Go directly to A&E,do not pass Go, do not collect £200...

Day 59  

General status update: 

Hair, Nausea demon, Chemo Muse, Chemo Brian, Stomach, Fatigue/weakness - never mind about them, we now have something much more urgent to worry about to worry about:

Temperature:     8.15 am - 37.3 deg Centigrade

                           9.25 am – 37.4                        

                          10.34 am - 37.5

                         11.12 am – 37.7

                         12.00 pm – 37.9

                         12.31 pm – 37.9

                           1.15 pm – 38.1 

Anxiety level (1-10): soaring upwards like a lark on the wing. 

State of mind: Oh no. OH NO. OH NOOOOOOOOOOO

At the beginning of the Great Fo Chemo Extravaganza, Stan the Oncologist told me that because of the very high risks to chemo patients from contracting any kind of infection at all whilst undergoing treatment, the single most important thing, in terms of looking after myself during chemotherapy treatment, was to get a good digital thermometer and monitor my temperature assiduously, particularly if I start to feel at all unwell (beyond the general havoc wreaked by the chemo itself, obvs). All of this is documented in the wonderful Big Red Book of Chemo, which you are given at your first session, and are instructed to keep with you at all times in case of emergency:

 Inside is recorded a list of all the drugs they give to you at each treatment session, and there are handy colour-coded charts of side effects, and at what level those side effects become serious enough to require either a call to the Chemo Helpline (amber), or an immediate trip to the A & E (red):

If your temperature goes above 37.5 deg C, you should call the chemo help-line immediately for further instructions, and they may wish you to come into the hospital to be assessed for further treatment; if your temperature rises to 38 degrees you should go straight to A & E without passing GO.

Because chemo patients are severely immune-suppressed, infections can kill you quite quickly if left untreated. I’m not quite clear what they can do in the case of viral infections, which aren’t susceptible to antibiotics, but a couple of women on my ‘Starting Chemo in December’ thread on BCC UK have been hospitalised with infections, and others seem to have spent a lot of time injecting themselves in the stomach with something called Filgrastim, to stimulate the growth of white blood cells that have been nuked by the chemo, so that they will be strong enough for more chemo.

I have tried very, very hard to avoid infections, with all manner of intensive hand-washing and antibacterial gels, avoiding crowded places and public transport during the particularly immune-suppressed part of the cycle, etc. etc. Given that I am highly susceptible to respiratory infections in the normal way of things, and spent a week in hospital with pneumonia a few years ago, it has seemed like a small miracle that for the 58 days since the start of my chemotherapy treatment, in the depths of winter, I have managed to remain free of infection.

Until this morning, that is, when I woke up with a heavy cold. 

Maybe I caught it when we went out to dinner on Saturday, like normal people, or maybe I caught it in Waitrose. You can’t wash your hands every 10 seconds. 

I decided that this was no cause for panic, as my temperature was only 37.3 deg, and it got that high before, a few weeks back, without rising any further into the danger zone. Anyway, a cold in itself isn’t a fever, is it? And there’s not much you can do with a cold except ride it out, and wait for it to go away. If it turned into pneumonia, that would be different, but at the moment it’s JUST A COLD. 

Accordingly, I calmed down R, who was rather more worried than me, and sent him off to work, having promised to monitor my temperature hourly, and text him if anything dramatic started happening. 

Hmmm.

I wasn’t too concerned until it went over 35.5, which is when you’re meant to call the hospital; I thought I’d just give it a while more, see if it settled down again. Then it hopped up from 37.7 to 37.9, and I suppose I should really make that call, but I’m so sick of calling hospitals. I’m meant to go down there this afternoon, anyway, to have my PICC line flushed, so I’m thinking I’ll wait until then to bring this to the attention of the authorities, unless it actually goes over the 38.0, ‘all-alarm-bells-flashing’ level.

 I’m just really tired of all this stuff, and I’ve only got a cold, and the thought of being admitted to hospital again now just fills me with horror. I mean, they don’t even have Wi-Fi on the in-patient wards, so how could I write the blog? 

I’ll take a bag down with me when I go to the hospital, just in case they admit me – there is nothing worse than being admitted to hospital by surprise, when you haven’t got any kit. There are certain basic necessities without which existence is essentially unsupportable. OK, let’s make a list:  

Fo hospital bag 

Notebook computer

Kindle Fire - my portable library

Mobile phone

Chargers, cables etc. for all of the above

Real low-tech Paperchase notebook, with owls on the cover, and pens. Like in the old days. No charger necessary.

Real books – limited to 3, for weight reasons. R can always bring more later.

Pajamas, dressing gown, slippers, toothbrush.

1.15 pm:  OK, no more list, as my temperature is now 38.1 deg, so I’ve got to take it seriously. B***eration. Better phone them, I suppose. 

10 minutes later: 3 phone calls to the Chemo Day Unit went unanswered, so I called the Chemo Emergency Helpline, and got the on-call oncologist. I tried to persuade her that as it is only a cold a trip to A & E might be excessive, but she said it didn’t matter: they have to do a blood test immediately, check the level of my white blood cells, see if I am neutropenic and, if so, admit me to the hospital to do whatever they do to neutropenic patients. 

I’ve called R – who is in the middle of some major grant-awarding all-day committee meeting, and told him NOT to come. If I’m not neutropenic I can come home, hopefully; if I am, they’ll admit me straight away and there’ll be nothing he can do anyway. 

In all eventualities, I will have my portable library, and can keep myself amused. 

Right, then, I am going to copy and paste this into Blogger now, and it can be today’s post – I might not have access to the internet later. Please keep your fingers crossed for me as I disappear into the loving embrace, once again, of Charing Cross Hospital – mon amour. 

I really want to come home tonight.