Two Summers of Eating Sand:
Chemo, Nausea, and Nutrition
A satisfying meal constitutes one of life’s most reliable pleasures, something most of us experience and take for granted on a daily basis. Chemo abducted my sense of taste and turned eating into a chore. A low-level, chronic nausea and sour stomach eroded my appetite, and as soon as I took a bite I didn’t want it anymore. At the time of my first diagnosis, a childhood friend and fellow survivor warned me not to eat my favorite foods during chemo because it would forever kill my desire for them. Wise words.
Chemo saves lives but paradoxically steals life’s essentials, almost as if its mission is to strip us down to our structural studs. Stranded in a taste desert for months on end, we cannot traverse its forsaken wilderness without paying a toll; the ransom it demands in exchange for its life enhancing qualities. Even as it offers our best hope of a return to health, it will peel away much of what delivers contentment in daily life, often with interest, as some side effects may linger for years.`
I never vomited during chemo and rarely felt nauseous as the drugs streamed in through the port. Every infusion began with pre-meds delivered directly into the port, which significantly reduced nausea when the heavy hitter chemo drugs came aboard. Still, at some cellular level that the medication couldn’t reach, my body registered queasiness and paired it with the experience of chemo infusion. The association remains firmly in place more than five years later.
In the days following a chemo treatment, insidious seeds of distaste would creep into awareness. During an early infusion of Adriamycin and Cytoxan, infamously known as the “Red Devil,” I savored a pink Starbucks drink and a bag of potato chips. Although they tasted delicious and lacked any immediate, negative reaction, I can no longer tolerate the thought of either one. Sometimes, I wish I would have loaded up on donuts, cookies and pizza during chemo because I’d be cured of any cravings for those unhealthy treats.
Compared to foodies who discern the nuance of every spice immersed in a dish, I didn’t have far to fall. Long before cancer, I noticed that my taste-buds lacked sensitivity and concluded that I was born that way. Chemo took it down a notch, dulling any sensation of taste, as if all meals were covered in a fine layer of sand. If taste equated to color, chemo drained the rainbow, leaving only ash-gray on the plate. My appetite remained sufficiently healthy and I wanted to eat, but nothing evoked interest, including my favorite Trader Joe’s chocolate bars and daily coffee. Before cancer, I treasured my morning routine at the office. I’d check emails, bask in the sunlight blazing through my east-facing window, and sip a coffee bursting with extra cream. During chemo, the mere thought of coffee turned my stomach, eliminating that pleasure for the better part of a year.
As the months wore on, I continued eating regular meals because I needed nutrients but found limited satisfaction. A friend prepared a kale and sausage soup that blasted through the sand barrier, offering genuine enjoyment. But generally, I wandered in a tastebud wasteland and found myself looking for distractions to help get food down. A few weeks in, the Red Devil generated a metallic tang that left me feeling like I was eating forks. I attempted to evade nausea by reading the newspaper or a book during meals.
It worked because I didn’t lose weight during chemo, something the oncology team usually wants to avoid. Cancer patients need their strength to withstand the rigors of treatment, which for me included moving onto surgery and radiation after chemo. Prior to the regular use of nausea-reducing medications, chemo typically resulted in the loss of copious amounts of weight. This is no longer the norm.
Across two cancer diagnoses and 36 rounds of chemo that spanned two summers, I often felt like I was eating a beach one spoonful at a time. No amount of seasoning could perk up the flavor or generate interest in eating. My taste buds went silent.
Almost like magic, the full rainbow of taste suddenly reappeared. A few weeks following my final infusion, my friends and I cozied up at an elegant afternoon tea; the gentle light of early fall casting a glow about the room. Amid the trays and teapots clustered on the table, I found myself reaching for seconds of the accompanying delicacies. Heaven’s gates had opened, bestowing clotted cream and scones, marmalade and jam, miniature cucumber sandwiches and smoked salmon. Exquisite desserts gleamed like jewels; the sweetness of life oozing from every bite. I couldn’t hold back the tears. Pure delight poured in like sunshine after months of gray days. The attentive staff shared in our thrill and sent us home with treasure boxes; neatly-packed leftovers that kept the party going for several days. I count that mini-banquet as among the most memorable meals of my life, a delectable slice of elation that being alive can bestow
Chemotherapy regimen for first diagnosis:
● Adriamycin, Cytoxan (Red Devil): 4 rounds
● Taxol (Paclitaxel): 12 rounds
Chemotherapy regimen for the second diagnosis:
● Abraxane: 12 rounds
● CMF (Cyclophosphamide, Methotrexate, Fluorouracil AKA 5FU): 8 rounds
Chemo-related side effects are discussed in a separate piece, titled, “Don’t leave home without immodium and extra underwear: Chemo Rules”