer treatments over the last few decades appeared in the Health Section of the New York Times yesterday. You may find it of interest?
1 comment:
Interesting. I did not know most of this.
Ileana
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