I got home today and kept forgetting to  look for the Mekinist shipment in the fridge. When I finally did, I found they triple-bagged it. God forbid they should use only one, or even only two, bags. It’s a tiny pill, almost cute. I take one, once every two days (on the same day I take dabrafenib). I start tonight.

I’ve been taking dabrafenib for months and haven’t had the fever/chills side effect. I’m a little worried this twosome will bring it about. I’m also a little worried because I read the insert that came with the package, which reads like a found poem I’ll call TALK WITH YOUR DOCTOR:

Tell dentists, surgeons, and other doctors that you use this drug. You will need to have heart function tests while taking this drug. Talk with the doctor. This drug may cause high blood pressure. Have your blood pressure checked often. Talk with your doctor. Have blood work checked as you have been told by the doctor. Talk with the doctor. Sometime, dabrafenib is taken with trametinib (Mekinist). If you are taking dabrafenib with trametinib, be sure you know the side effects that can happen with each drug. When these drugs are taken together, the chance of certain side effects may be raised. These side effects can be very bad and sometimes deadly. This includes bleeding, blood clots, eye problems, fever, heart problems (like heart failure), high blood sugar, other cancers, and skin problems. Talk with your doctor about the chance of side effects with your drugs. Very bad eye problems have happened with this drug. Sometimes, this has led to loss of eyesight. Call your doctor right away if you have blurred eyesight, loss of eyesight, or other changes in eyesight. Call your doctor right away if you see color dots or halo or if bright lights bother you.

Do I know how to have a good time, or what? Then, you get to page two, where they describe what the actual side effects might be, in living color and 3D:

So in my infinite wisdom, I’ve decided to take my first dose tonight, right before bed. At least if it makes me die right away, I’ll die in my sleep, I guess, is my thinking. On the off chance I bleed to death or go blind and freeze to death or develop fatal stools or breath that smells like fruit, please know how much I’ve loved you all and how much I’ve loved writing my way, sardonically and angrily, through almost a year’s worth of this crap. Also, please know I’ve never, ever liked blue cheese.

You should also know how completely melodramatic I’m probably being right now. I spoke with Nurse Practitioner R on the phone today, while I was on Amtrak and the kids were watching a movie. She sounded mildly annoyed, because she’d been in with a patient when I called, and maybe she was the only one around, and she’s heading into her third trimester of pregnancy which means she is going to have less and less tolerance for bullshit. Still, I told her that the pharmacist had freaked me out over the phone. She begged me to please continue to let them handle it, and not to listen to a random CVS pharmacist in Illinois who does not have access to my medical history. Apparently I had an EKG last April, in the hospital. (I was so out of it, I guess I wasn’t aware.) I don’t really need another one. I tried to object to the fact that I’ve been doing so well on dabrafenib and didn’t understand why the combo was suddenly necessary. She mentioned the one argument I’d heard in the office, which is that the two together tend to mitigate side effects (alarming package inserts notwithstanding, I guess). But then she mentioned the more salient argument, which is that one drug alone can eventually lead to resistance, whereas the combination of the two drugs makes that much less likely.

That, I can get on board with.

À bas la résistance!

I wish you all a healthy night of sleep. And I wish myself the same. Still not sure if I’ll keep the thermometer on my nightstand, but it’s a thought.