Wednesday, March 20, 2013

World Mum


Day 101 

General status update

Chemo Muse: oh boy, did WE have a night – see below

Despair Demon: got a brief look in as I crashed and wept this morning after a night of steroid euphoria, but R gave me a cuddle and so he returned to his nest in the airing cupboard. Actually, I think he’s getting quite comfortable in there now – it’s roomy and VERY warm, and he’s made a comfy nest of towels.

Nausea demon: weakening – he let me lie in until 6am this morning, and then we had anti-emetic meds, tea and toast together.

Chemo Brian: he’s getting very excited about attending the private view of the David Bowie exhibition at the V&A with us on Friday. R and I are going to be having a rare day out together - accompanied by all my invisible friends, obvs.

Matron Becky: she has metamorphosed overnight into a figure of global significance who will Save the World from Patriarchy – see below

PICC line (deceased): I’m being haunted by a phantom PICC line - its ghost is hanging round my arm, and I keep thinking it’s still in place. Can’t get used to the new freedom.

State of mind: Boy, all these drugs are messing with my head – but at this stage of the chemo cycle that is a far, far better thing than have the chemo drugs messing with my stomach.

Anxiety level (1-10): my partially root-canalled tooth twing(e)ing again this morning, so I’ll be popping into the dentist later on - need I say more?

Hair: is hoping to address its long-term self-esteem problems with the help of the Mother Goddess – see below



Very, very late last night on Twitter.....



I am completely manic and off my head on the steroids - it's like I'm POSSESSED. But in a good way. So strange.
2:58 AM - 20 Mar 13 


Can't sleep, and soon either my brain is going to spontaneously combust or I'm going to start talking to God, I reckon.
  


And it'll be very interesting to hear what She thinks of Her new Pope, for a start.
 
  


@carolinefo I'm here! I'm awake. I'm slightly drunk and I feel like an idiot who just stepped onto court with Rafa Nadal. *waves bat*
3:13 AM - 20 Mar 13 



@PaolaOeste Excellent! I'm eating a Gü Key Lime pie, because The Steroids Want It. I may have another one in a minute..
 



@carolinefo The steroids are right. Limes prevented scurvy in generations of British seamen. It is therefore MEDICINE. In whatever form.
 



@PaolaOeste V.good point. I'd better have the second one, just to be absolutely sure of preventing the sudden onset of scurvy during the night.
3:37 AM - 20 Mar 13 ·



@PaolaOeste You can't be too careful in the circs - scurvy would delay my last dose of chemo, and my oncologist would be FURIOUS.
3:38 AM - 20 Mar 13 · 



@carolinefo COMPLETELY. Vit C is *so* important in cell structure  that, frankly, I'm amazed Gü Key Lime pie isn't handed out to all women
  




@PaolaOeste Yeah, I think we should suggest that to the government. Free Gü Key Lime Pie for all women would be BIG vote winner.
3:51 AM - 20 Mar 13 · 

 · 
  
@carolinefo I am so bloody impressed, btw, by how you have actually managed to change stuff through your blog. You're AMAZING.
3:45 AM - 20 Mar 13 ·


@carolinefo Also, Matron Becky (?) she's basically Batman.
3:45 AM - 20 Mar 13 · 


  
@PaolaOeste Yeah, she's FANTASTIC. I 'm hoping she'll adopt me. I'm older than her, but I don't see why that should stand between us.
3:49 AM - 20 Mar 13 · 



@carolinefo Matron Becky shall be made either New Pope or World Mum. Oh God. Just imagine, 2000 years of silly patriarchy aside, WORLD MUM.
3:56 AM - 20 Mar 13 · 



@PaolaOeste That idea is just FANTASTIC. Matron Becky perfect for World Mum. World Mum would wipe floor with ANY Pope.
3:59 AM - 20 Mar 13 · 



@carolinefo I am actually hugging myself with glee. When World Mum comes to Popetown. *rocks*
3:57 AM 4:00 AM - 20 Mar 13 ·



@carolinefo *freaks out at the idea of World Mum* (I'm imagining my mum here) (aargh)
4:00 AM - 20 Mar 13



@PaolaOeste Ah, but Matron Becky will be the ÜberMum - the Mother Goddess. She will not tell you your hair looks bad.
4:01 AM - 20 Mar 13 · 



@carolinefo *weeps* my crap, fine, unstyleable hair shall be accepted!



@PaolaOeste Mine too! Mine Too! Even the chemo didn't want my hair..
4:06 AM - 20 Mar 13 · 



@carolinefo I am basically *sucking* my fine hair into my head by willpower so yours will stay. *does lemon face*
  



@PaolaOeste that is very, very supportive of you. Still holding my breath in case it goes after dose 6.
  


  
@carolinefo I'm ready to build idols and make bonfires for World Mum Becky.
4:04 AM - 20 Mar 13 · 


@PaolaOeste Yes!!! She Shall Rule!
4:06 AM - 20 Mar 13 · Details


  
@PaolaOeste Now wondering how to explain disappearance of BOTH Gü Key Lime Pies to R tomorrow. Will say Mother Goddess told me to do it.
4:05 AM - 20 Mar 13 · 



@carolinefo But the Patriarchy would have had you utterly powerless. World Mum empowered you to nourish yourself. NO FRICKIN CONTEST.
4:07 AM - 20 Mar 13 



I think I might have to lie down now @PaolaOeste going a bit woozy xxx
4:14 AM - 20 Mar 13 · 



@carolinefo Sleep well, darls. World Mum will take care of you. xx
4:15 AM - 20 Mar 13 · 





Tuesday, March 19, 2013

100 Days of Chemo Nights


Day 100 

General status update:
FEC  cycle 5, day 6

Nausea demon: he’s feeling rather emasculated, and deeply depressed - we had an extraordinarily early breakfast together in the breaking light of dawn, as is usual, but he is having to accept that the extra steroids this cycle have made him lose his edge.

Chemo Nano-Rats: you remember the screaming toxic horror of my stomach in the earlier cycles, right? Well, with the Omeprazole and extra steroids combo, the power of the Chemo Nano-Rats has also been reduced, to say 40% of their former strength. This makes the difference between side effects that are head-bangingly, screamingly unbearable, for this worst week of the chemo cycle, and side effects that are unpleasant but tolerable. This makes the difference between me being a howling, tormented lab rat, running around the flat in acute distress, or curled up in a foetal position and weeping uncontrollably, and me being a human being having a moderately unpleasant time, but managing to get on with everyday activities. Please note, other patients who may be experiencing similar problems. Learn from my stupidity.
Get help at an earlier stage of the proceedings.

Chemo Muse: we’re back on track after yesterday’s little emotional blip, and she has really had me motoring today, in all manner of energetic activity. We are the Dexy Sisters – we rock!

Despair Demon: the Chemo Muse has bundled him back in the airing cupboard again, but given the precarious and temporary nature of steroid-fuelled good spirits and energy, he’s just waiting for another little crash so he can get back to work again.

Super-Senses: my sense of smell has gone ballistic again this cycle – through the open window of my study I can smell every item of food that is being cooked in a four hundred yard radius of Brook Green, W6. But now I know what it is like to be a dog. Except that dogs find the smells attractive.

Chemo Brian: he’s not getting much of a look in at the moment, what with all the lovely steroids. I’ve been going like a maniac again today. Maybe tomorrow, Brian. We’ll get in a bit of serious sofa time soon, I promise.

State of mind: Planning world domination – together with the Dexys and the Chemo Muse, ANYTHING is possible.

Anxiety level (1-10): I’m whizzzzzzzzzzing. You can’t be anxious when you whizzzzzzzzzzzzzzing, can you?

Hair: still hangin’ on in there. Seems to be feeling a bit neglected, what with the now almost total lack of attention after having been the star of the show for so long, but trying to put a brave face on it.



Well, the title of today’s post says it all: this is Chemo Nights, Day 100.

It seems a good time to review progress so far, doesn’t it?

Much to my surprise, I’ve actually managed to write a blog post here on Chemo Nights every day for the last 100 days, starting the evening before my first chemotherapy treatment, when I was ricocheting off the walls with sheer terror; I started writing it to see if that would help me keep sane through what I knew was going to be a truly horrible time – which it has been, and it’s by no means finished yet. The verdict on my current level of sanity is still out, I’d say – but the daily deadline for the blog has certainly kept me occupied and focused at a time when I could have been feeling not just ill and distressed, but also without purpose, so it’s definitely helped a great deal.

I made the blog’s subtitle ‘100 days of chemotherapy’, because it sounded snappy, but six cycles of chemo is actually 18 weeks, or 126 days, and one cycle was delayed for a week, because I had an infection, and so by the time my chemo experience finishes, 21 days after the sixth and final dose on (God willing, inshallah, may there be no more infections to come) Thursday 4th April, it will be the 25th of April, and 134 days of Chemo Nights.

It’s turned out to be a much bigger enterprise than I first thought and I’m pretty tired now, both from the cumulative exhaustion engendered by the chemotherapy drugs, and by the effort of the daily writing, which has sometimes been very hard to keep up (some days I really lost it and it was only R’s encouragement that kept me going – he is an excellent motivator) but I want to keep it going to the end, partly because I have more things to say on various cancer-related topics apart from the day to day record of living through chemo, and partly because I want it to be a complete documentation of the FEC chemotherapy regimen from the first day to the last, to provide a comprehensive reference tool for other patients coming to it later, who can learn from my mistakes and misunderstandings, which have been manifold. My experience could have been a lot easier in many ways, which I only know in hindsight, and I hope very much that others can use my experience to make their own less difficult.

I’m happy to say that the blog has acquired quite a sizeable following: it has had about 42,000 hits so far, and is read by 500-600 people  a day - the audience mainly came via Twitter in the first instance. It now has a wide readership including many doctors and nurses, and medical anthropologists and sociologists – as well as other cancer patients and all my friends on Twitter and Facebook.  An extract from the blog has just been printed in a Canadian academic journal of Bioethics - they feel that the modality of this kind of direct reportage of the patient experience is a highly useful one for medical education, in giving access that cannot be gained through more conventional academic writing.

My hospital, the Charing Cross Hospital in Hammersmith, has also taken note of the blog, and I was recently contacted by the Head of Cancer Nursing at the Imperial College Healthcare Trust, of which it forms part, to request my permission to use material from the blog relating to both good and bad experiences of patient care at the hospital as part of their on-going training programmes for medical staff in improving the patient experience. This has already been implemented for the first time at a session a couple of weeks ago. There has also now been one change to hospital procedure after problems I have highlighted in the blog; I’m very happy to say that Charing Cross has taken a very positive attitude to the blog and responded very well to my criticisms.

Simultaneously, I have been raising money for the Haven Breast Cancer Care Centres by asking people to sponsor my chemotherapy treatment, the rationale for which was set out in this blog post back in December

The basic idea is that if you're fed up with being asked  for sponsorship to fund the gap year projects of spoiled teenagers who should be getting a job to pay for their travels, or sponsoring people to do things that they'd rather like to do anyway (abseiling down the Amazon, etc.), why not instead sponsor someone to do something that is the last thing in the world they want to do - endure the hell that is chemotherapy treatment -  and, in so doing , raise money for the truly excellent cause of The Haven Breast Cancer Care Centres, which provide such amazing support to those going through breast cancer. This is, as far as I know, the world’s first ever sponsored chemo: the Haven certainly hadn’t come across one before!

It’s also quite certainly the first ever hamster-sponsored chemo: I discovered belatedly this morning that a certain ‘Jason’, who sponsored me some weeks ago, was actually the pet hamster of my friend @aliceturner on Twitter, who in December won the Chemo Nights award for  'Best Rodent In Snood'. OK, it should perhaps have been a clue that Jason's message was 'I very much admire your elegant snood'. I am rather slow sometimes.

As of today, after 100 days of chemotherapy treatment, I’ve raised £1250.75 so far for the Haven, which makes me very happy indeed - as I have written elsewhere , the Haven has helped me enormously, right from the early days after my diagnosis of cancer back in September of last year.

A thousand quid isn’t bad, but I’d really like to do more, so I’m going to try and get a bit more publicity for the blog, and hopefully attract some new readers and more sponsorship for the chemo – so if there’s anyone out there who has been meaning to sponsor me, but never got round to it, it’s not too late!

This is the link to my Virgin Giving Fundraising page:

And, while I’m at it, I’d just like to thank all those who have very generously donated so far – I am very behind with my thank you emails, but you will all get one in the end. It has truly helped me in enduring the horror of the chemo to know that something good is coming of it  - I will never know if the chemo has helped me or not, because that’s not how it works at this stage of the technology, although if the cancer comes back I’ll know that it didn’t work – and I am so grateful to you all not only for donating, but for giving me this psychological boost as well, when morale has been at times so very low. 

To end this 100 day review I’d also like to thank all those people have responded to the blog – which is many times more than those appearing in the comments section,  because most people prefer to respond by email, or on Twitter or Facebook. I’ve ‘met’ so many interesting people, and received so much support and encouragement, and have been delighted to know from other people dealing with cancer, either as patients or as the relatives of patients, that the blog has proved useful and comforting to others in a situation where you often feel so terribly helpless and alone.

I’ve also been receiving wonderful support from my family and friends, both in the UK and in my former home of Ayvalik, on the north Aegean coast of Turkey, and all my amazing Twitter friends, who have helped keep me going by sending me photos and messages and jokes and presents, so that even on the darkest days there has always been something there to cheer me and make me smile. I am a very lucky woman indeed.

I can’t thank you all enough, and it makes me cry just to think about it.

I wouldn't be surviving this at all, of course, without R – he is the light of my life, my greatest support, my love and my best friend. In the last six months of cancer hell, in a relatively new relationship, we have been sorely tried, and it has been unbelievably hard for him, but he has always been there for me, and kept me going, as I have tried to keep him going. There are simply no words adequate to express how I feel about R.

We’re not out of the woods yet, by a long chalk, but at least the end of the chemo is in sight, and things are looking a lot brighter this week than they have for a very long time –  there are another 34 days of  chemo to go, and I hope you’ll keep reading Chemo Nights to the very end.

Thank you.

Monday, March 18, 2013

Crash and burn (reprise)


Day 99 

General status update

Nausea demon: we saw in the dawn again together this morning, but the extra steroids and the Omeprazole are definitely helping – this cycle the various stomach side effects are not nearly as acute as in previous cycles. Physical and mental distress significantly decreased. Thank you again, Roma and Becky.

Despair Demon: he escaped from the airing cupboard and accompanied me to the hospital today – it didn’t go well.

Chemo Muse: she rather overdid it yesterday; even she admits that.

Fatigue/exhaustion: acute. It’s getting worse every cycle, and hitting earlier in each cycle.

Chemo Brian: I’ll be joining him on the sofa very shortly – even with the extra steroids day 5 of FEC is bad bad BAD

State of mind: unimpressive

Anxiety level (1-10): ramping up again, on all fronts.

Hair: whatever

  
Had I only retained the sense I was born with, as MamaFo has so very often been heard to say (inscrutable north Yorkshire sayings, no 79), I would have postponed my radiotherapy planning meeting at the hospital today: even with the help of extra steroids, Day 5 of the chemo cycle is not a good one on which to interact with people, especially in a hospital environment with highly skilled medical professionals intent upon performing on you yet more physically intrusive procedures with unpleasant side effects.

I thought the meeting was just to talk about the radiotherapy, which will irradiate my right breast, from where the cancer tumour was removed, in order to prevent a local reoccurrence of the cancer in the same breast –

If you had a lumpectomy without radiotherapy afterwards, there would be a 40 -50% chance of breast cancer returning in the breast; with radiotherapy, the probability of a local reoccurrence is only about 4 - 5%. So the lumpectomy allows you to save your breast, but you can’t really have it without radiotherapy as well – that’s the price you pay for not having a mastectomy and losing your whole breast. The radiotherapy, locally targeted, is thus  quite separate from the chemotherapy treatment, which is systemic and aimed at picking up any circulating tumour cells that may have already drifted into your blood system before the tumour was removed.

- but it turned out that they needed to do a scan of my breast, and draw markers on it, and make calculations as to where exactly in my breast to target the radiation, and as the very pleasant and helpful radiotherapist talked me through all this I could feel my upper lip beginning to tremble, and inside my head I was shouting No! I don’t want ANYONE DOING ANY MORE STUFF TO ME! Just leave me and my body alone now!

I managed not to cry until she went out of the room for a couple of minutes to check something, but then I completely lost it and sat there, tears streaming down my face, thinking I really can’t do any more of this, why can’t they just leave me alone for a bit now, I’m full of poison from the chemo and as soon as that stops, they’re going to nuke me and burn me with the radiation.

Yeah, I think we can say I crashed a little today, Dexys or no Dexys.

As it happened, we had to the postpone the scan, anyway, because I need to go away in early May, back to my former home on the north Aegean  coast of Turkey – an important, long pre-planned engagement involving other people, coming from the USA, organised before my cancer diagnosis. I asked the radiotherapist if the treatment could be postponed for two weeks until late May, and she said that the scan would also then need to be postponed, as 2 months ahead is too long in advance to do it. She is going to confer with my oncology consultant about the delay, and get back to me.

I hope the oncologist is going to be OK with this – until a couple of days ago, I had thought I was just going to have to cancel the whole thing, that I wouldn’t be strong enough to do a big trip so soon after chemo, but then this weekend I thought ‘Sod it – I’ve had six months of hell, of my life totally taken over by the cancer, of belonging to the hospital – surely I can have just this two weeks back for myself?’

I know I’m not thinking very straight at the moment – a weekend of steroid mania, now a big emotional collapse – but I just quite desperately need a break now, after the chemo finishes, and since this trip had been planned long before the cancer struck, it seems right to go ahead with it if I possibly can.




In Ayvalik, where May is warm and sunny, I will be able to sit in the courtyard at the Camel Barn, with a cat dozing on my lap, and get something of myself back. This image has been in my mind again and again over the last few months as I have tried to escape mentally from what has been happening to me by visualising happier places: my old Lloyd loom chair  under the olive tree, the sun, the cat, the soft pink Sarimsakli stone of the the old stone walls of the barn.

picture not posed by a model - that is my actual cat, Ollie, currently being very well cared for by a friend

The Aegean spring is the thing I miss most about my old life - it is incomparable.  A walk through the olive groves filled with wild flowers would do me more good right now than all the chemotherapy and radiotherapy in the world....




I do hope they’ll let me go. 



Sunday, March 17, 2013

The Tide is High


Day 98

General status update:  

Nausea demon: He didn’t wake me up until 5am this morning, which was an improvement.

Chemo Muse: As we are on extra steroids this cycle (see below), she deemed it time to restart my exercise programme this morning - “Mens sana in corpore sano! You’ll write so much better if you get your body moving again as well as your brain! We can do BOTH!” – and sent me off at 7.30 am for a 4 mile walk along the Thames Towpath to Barnes Bridge and back, the first time I’ve done the whole walk since my surgery in October. The tide was high, the rowers were out in force – it’s Boat Race day in 2 weeks’ time – and it was so great to be out there in the fresh air with all the other early morning walkers and runners: another step towards the land of the living, and away from the land of the dying.

Chemo Brian: He says he’ll be waiting for me on the sofa when the energy crash comes later on today.

Despair Demon: still locked up in the airing cupboard; there’s nothing he can do to combat the awesome strength of the continuing steroid power surge.

PICC line (deceased): may it rest in peace, in whatever graveyard of medical waste it has now been consigned to. Maybe I should have brought it home and given it a proper burial on Brook Green - it was part of my body for 14 weeks, after all. Or kept it in a jar. Ah well, too late now.

State of mind: I am the Chemo Muse, the Chemo Muse is me. We have The Power: we are the Queens of Dexamethasone.

Anxiety level (1-10): anxiety? About WHAT?

Hair: It’s been exceptionally shiny throughout the whole first 14 weeks of chemo, but now I think it’s also starting to glow in the dark. Not sure whether to be worried or not.




It’s day 4 of  my fifth cycle of the FEC chemo regimen; normally, this is the day after I finish taking the steroid drug, Dexamethasone, which has a strong protective effect against the worst ravages of the chemotherapy drugs, and it’s the day when things start to get really bad. This time round, though, I’m still on the Dexys and feeling remarkably chirpy. This is how it happened…

Last Friday morning (day 2 of the cycle, steroids on full power) our cleaner, Roma, arrived at the flat to find me in a burst of manic hyperactivity, and talking very fast:

‘HelloRoma,it’sgoodtoseeyou,yesIhadthechemoyesterdaybutI’mfeelingjustFINE’cosI’vegotsteroidsfor2daysandguesswhatI’vedonealreadythismorningI’vecompletelyreorganisedthekitchencupboardssothatstuffdoesn’tfalloutanymorewhenyouopenthemandI’vedonealltherecyclingand…’

‘There’s something I’ve been meaning to ask you, Caroline’ said Roma.

‘Why do they only give you the steroid tablets for 2 days after the chemo, when the bad side effects go on for 8 or 9 days? When the steroids stop you have a big crash and then you have a very bad time for a week – why can’t they give you the steroids for longer, when the side effects make you suffer so much?’

This stopped me in my tracks.

‘Well, I asked the oncologist if I might have them for longer, but she said they are very strong, and also have side effects, and you shouldn’t take them too long, and if you have more then you just get the crash later on..’

‘Yes, but if you took them for longer, the chemo drugs would have had more time to go through your system by the time you stopped taking them, wouldn’t they? So the crash wouldn’t be so bad. And it’s not like you’d be taking them for weeks or months – just a few extra days. I’ve seen how bad you get after the steroids stop – surely a few more days of them would do you more good than harm?’

Roma, who doesn’t have a medical degree but does have a great deal of common sense, was making a very good point. A lot of people don’t tolerate steroids very well – one of my Cyber Chemo Buddies had to stop taking them as they were giving her hallucinations – but I absolutely thrive on them, which has done something to compensate for the extremely bad adverse reactions I have had to virtually every other drug that has been pumped into me for the last 6 months. If they work so well for me, why shouldn’t I take them for a few more days to protect me while the chemotherapy drugs are doing their worst to my body?

It was definitely worth revisiting this issue, and as I was going back to the hospital that morning to receive my immune system-boosting injection, I decided to take it up with Matron Becky. Becky agreed that given my very high level of sensitivity to the steroids, and their strength, having a full dose for 3 days and then stopping dead was bound to result in a big crash, and she was surprised that I wasn’t already being given a half dose for the next couple of days to taper off the steroids gently.

She brought in the on-duty doctor at the chemo ward, who listened to my tale of 3 days of the Joy of Dexamethasone followed by a week of FEC Side Effect Hell, and she said ‘Fine. If the steroids work for you, and that’s what you need, I don’t see why you shouldn’t have it – I’ll just have to run it by the oncology registrar.’ Five minutes later she was back with a Dexamethasone prescription which gives me the full dose for a further 2 days (days 4-5 of the chemo cycle), a half dose for the next 3 days (days 6-8 of the cycle) and a quarter dose for the following 3 days (days 9-11) of the cycle.

You have absolutely no idea how happy this makes me although, if you’re a regular reader who has accompanied me through the wailing and weeping and bitter howls of anguish of the first four cycles of FEC Side Effect Hell, you may well have a bit of an inkling. In the previous cycles, during the very worst days - i.e. days 4-8  - I have been in a truly wretched state, unable to do very much at all except endure, and want to die, and wonder why I ever agreed to have chemo at all. Today it’s day 4 and, still on the Dexys, I went for a two hour walk this morning, have spent a couple of hours writing, and am still full of energy. The nausea was bad early this morning, but it’s now quite tolerable.

So we’ll see how this experiment proceeds, if I suffer side effects from the steroids by taking them for longer, but for the moment it’s working just fine.

Today should have been a day of FEC Hell, and hasn’t been.

This solution wouldn’t fit everyone: as with all these drugs, everyone responds differently according to their own genetic makeup, but I’ve written about it in detail to underline the point for anyone facing chemo after me that in this situation you have to find out what works for you, and then ask for it. It’s so easy simply to accept the standard routine which, inevitably, is ‘one size fits all’ approach – no one can predict individual reactions either to the chemotherapy drugs, or to the drugs prescribed to help with the side effects.

It’s also so easy to take no for an answer, as I did when I first brought this up with the oncologist weeks ago; she said no, I couldn’t have any more steroids, and I accepted it. It took Roma’s observation of the horror of my bad days, and her questioning just why I had to keep on suffering like that when the steroids clearly helped me so much, to make me go back and try again.

Thank you Roma, and thank you again, Matron Becky, for helping me see how to make things better.

And if I start suffering from the legendary ‘Roid Rage’ then I promise to hold neither of you responsible, though I can’t speak for R, obvs…







Saturday, March 16, 2013

Gaudete, gaudete, PICC line est ejectus


Day 97 

General status update


Nausea demon: full of himself, raring to go  – he woke me at 4am, and we spent the dawn hours together, playing Mah-jong on the computer and listening to podcasts of The Archers. He’s becoming quite an Archers’ fan, after spending the last 14 weeks with me; it was either that or return, screaming, to the Infernal Regions. He’s tough, though, the Nausea Demon – he wasn’t going to be defeated by an everyday tale of country folk, and he likes it more now I’ve explained to him all the key vocabulary like ‘silage; and ‘weaners’. He definitely thinks Tom should stay organic, and has developed a whole theory about how Brenda is going to leave Tom because she doesn’t want to settle down like he does, whereupon Tom will cry on Kirsty’s shoulder and they will end up together, and the tragically widowed Elizabeth will marry Kirsty’s ex, the lovely cricket guy, so everyone will live happily ever after except Brenda. But then Brenda will finally discover her deeply-suppressed inner Sapphist, and not before time, because a lesbian in the village is LONG OVERDUE. Sorted.

Despair Demon: Still confined to the airing cupboard, but I’ve been taking him tea and toast.

Chemo Muse: More and more resplendent and terrifying, especially in light of yesterday’s events – see below. ADDENDUM: no, don't see below, was too tired to write, you'll have to wait until tomorrow.

Chemo Brian: I love him more every day – he doesn’t seem to have done too much damage to my cerebral capacities, and his warm fuzziness is so consoling when things get really bad. I think he is sponsored by the makers of Lorazepam – they work very well together.

PICC line: see below

Hair: it LOVED the Reiki on Monday, and is lobbying for an Indian cranial massage at my next complementary therapy session, on the grounds that my head should be taking priority in soothing treatments after the repeated assaults from the chemo drugs and the agony of the Cold Cap: it has a very good point. The Cold Cap actually made me cry for the first time this week. It hurt so much, despite a big dose of painkillers, that I just lost it, and it was marginal as to whether I ripped the damn thing off my head. But I didn’t. My sister, when I told her about this, reminded me that the first time I had the Cold Cap I barely flinched, and I seem to be finding it harder to bear every time. I think I’m just so worn down by horrible things happening to me physically that my resilience is seeping away; I’m limping towards the finish line. Still, the Cold Cap has saved my hair, and there’s only more session to go.

Anxiety level (1-10): considerably reduced after what happened at the hospital yesterday –see below.

State of mind: not quite as joyous as I was, because although there is only one more dose of chemo to go, there are still two whole sets of side effects to endure, and they’re kicking in big time already this cycle.



When I went back to the Chemo Ward yesterday to receive the injection of Pegfilgrastim to boost my immune system, Matron Becky sprang a little surprise on me.

‘I’ve had an idea’ she said ‘about your PICC line. You’ll probably say no, but I just thought I’d mention it.’

I was all ears, obvs. Was there some way we could punish the PICC line for its complete failure to perform, for the third time running, when FEC5 was about to be administered on Thursday, after performing perfectly three times in a row at times when it didn’t really matter? I’d definitely be up for that, my once deeply grateful attitude towards the PICC line, for sparing my veins and its ease of use, having been transformed into sullen resentment after all the trouble it’s caused me during the last three doses of FEC.

‘You’ve only got one more dose of chemo to go’ said Becky ‘and the PICC line has caused major problems for the last three doses. You’ve had the last 2 doses into your veins anyway, and that hasn’t caused any problems at all.’

She picked up my left hand and examined it.

‘There’s a good vein there on the back we still haven’t used – what would you think about having the PICC line taken out, and just using that vein for your last dose of FEC? If the PICC line was gone, you wouldn’t need another two hospital appointments to have it flushed before your last dose of FEC on April 4th. You wouldn’t need to come back to the hospital at all until your pre-chemo check on April 3rd. And it would make you a lot less stressed before your last chemotherapy treatment, because you wouldn’t be worrying about whether or not the PICC line would work.’

Wow – no more PICC line? No more dressings covering half of my upper arm, forever reminding me of my cancer patient status? No more weekly hospital visits to maintain the damn thing? No more anxiety about its stubborn refusal to perform at the vital moment?

I was immediately giddy with excitement at this opportunity to simplify and de-stress things, to start cutting my umbilical ties to the hospital even as the chemo finishing post is looming into sight on the horizon.

‘That sounds like a very good idea, Becky. When could I have it done?’

Inserting the PICC line had been an intricate procedure involving ultrasound and local anaesthetic; I assumed that taking it out would require an appointment back at the PICC line unit.

‘Now. It’s really simple – I just have to pull it out. You won’t feel a thing.’

And she did, and I didn’t.

I think I heard a tiny scream from the PICC line as it was dragged out, though - but I have no sympathy at all. Let its fate be a warning to all future PICC lines who feel the need to be temperamental - THIS is what will happen to you if you get on the wrong side of Matron Becky...

And there is my actual PICC line, the narrow stripy catheter lying twined around the orange thing. This picture was not posed by a model.

The other good thing that happened at the hospital yesterday I will have to tell you about tomorrow, as the nausea is getting to me, and I’m very tired, and I have to lie down right now.

Friday, March 15, 2013

Rollercoaster


Day 96 

General status update

Despair Demon: the Dexy-fuelled Chemo Muse ambushed him early this morning, tied him up, and imprisoned him in the airing cupboard. At least it’s nice and warm in there.

Nausea demon: On the floor at the moment, bludgeoned by the IV Fosapprepitant, the steroids (which do combat the nausea, as well as making me high, remember), and the Ondansetron, Domperidone and Cyclizine anti-emetic drugs I have taken orally this morning. He’s just biding his time though, until Sunday, when the steroids wear off.

Chemo Muse: When we get steroided up on the Dexys after each dose of chemo, she expands like a genie coming out a bottle, and fills the room in a shimmering, swirling cloud of mist threaded with iridescent rainbow lights gleaming from the long, writhing snakes of her hair. (what can I say; I’m on drugs, alright? There have to be SOME good bits in the chemo nightmare). She is very, very powerful this morning, as a result of which I wrote 500 words before 8am.

Chemo Brian: gazing in awe at the newly-psychedelic Chemo Muse, and muttering about how she reminds him of a particularly wild mescaline trip he took with Aldous Huxley in the Sonoma Desert back in the day. Jesus, HOW OLD is Chemo Brian? I thought he was just an old hippy – he was at Woodstock, after all – but if he was hanging with Aldous he must be an old proto-hippy. Ah, good point – Chemo Demons aren’t mortal, are they? Chemo Brian is the Stoner for All Ages.

PICC line: in disgrace after it refused to function in the Chemo Ward yesterday, even for Matron Becky, after behaving perfectly 3 times over the last 10 days and gushing blood like a geyser in Yellowstone Park. We both looked at it, completely aghast. thinking ‘I JUST DO NOT BELIEVE THIS’. It’s claiming to be suffering from intolerable levels of stress and performance anxiety because of the increasingly high expectations heaped upon it. ‘Yeah, but you can hardly say that this HASN’T HAPPENED BEFORE, CAN YOU’ muttered Becky, darkly, as she prepared yet another injection of saline solution to flush it with. Actually, given that it had two assertive and increasingly pissed off women staring at it with increasing fury every time it failed to perform yesterday, maybe it’s not surprising it couldn’t get it up…

State of mind: only one more FEC to go, only one more FEC to go, only one more FEC to go!!!! Sorry, did you say something?

Hair: Dozing gently, as per post-Cold cap protocol, in snood and Smurf hat. It loves this bit of the cycle.



I wrote all of the above very early this morning in a mad burst of steroid-fuelled energy and then paused, intending to write the actual blog post this afternoon. I had to go off to the hospital first for another of those very expensive Pegfilgrastim injections to boost the production of neutrophils in my bone marrow, to strengthen my immune system and keep me infection-free during this chemo cycle. Because I’ve had two infections during the first four chemo cycles, the oncologist is very concerned to prevent any more from taking hold.

At the hospital two very good things happened – it was probably my best hospital visit ever, but unfortunately I can’t write about it now because my energy has crashed completely.

I’ve become so weak all of a sudden that I just have to go and lie down.

This is the Way of Chemo: sometimes the fatigue hits you so hard that your body tells you ‘Lie down – NOW’ and you simply cannot do anything else.

Tomorrow I’ll tell you about the good things that happened – at least those regular readers who have suffered with me every inch of the way through the last 14 weeks will know, for once, that tomorrow there is a cheerful post to look forward to.

Unless something bad happens during the night, that is, a possibility which can’t be entirely ruled out, given the run of luck I’ve had so far.

See you tomorrow, my friends.

Thursday, March 14, 2013

FEC the penultimate


Day 95 

General status update: just got fecked again… 

Today was FEC5, my fifth of six doses of the FEC chemotherapy regimen, once every three weeks for 18 weeks. 

It wasn’t without problems, which I won’t bore you with, but we got there - Matron Becky, Nurse Evelyn and me. I am full of chemotherapy drugs, various anti-emetics, and the lovely, whizzy steroids. We all know what will happen next, however – hold on to your seat for days 4-10 of this cycle, as it’s likely to be another bumpy ride.

But I couldn’t write a blog post tonight for reasons which had nothing to do with chemo: other events intervened.

So this is just to say FEC5 is done, I’m all in one piece for the time being, and the next time I go for chemotherapy treatment, in 3 weeks’ time, will be the last.

Hallelujah!


Wednesday, March 13, 2013

Eve of Destruction


Day 94 

General status update

Anxiety level (1-10): the root canal treatment yesterday was so unspeakably vile that the administration of chemotherapy tomorrow seems like a lesser evil. It’s all relative, innit?

Despair Demon: He was VERY freaked out by the Reiki on Monday, which undid all his good work and left me in an entirely uncharacteristic state of smiling, beneficent calm, which spooked R, too. It seems that Reiki is as Kryptonite to the Despair Demon. Well, tough – he’ll have plenty of time to reassert himself next week when the side effects of FEC5 are at their worst.

Nausea demon: I wish he wouldn’t get quite so Tiggerishly excited each cycle the day before the chemo is administered – I think it’s quite unseemly.

Chemo Muse: she’s very pleased with me as I finally got round to cutting and pasting all 93 blog posts into one document, which revealed that since chemo started 13 weeks ago I have written 103, 494 words, which is 10,000 words longer than my D.Phil. thesis (which took 4 years to write). Blimey.

Chemo Brian: Just seen off the Anti-Tooth Fairy, whose work here is (we all profoundly hope) done for the time being – the root canal won’t be completed until April, after the chemo has finished. They didn’t get on too well at first, but he warmed towards her after she took over his knitting and completed the Impossible Donkey in the Knit Your Own Nativity Scene.

PICC line: positively purring after its rendezvous with Matron Becky at the hospital this morning, when it behaved beautifully, flushing and giving blood on demand.  It says Becky has ‘good hands’ and, if she were a horsewoman, would undoubtedly be taking Olympic gold at dressage. And my PICC line would know.

Hair: Preening itself after being much admired at the hospital this morning, simply for still being attached to my head – very few heads of hair make it through FEC unscathed, apparently, cold cap or no cold cap.

State of mind: Still traumatised by yesterday’s half-completed root canal treatment, one of the most physically unpleasant procedures ever devised. We are now six months into this new world of physical pain inflicted by people with medical degrees, and if you look in my eyes you will see the message now tattooed across my irises: ‘I will tell you anything you want to know, betray all my friends, not to mention my country, and hand over to you all my worldly goods – just DON’T HURT ME ANY MORE’.

So, here we are again – the night before chemo, for the fifth time of asking. It’s routine, now. The bag for the chemo ward is packed: big woolly cardigan (to alleviate the cold from the Cold Cap), painkillers (to alleviate the pain of the Cold Cap), Smurf hat and snood (to swathe the post-Cold Cap frozen and gooey head), Kindle Fire, real books and the Big Red Book of Chemo, into which all the drugs administered must be written. Fruit, sandwiches, and drinks will be added in the morning before I leave.

My PICC line was taken through its paces by Becky the Chemo Matron at the hospital this morning, so it should work this time, and Becky has promised to be there tomorrow morning to supervise the administration of FEC5 from the off. FEC3 and FEC4 were very bad days indeed for me in the chemo ward, but I know that every effort is being made this time to ensure that things will go smoothly tomorrow.

And by mid-afternoon tomorrow I will be able to walk out of the hospital knowing that I will only have to do this one more time.

And in ten days’ time the worst of the side effects will be over, and I will know that I only have to suffer them one more time.

I can do this, really I can.

Where did I put the Lorazepam?

Tuesday, March 12, 2013

Open wide...


Day 93 

General status update: semi-root canalled, numb and woozy...



Not my actual dentist - she has much better headwear, obvs.

I’ve just had the root canal treatment – or half of it, anyway. It proved to be very problematic for the dentist as I apparently have an exceptionally small mouth/jaw and am unable to open it very wide, the tooth is right at the back, and getting access to the tooth with those long thin pointy things they use to burrow around in the root canals was extremly difficult for her, not to mention agonising for me as I struggled to keep my mouth open wide enough for long periods of time. She tried putting a small piece of scaffolding inside my mouth to hold it open, but that hurt even more.

Also, with the infected root still sensitive, I needed enough anaesthetic to sedate a small horse, which came in 3 separate instalments, with the dentist injecting a new and more powerful dose each time she poked something sharp deep inside my tooth and my body spasmed as I screamed.  



After nearly two hours, both the dentist and I had had enough: the canals are all opened up, and partially cleaned, but she ran out of time, and I was beginning to lose the will to live. So she’s put more medication inside the canals, which will kill off the nerves completely, put another temporary filling on, and the rest will now wait until my chemo has finished. The dentist is now talking about giving me some heavy duty sedation next time – the more out of it I am, the longer I will be able to keep my mouth open, and the better chance there will be of her actually being able to complete the root canal treatment. If that doesn’t work, then the tooth will have to come out.

I’m just glad of the temporary respite from more dental horribleness – and praying that nothing else happens to my teeth in the remaining 6 weeks of the final two chemo cycles.

The plus side of all this is that after the extreme unpleasantness of what happened today, having FEC5 on Thursday seems less daunting – at least they don’t make you hold your jaw wide open while they pour the chemo drugs into you.

And chemo doesn’t involved any drilling at all…


Monday, March 11, 2013

A kind of magic


Day 92 

General status update

Anxiety level (1-10): am now operating a kind of ranking system in the general status update, whereby the day’s most troublesome aspects are featured at the top, thereby taking the reader right into the heart of the matter, whatever the matter may currently be. Obviously as this is the beginning of a week in which I will be having both root canal treatment and my 5th dose of chemo, anxiety is at the top of the agenda, and as of this morning I was melting into an anguished pool of terrified hopelessness (see Despair Demon, below) but then SOMETHING HAPPENED (see further below).

Despair Demon: has been working overtime for the last 24 hours to bring me to a new low of fear, loathing and self-pity – I had to ask my fearsome friend Gill to phone up and give me one of her legendary ‘pull yourself together, you wimp’ bollockings. They’re terrific. Gill could instil backbone into a cheese soufflé - she should be available on the NHS. And then he got further kicked into touch by some magic (see below).

Nausea demon: Waiting his turn, impatiently, to start tormenting me again on Thursday.

Chemo Muse: She’s now in total awe of my friend Gill, from whom she learned a few things today about how to motivate me.

Chemo Brian: He’s played the new Bowie album so many times now that we’ve all memorised the lyrics. The Nausea Demon is complaining about this noise, being of the hip hop generation, with correspondingly ridiculous trouserage. The other day I pointed out to him that photo in the newspapers of Justin Bieber on his birthday outing with what passes for trousers hanging off his arse, and said ‘Is this REALLY what you want to look like? A giant toddler who can’t keep his nappy on?’

PICC line: it’s all happy and excited about going to see Becky the Chemo Matron on Wednesday for its pre-chemo check; it points out that it always had the potential to do well, just as Andy Murray always had the potential to become a Grand Slam champion – but like Andy, it just needed to find its Ivan Lendl to coax it into peak performance at the crucial moment.

State of mind: when your PICC line starts talking to you about tennis,then you know you’re starting to lose it BIG TIME.

Hair: very miffed at having fallen from the top to the bottom of the ‘things to worry about’ list – I hope it won’t start shedding more now, by way of protest.
  

When it comes to suffering, one really has to be sceptical about Nietzsche’s blithe assertion "That which does not kill us makes us stronger”. Whilst this aphorism is undoubtedly true of vaccinations against disease, most of the time suffering does not bestow nobility or strength: it just kicks the stuffing out of us and makes us very sorry for ourselves indeed. 

And when I say ‘us’ I mean, obviously, ‘me’.

This morning, with a little help from the Despair Demon, I probably reached an all-time high in the self-pity ratings: the prospect of both root canal treatment and chemo this week, starting tomorrow, was making me feel very shaky indeed. There were some tears, it seemed pointless to try to do anything today in the shadow of the oncoming torment, and by 10.30 am I was ready to abandon any further pretence of purposeful activity and fall into a prolonged horizontal sulk on the sofa, in the arms of the ever-welcoming Chemo Brian.

Then the phone rang, and a woman introduced herself as Sabrina, the complementary therapist at the Hammersmith Hospital to whom the Chemo Matron had promised to refer me, and about whom I had almost forgotten. We talked for a few minutes, I explained what was going on in my life this week and clearly sounded like a woman on the edge of a nervous breakdown, as Sabrina immediately suggested that I should come and see her this afternoon. I agreed, wondering if it was really a good idea, when all I really wanted to do was to be left alone, curl up and go to sleep. Maybe I should phone back and cancel….

This attempt to revert back to lassitude and immobility was averted in the nick of time by the application of a telephonic cattle prod; my friend Gill - a woman with all the empathy and gentleness of approach of a Regimental Sergeant Major on crystal meth - called and, when I whined, instructed me to get off my rear end and take myself to the hospital, pronto. Duly electrified into movement and action, I presented myself at the Hammersmith Hospital  – which is, oddly, in White City. Why are none of the west London hospitals situated where they are meant to be? It’s really most confusing  – not entirely sure what to expect, but grateful for anything that might make me feel a bit less stressed about what is to come this week.

Sabrina took my medical history, and explained that all cancer patients (in the Imperial Healthcare Trust, anyway) are entitled to six sessions of complementary therapies to help them deal with both the physical and psychological side effects of cancer treatment: the therapies on offer include acupuncture, aromatherapy massage, cupping therapy, reflexology, Indian cranial massage, and Reiki.

For my immediate needs (essentially ‘dread management’) Reiki, a healing and relaxation therapy, originating in Japan, and administered by what might best be described as the light laying on of hands, seemed most appropriate. Reiki (pronounced Ray-key) is apparently a Japanese word meaning “Universal Life Energy, an energy which is all around us”, and Reiki therapy, which claims to channel this Universal Energy ‘through the practitioner and into the receiver’ immediately seemed to me to come under the broad heading of what R, a vigorous proponent of evidence-based medicine, calls ‘woo’ (pressed to provide a more precise definition than ‘woo’, his one word answer is ‘bullshit’).

My own feeling, however, is that there may be more in heaven and earth than what is already evidenced by randomised clinical trials, and I was perfectly willing to try a little ‘woo’ and see where it got me. After all, it couldn’t make the chemo or my overwhelming dread of it any worse, could it?

I lay down on a massage bed, and Sabrina cocooned me in a blanket. The lights were dimmed, soft, ethereal music was playing, and the air was scented with lavender oil, providing a deeply relaxing environment. I thought I could quite happily just doze off and have a nap like that, without bothering with any treatment. I was instructed to close my eyes and relax my body totally, and then Sabrina laid her hands, very lightly, on my head and kept them there, cupping the top of my skull for several minutes.

Was there a flow of ‘Universal Energy’ from Sabrina into me through this laying on of hands? I have absolutely no idea, but it felt wonderful, and what struck me immediately, and very strongly, was that this therapy, through its very gentle use of touch, was the polar opposite of all the physically intrusive, often painful and always unpleasant medical procedures that are constantly being inflicted on me during my treatment for cancer: surgery, injections of radioactive dyes for scans, drawings of blood, infusions of chemotherapy drugs and, of course the Cold Cap, the Day-Glo pink helmet which you see in my photograph, which has preserved my hair at the cost of the intense physical pain involved in freezing my head for several hours at a time before, during and after each during chemotherapy session.

When Sabrina held my head so gently in her hands it was like the antidote to the Cold Cap, a healing of all the pain that has been inflicted on me during the last six months of my cancer treatment. It soothed me, and relaxed me, and allowed to me lay down some of the burden of stress, pain and anxiety I have been carrying for so long.

However it works, it worked.

As the treatment continued, and Sabrina moved her hands to other places on my head, and then other parts of my body (you are fully dressed for this, and the touch is very light – as I said above, it is a laying on of hands, not a massage) I became deeply relaxed, and a little drowsy, and the tight knot of anxiety in my mind unravelled into something more peaceful.

I left Hammersmith Hospital today feeling considerably better than when I went in, which is only the second time this has happened in the last six months of frequent hospital appointments (the first, as regular readers will remember, being The Day I Met Matron And She Magicked My PICC Line Better).

This evening over dinner I described the treatment and my reaction to it to R, prepared for him to scoff, but he didn’t. His view, based on the obvious improvement in my state of mind and affect, was that ‘We could call it transference, or meditation, or calming down, or a kind of magic, but whatever it is, it obviously worked.’

If we call it a kind of magic, that’s perfectly fine by me.