Friday, November 12, 2010

Back To My Oar

The short version of this story is that I managed to survive my first two weeks back at work.

I work on the same product development team as before the onset of my illness, which has both comforting and disorienting aspects to it. On one hand, I'm familiar with much of what's going on; on the other hand, it's as if I have been suddenly transported forward in time about 18 months. Fortunately, the team is approaching the end of a product release cycle, so I'm engaged in such low-pressure activities as reviewing documents vs. software code, which allows me to reacquaint myself with the various software tools, without having to use them to actually create anything new at this point.

Going in, there are two open questions in my mind about my ability to do this. The first relates to the simple requirement that I remain more or less stationary for eight or more hours a day, usually in a sitting position. This involves pressures on ribs and spine that, eventually, begin to bother me, giving rise to the desire to stretch out in a prone position. Since I work at home there is no problem with this logistically; but, to get anything done, the bottom line is that I need to be able to somehow piece together a number of sufficiently lengthy work periods, with hands actually on keyboard. The lie-downs stretch out the work day. So far, this does not seem to be much of a problem, but it's way too early in the game to tell.

The second concern revolves around the question of "chemo brain". Almost since the day chemotherapies were first introduced, patients have complained of a variety of neurological side effects, generally adding up to a sort of mental fog, an inability to focus or concentrate. Historically, the medical community has tended to soft-pedal such complaints as psychosomatic, or in any case as dominated by the benefits of said therapies. The blood-brain barrier, it was thought, prevented the chemotherapeutic agents from affecting the brain much. But over time, the anecdotal evidence apparently accumulated to an extent that required attention from the research community. So far, the research tends to confirm that chemo brain is real, but may be a result of some combination of chemotherapies, of the cancers themselves (the latter possibility arises from the fact that even cancer patients who have been treated only by means not involving chemotherapy can exhibit the symptoms), or simply of the stresses induced by the fact that the patients have life-threatening diseases that make them feel real bad, and have to take drugs that make them feel even worse.

At the time of my stem cell transplant, and for some time thereafter, I could claim some chemo brain-like symptoms; I could stare into space with the best of them. I tend to think, though, that in my case a lack of mental stimuli, chronic exhaustion, and feeling just plain awful much of the time, were mostly to blame. As I have recovered, I have noticed the episodes that could be characterized as instances of chemo brain diminish in number, duration, and intensity. Again, although it's too early to tell for sure, I'm so far unable to detect any diminution in my ability to marshall the brain cells for the work at hand. Shoot, I may even be smarter. No, probably not.