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| 25 years ago, at about this time of year, while anxious over finishing my Ph.D, I found out that I had cancer and was finally at the end of my six cycles of chemotherapy. After a few months of recovery, I was told it was time to start writing my thesis. |
| This entry is about Post-chemotherapy cognitive impairment (PCCI), also known as chemotherapy-induced cognitive dysfunction. Most folks skip that mouthful and just call it chemo brain or chemo fog. At the time I went through it, I did not know it was a thing, but when I read the symptoms of the disorder, I am convinced that I was suffer of this malady. |
| Not long after I finished my treatment, my advisor told me that I had done enough to write my thesis, so I began collect my research notebooks, spectra, published papers, and crystallographic data to write my thesis. During the process of finishing up, I found that I made a large number of poor writing mistakes in terms of organization of the material, style of writing, and word choice. I originally attributed these problems to stress and tiredness. |
| Some examples of my crimes against good scientific prose are my insistence to include scientifically trivial points in my thesis and elaborate them in detail. This is, I believe, a consequence of poor judgement brought about by the chemo brain. I also would write in a manner not consistent with proper scientific usage. I wanted to write a thesis that broke the rules of staid scientific writing and resembled a novel. I see these delusions as silly now, but I the time I thought it was profound. |
| I would have trouble picking the precise word, and the proper scientific word for the given context. This struggle to find the correct way to say things led to my writing becoming simple and repetitive. I would write passages like: |
| "In Figure 3.1 is the spectrum of compound X. The peak in the spectrum at 0.0 is TMS. The spectrum shows three aromatic peaks. The peak at the highest ppm value in the spectrum is the ortho hydrogen. The peak in the spectrum at 20.5 ppm is the para hydrogen. The peak for the meta hydrogen is the peak that occurs at the most negative ppm in the right side of the spectrum. There are no other unassigned peaks in the spectrum." |
| Even if you do not understand the science behind the passage, the stodginess is evident. It reminds me of a passage in 'A Connecticut Yankee in King Arthur's Court' where Mark Twain describes the newspaper account of the results of a jousting tournament. |
| Luckily I hired our group secretary to edit my thesis. She pointed out my mistakes and in essence taught me a lot about writing. It took me about twice as long as it should have to write my thesis, and I delayed my defense several times. Physically during this period I was beginning to recover. My aches became less each day. In a few months my taste came back. When I could enjoy food again, and I made up for lost meals , and then promptly gained 20 pounds in one month. I felt a little stronger as time passed. My hair came back and it was thick and wavy. I was so pleased because I have had limp, thin hair my whole life. Unfortunately the extra body only lasted a few months. I am certainly not making light of the time it takes for the body to heal. I really learned that recovery of health after wracking the body with these toxins in a process, a long process. After a few months (six to eight), on the outside, I was beginning to look healthy, but my ability to make rational decisions and to reason was still impaired for a while. I would say it took about two to three years for my brain to return to approximately the same functioning level as it had before chemo. |
| You can read about chemo brain at the Wikipedia entry at the end of this post. It cites several scientific studies. Doxorubicin (Adriamycin) is one of the drugs that was given to me that is described as having chemo brain as a side effect. From reading this article, I surmised that it is too early to know the exact causes and best treatment for this condition. In my case, I think time was the best cure. |
| So if you go through chemo or know someone who goes through the treatment, discourage them from making major life decision for a period after the treatment ends. Recover and enjoy life for a while before making big commitments. Cognitive problems may be more than stress and fatigue, especially if you were given certain drugs or were given high dose chemotherapy. Unfortunately, I believe my chemo brain contributed to me losing a postdoctoral position that had been held for me since before I was diagnosed. This unsuccessful experience led to a much better postdoctral and a resetting of priorities that brought me to where I am today. |
| Wikipedia entry on Chemobrain |
| Stay tuned for more of the story. |
| (Cancer Chronicles is a series of status updates that account the events of 25 years ago when I went through a bout with cancer. Its purposes are multi-fold: catharsis, education, information, celebration, etc. ) |
| This originally was posted to facebook January 2, 2013. |
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