Chemo Rage - Learn How Treatment Affects Your Brain, and Ways to Harness the Emotional Energy

Chemotherapy not only changes how your brain thinks, it also impacts your emotional regulation. How do you manage brain fog and chemo rage? Listen to learn about ways to harness this emotional energy and channel it in productive ways.  https://bit.ly/4iWTmpM

In this Episode:

• 01:39 - Streaming Series Review:  Adolescence
• 05:22 - New Jersey and Coconut Cream Pie
• 06:23 - What Does American Medical Debt Look Like?
• 10:17 - Chemo Rage: What it is and What Causes it
• 17:21 - How to Cope with Chemo Rage
• 20:34 - How to Help a Loved One with Chemo Rage
• 24:57 - Poem, "Speak the Cancer"
• 26:20 - Outro

Chapters

• 0:00 Intro
• 1:39 Streaming Series Review: Adolescence
• 5:22 New Jersey and Coconut Cream Pie
• 6:23 What Does American Medical Debt Look Like?
• 10:17 Chemo Rage: What it is and What Causes it
• 17:21 How to Cope with Chemo Rage
• 20:34 How to Help a Loved One with Chemo Rage
• 24:57 Poem, “Speak the Cancer”
• 26:20 Outro

Transcript

Hello and welcome to Everyone Dies, the podcast where we talk about serious illness, dying, death, and bereavement. I'm Marianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 47 years to help answer your questions about what happens at the end of life. And I'm Charlie Navarette, an actor in New York City, and here to offer an every-person viewpoint to our podcast.

We're both here because we believe that the more you know, the better prepared you will be to make difficult decisions when a crisis hits. Also, this podcast does not provide medical nor legal advice. Please listen to the complete disclosure at the end of the recording.

Welcome to this week's show. We're so glad to have you join Charlie and me for the next hour as we continue with our series titled, Everything You Always Wanted to Know About Cancer, But Didn't Have Anyone To Ask, with a conversation about chemo rage. This podcast is a combination of education and entertainment.

Edutainment, if we're going to make up words. Delivered in three halves. Our main topic is in the second half, so if you want to fast-forward to that chat-free zone, you can do that.

In the first half, Charlie has our recipe of the week and a report about medical debt. In the second half, I'm going to talk about how receiving chemotherapy can result in rage for some people. And in the third half, Charlie has a poem about cancer.

So Charlie, how are you? I'm fine, fine. Hey, have you seen Adolescent yet? I have not. What channel is it on? I know it's not a channel, but I knew you were going to ask me.

It's on channel 4. Was Sunny Elliot on channel 4? I think so. Remember we only had like three channels? Yes, but no, actually we had four, because remember, being in Detroit, we were right across the river from Canada. I was just going to say, we had the one from Canada.

We lived the dream, and we had four channels. So back to Adolescent. I don't know what channel it's on.

Probably not 4. It's about adolescence? Hey, you know, you are sharp as a tack. Yeah, it's about adolescence, and it starts with the police breaking into a home. Mm-hmm.

And you think with all the gunfire and police and police cars that it's, you know, they're going to be pulling out the rock or something. And it's a 13-year-old boy that they're after. And the rest of the, there's five episodes or four episodes, are taking you through the process of what happened.

And I don't much cry at movies or shows anymore. I'm a jaded person, I suppose. But the end, the very, very, very last scene, as there's this scene between this boy's mother and father, that I just, just had tears running down my cheeks.

It was just really well written, really well done, and so relatable in terms of they have two children. And one, you know, has been arrested, and I won't tell you more than that. And then this other one is a wonderful kid heading off to college and very empathetic and just kind of doing what you would hope your children would do.

And it's just, it was just really good. Okay, I'll look for it. I'm so glad I was able to talk with you about it.

Adolescence or adolescence? Well, I think if you get the first part of the spelling right, it'll come up. Because it was released, like, maybe the end of March. And it, like, blew up.

Like, immediately. Yeah. Okay, I'll look for it.

So that would be my week, my, my weekly, that would be my recommendation this week. Very good. I'll put, I'll put it in the show notes.

I'll look it up and see, you know, what channel it's on. In our first half, we are tripping out on the road to New Jersey, where more cars are stolen in the city of Newark than any other city in the United States. It makes sense, then, that in 1913, Jerry O'Mahoney of Bayonne, New Jersey, built the first stationary lunch wagon, and a diner was born.

Diners are a huge part of the New Jersey culture and landscape, and at its peak, the state had over 500 of them, more than any other state. And what better snack to get at a diner than coconut cream pie? Pie crust filled with coconut and topped with fluffy meringue will delight everyone at your next funeral lunch. Hey, bon appetit.

That's the best jersey I can do in this, uh, yeah, those years of drama school did not go to waste. Now, being able to afford to get medical care is a key barrier to accessing it. Even though over 90% of the U.S. population has some form of health insurance, medical debt is an ongoing problem.

1 in 12 adult Americans owe medical debt, largely those who are uninsured, low-income, or disabled. Who are the 20 million Americans who owe a total of $220 billion or more in medical debt? A study using the Survey of Income and Program Participation, SIPP, data on individuals owing $250 or more in medical debt, 2021 data, documents that 7 out of 10 study participants who had medical debt owed more than $1,000. 25% owed between $2,001 and $5,000.

The researchers explained, People with complex health needs that require ongoing care can see medical bills pile up over time. Those in worse health or those living with disabilities may also experience unemployment or income losses, further contributing to their difficulty affording medical bills. 22% of low-income individuals with poor health had medical debt.

People with low incomes who had fair health were more likely to report having medical debt than those with poor health but high incomes. Non-Hispanic Black patients were most likely of the five racial categories to have medical debt, with 13% of this population reporting that they had unpaid medical bills. Non-Hispanic Asian people had the lowest rate of medical debt.

Women were more likely to have medical debt than men. 9% of women reported having unpaid medical bills, compared to 7% of men. The researchers attributed this to the cost of childbirth and gender wage gaps.

Medical debt was most common among people ages 35 to 49, 11%, followed closely by those between the ages of 50 and 64, 10%. People who were eligible for Medicare coverage based on their age were least likely to have medical debt. Only 3% of individuals 80 and older owed money for medical bills.

The researchers concluded, quote, medical debt can happen to almost anyone in the United States, but this debt is most pronounced among people who are already struggling with poor health, financial insecurity, or both. The fact that medical debt is a struggle even among households with health insurance and middle incomes indicate that simply expanding coverage will not erase the financial burden caused by high cost-sharing amounts and high prices for medical services and prescription drugs. Please go to our webpage for this week's recipe for coconut cream pie and additional resources for this program.

Everyone Dyes is offered at no cost but is not free to produce. Can we count on you to contribute? Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone. You can also donate at www.everyonedyes.org or at our site on Patreon and search for Everyone Dyes.

Thank you, Charlie. Hearing that you've been diagnosed with cancer is an extremely distressing experience for most people. It is only with time that you begin to understand how it's going to affect your life.

The time taken away from all the other things that you have on your to-do list that you are going to now spend on surgery, chemotherapy, radiation, surveillance scans, and ongoing follow-up appointments. A common thing I would hear from people after their diagnosis is, I don't have time for this. And it is time consuming and stressful.

One study by Carlson and colleagues documented that 46% of the nearly 5,000 people in their study experienced significant distress. Being female, age 40 to 59, and having a diagnosis of pancreatic or lung cancer was associated with the increased likelihood of distress. Today I'm going to chat with you about chemo rage, the anger that can come while receiving chemotherapy.

Chemotherapy is a key cancer treatment strategy and most of the chemotherapy drugs target rapidly dividing cells, including both cancer cells and normal cells that are growing and dividing. Therefore, chemotherapy has many toxic side effects such as hair loss, skin changes, stomach problems, dysfunction of the bone marrow, and central nervous system toxicity. Recent research by Soffitti indicates that chemotherapy agents are in fact more toxic to healthy brain cells than to the cancer cells they were designed to treat.

Chemotherapeutic drugs can cause side effects in the management and use of information, attention, how fast our brains work, plan and organize, remember details, and multitask. These side effects of chemotherapy in the brain are called chemo brain. People seem to talk pretty freely about the brain fog that often comes with chemo brain.

And we have a show about brain fog and there's a link in the show notes for you to listen to. Chemo brain is a frustrating mental fog that clouds thinking and memory and is more than just a minor inconvenience. You might find yourself struggling to remember the name of your favorite coffee shop or blanking on a birthday of a close friend.

Tasks that once seemed effortless now require intense concentration, leaving you mentally exhausted and frustrated. Researchers Kolchak and Kolb have focused their research on chemo brain and which parts of the brain are damaged with chemotherapy. Their studies with mice suggest that chemotherapy makes epigenetic changes to the brain.

Epigenetic changes are changes to the DNA that control whether genes are turned on or turned off but do not change the order of the DNA building blocks. Epigenetic changes play key roles in brain and behavior. They found that chemotherapy related damage to the prefrontal cortex part of the brain which is responsible for self-control, regulating emotions, and being able to plan ahead.

These researchers offer possible biological explanation for chemo rage and brain fog. It's natural to feel angry when you have a cancer diagnosis. You might feel angry going through treatment and having to cope with the side effects.

You may be angry if the cancer causes you to make changes in your life. Cancer affects your relationships, family life, work, and social life. Chemotherapy does not just change how your brain thinks.

It also impacts your emotional regulation. The brain regions responsible for managing emotions and impulse control can be affected by chemotherapy making it harder to keep your cool when faced with challenges. The constant struggle to perform everyday tasks as you once did can lead to a build-up of frustration that can erupt into full-blown rage.

Difficulty concentrating or multitasking is another major trigger. Tasks that once seemed simple like following a recipe or balancing a checkbook suddenly become overwhelming challenges. You might find yourself reading the same paragraph over and over unable to absorb its meaning or perhaps you start five different tasks only to complete none of them.

This constant mental juggling act can leave you feeling overwhelmed, inadequate, fueling the rage. Getting a cancer diagnosis is associated with loss. Loss of body parts, loss of day-to-day functioning, the loss of control over one's body.

These factors can trigger anger along with the obstacles they encounter within the medical system such as being kept waiting for appointments or difficult interactions with healthcare professionals. Chemo rage is not a fleeting reaction it's a complex reaction to a disease that undermines one's sense of self and independence. Fatigue, bone deep weariness is a typical side effect of chemotherapy and can play a significant role in chemo rage.

When you're exhausted your emotional reserves are depleted making it harder to cope with even minor irritations. Social and professional obligations can add another layer of frustration. You might struggle to keep up with conversations forgetting important details or losing your train of thought mid-sentence.

At work tasks that once came easily now require intense concentration potentially affecting your performance and self-esteem and can leave you feeling isolated, misunderstood, and angry. Another cause of chemo rage could be the steroids that you receive as part of the chemotherapy to reduce nausea and vomiting, improve appetite, reduce swelling, and help prevent an allergic reaction. It's important to complete all cycles of the prescribed chemotherapy and the steroids are a way to help your body do this but steroids can increase irritability, aggression, and decrease impulse control which can lead to sudden bursts of anger that can happen over what we might otherwise consider to be a minor incident.

Chemo rage is a normal response to an abnormal situation. It's a sign that you're human and that you're not willing to let cancer define you. The key is learning how to harness this emotional energy and channel it in productive ways.

We all show anger in different ways. Some people get impatient or shout, others get upset and tearful. You might get angry with the people you care about.

Anger can hide other feelings such as being sad or scared. It's important not to hide your feelings if you're angry or upset. It may help to tell people that you're angry about your situation and not at them.

Finding ways to relax and reduce stress can help with anger. Try not to feel guilty about your angry thoughts or irritable moods. Anger can be a strong emotion and you may find you can use it in a more positive way.

For example, it can help you focus on what's important in your life. It can give you the determination to start something new like a hobby or a challenge. If you're angry most of the time or it's starting to affect your life, it might be helpful for you to talk to a counselor or a psychiatrist.

You do not need to feel as though you are at the mercy of the feelings that the chemotherapy is activating. There are some things you can do to help you be you. Mindfulness and relaxation techniques can be powerful tools.

When you feel anger rising, try taking a few deep breaths focusing on the sensation of air filling and leaving your lungs. A simple act can help ground you in the present moment preventing your mind from spiraling into frustration. Cognitive behavioral therapy, CBT, approaches can help to manage chemo rage.

CBT can help you identify negative thought patterns and replace them with more constructive ones. For example, instead of thinking I'm so stupid for forgetting this, you can reframe it as my brain is healing and it's okay to make mistakes. This shift in perspective can help diffuse anger before it intensifies.

Exercise and physical activity might seem like the last thing you want to do when you're feeling angry and fatigued but physical movement releases endorphins which are feel-good chemicals that can help boost your mood and reduce stress. Even a short walk around the block or some gentle stretching can make a difference. Journaling and emotional expression provide a safe outlet for your feelings.

Sometimes simply acknowledging your anger on paper can be helpful. Write about your frustrations, your fears, your triumphs. Don't worry about grammar or spelling.

This is for your eyes only. The act of putting your emotions into writing can help you process them and give insight into your triggers and coping mechanisms. If you have a loved one who's having chemo rage, your understanding and support can make all the difference.

The anger is not directed at you personally, even though it might feel that way, but rather at the situation. Try to put yourself in their shoes. Imagine how frustrating it must be to feel like your own brain is working against you.

This perspective may help you respond with compassion rather than defensiveness. When discussing sensitive topics or providing reminders, choose your words carefully. Instead of saying, you forgot to take your medicine again, try a gentler approach like, would you like me to set a reminder for your medication? This subtle shifted language can help prevent feelings of inadequacy and reduce the likelihood of an angry outburst.

Think being helpful could go a long way in reducing stress and frustration. Offer to help with tasks, but be careful not to take over completely. For example, you might create a shared calendar to help keep track of appointments or offer to be a second set of ears during important conversation with healthcare practitioners.

If you notice that anger is significantly impacting quality of life or relationship, gently encourage your loved one to seek support from a therapist or counselor who specializes in working with people living with cancer. The timeline for improvement will vary from person to person. Some people report significant improvements within months of completing chemotherapy while others may continue to experience symptoms for years.

Lifestyle changes to support brain health can also contribute to recovery and emotional stability. A balanced diet rich in omega-3 fatty acids, antioxidants, and vitamins can help nourish the brain. Regular exercise, adequate sleep, and stress reduction techniques like meditation can all contribute to improved brain function and emotional regulation.

The symptoms of chemo rage are valid and deserving of attention. By addressing these challenges head-on with compassion and determination, people can reclaim a sense of control and well-being. walk into the room like what the hell did i come in here for or i i just put down a pen to pick up something and then i forget what i did with the pen and listening to you i mean me being forgetful is nothing compared to someone you know as you've been describing chemo rage but um i don't know it just makes me a little nervous and again if it's being selfish thinking about myself but uh yeah because i can't imagine being forgetful and just feeling more emotional at a higher level than what i do so yeah i guess i'm just thinking about myself uh yeah but oh i i can't imagine that's that's tough and like you said i mean there's other people around you and yeah it's tough well and if you've got a full-time job and you've got kids oh right exactly right you know all the other things that can be going on and you can't you know remember how to use your food processor or something you know you can see how that food process might just go flying across the room very true very true for our third half i have for you a poem written anonymously about cancer titled speak the cancer from whom are you hiding your pain for whom are you wearing that smile do you have someone to lend you a shoulder to let you know that it's okay to cry yes my friend it's normal to feel drained and to feel pain both inside and out it's okay to scream when they prick you over and over to treat you there's nothing wrong in being angry you must vent shouldn't stay inside some days are bad i know when you have the best ones around everything turns out to be good you must speak to your fears cancer is no taboo you can be anxious as long as you have a pal who will pat your shoulder and give you a hug speaking about it won't portray you weak instead hoarding inside will kill you so speak now and that's it for this week's episode please stay tuned for the continuing saga of everyone dies and thank you for listening this is charlie navarette the latin phrase civis pacem para bellum translates to if you want peace prepare for war and i'm mary ann and we'll see you next week remember every day is a gift this podcast does not provide medical advice all discussion on this podcast such as treatments dosages outcomes charts patient profiles advice messages and any other discussion are for informational purposes only and are not a substitute for professional medical advice or treatment always seek the advice of your primary care practitioner or other qualified health providers with any questions may have regarding your health never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast if you think you may have a medical emergency call your doctor or 911 immediately everyone dies does not recommend or endorse any specific tests practitioners products procedures opinions or other information that may be mentioned in this podcast reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of everyone dies or by other members is solely at your own risk