Well I was warned that certain chemotherapy drugs can cause your nails and nail beds to change colour, become dry and brittle, cracked, grooved and/or ridged, lifted, or sensitive.
Dry and brittle, ridged and discoloured I can cope with. I can even accept losing a couple of toenails. That’s all cosmetic, and even though it might take some time, it’ll all get better after treatment finishes. I just didn’t imagine the “sensitive” side of it would be quite so painful. Sensitive didn’t even begin to cover it.
At least now my fingernails and thumbnails (but mostly my thumbnails) are no longer so tender and sensitive to the degree that I’m unable to carry out lots of daily tasks that you usually take completely for granted. But they were for around three or four days last week. Any grasping or pressing, especially involving the thumbs, was very, very painful. Unscrew the lid off a new milk bottle? Not a chance. Pull the stalk off strawberries? No way. Open a tin of tuna? No. Do up the button on your jeans? Just. Press the button on the ticket machine in the supermarket car park? Doable, but only just. Turn taps on and off? Painful, but doable. Tap your PIN in at the supermarket checkout? Same. Peel an orange or a banana? You’re having a laugh. I even needed help taking my socks off a couple of times.
My thumbnails and a few other fingernails are now a bit of a mess (yes, those are my hands in the photos). On top of that, one toe nail just completely fell off the other night as I was rubbing cream into my feet. At least one other toenail looks like going the same way. Hey ho.
If you happened to bang your nails on something, the pain was excruciating – a bit like when you hit your thumb really, really hard with a hammer. You have no idea how many times a day your thumbnails collide with something or other. Normally you don’t even notice, but when they’re tender, even the slightest knock hurts. You lock the door when you leave the house and your thumb nail hits the door. Agony. You dry your hands on a towel and your thumbnail hits the towel rail or the wall. More agony. You run your hand down the bannister as you come down the stairs and you bang your thumb on the post at the bottom. You literally see stars. And so on, and so on, and so on. It’s just as well I was on my own in the house… no-one was there to hear the swearing. It really was that bad.
When I related a potted version of this to the oncologist at our pre-sixth chemo session review the day before yesterday, she did a series of tests to check for chemotherapy induced peripheral neuropathy, or CIPN, a known side effect of paclitaxel, the chemo drug I started two weeks ago. If I were to develop CIPN to any degree, we’d have to think about stopping the chemo as the trade-off at this stage between what the chemo’s doing to the tumour and the potential long-term damage it can cause to the nerves would no longer be in my favour.
The tests included me closing my eyes and the oncologist placing one object into one of my outstretched hands and another object into the other. I then had to make a fist with each hand and say what the objects were. For the record, they were a small coin and a paper clip. I guess if you had no feelings in your fingertips, you wouldn’t be able to work out what they were. Clever, eh? Last week, though, my problem was too much sensitivity, not a lack of it. And the problem was the nails rather than the tips of my fingers or toes. There were some signs of insensitivity in a couple of toes, but nothing too bad.
Yesterday’s chemo session – the sixth of eight- was uneventful. Let’s see what happens with the nails between now and the next session in two weeks’ time. I’ve trimmed them down to almost nothing, which seems a shame as they haven’t actually grown in the two-and-a-half months since I started chemo. I’m still rubbing in the drops I’ve been given by the clinic and I’m considering putting on some dark nail varnish. There’s a theory that because paclitaxel is light sensitive (a thick black plastic bag is put over the infusion bag to protect the drug from the light), dark nail polish has the same effect on your nails as the black poly bags do on the infusion.
I’ll be keeping my fingers crossed there’s no repeat of last week – at least for as long as I’m able to!