Thursday, May 03, 2007
C is for Chemotherapy
After my late late lunch of smoked salmon sandwiches and fruit salad, my little nurse busies herself readying the chemo paraphernalia. In comes a scientific looking drip stand, with buttons and a touch screen. In come those recycled paper trays they use, filled with syringes. Two small clear ones (the pre-meds: Ondansetron, an anti-emetic; and Dexamethasone, another anti-emetic and dreaded appetite-inducing steroid), four beautiful raspberry coloured big ones (the evil epirubicin, remover of hair and stimulator of nausea) and two small bags of clear fluid (the fluorouracil and the cyclophosphamide).
I am given a lorazepam (a sleeping tablet) to chill me out before we start proceedings and another nurse comes in to fit the ice cap. It’s a gel cap, like a swimming cap, that’s been in the freezer far too long. She pulls it over my head (always had a large one) and then fits a neoprene swimming hat over the top. Both have chin straps. R takes photos with his phone. Nice.
The cold is not overwhelming. In fact it is better than expected. I can do this. This will be alright.
I have taken note of what I have been reading. Dina’s book talks of the nausea associated with chemo having such a Pavlovian response on her viewing habits that she can no longer watch some of her favourite programmes – those with which she thought she’d distract herself in the early days of chemo. So, keen not to rule out my favourites, but wanting something to distract us during the chemo, we resort to the armoury of free downloads I made in preparation of rainy afternoons in the middle of nowhere in Uganda. It’s a shame of course, that they are not being used for their original purpose, but it seems a perfect purpose now. Zoolander is first up and on the ibook. Writing this two days later I cannot remember any of it. So the sleeping pill certainly succeeded in making me suitability drowsy.
Then we start. The nurse sits by my bed and fixed up the Huber needle already inside my Portocath (they inserted that as part of the procedure) to the drip. She draws up some blood to check the valve is working both ways, which it is, and then sticks a flush in. She follows this with the Ondansetron.
Immediately, there is a prickling sensation inside my chest. The Portocath goes into the main vein near my heart so this is some sort of reaction just where the drugs first enter my body. It intensifies and becomes quite unbearable. What’s worse is that it descends down to my groin where it feels like the worst ants in your pants imaginable. I feel like jumping off the bed and plunging my arse into a bath of cold water. I feel like jumping up and giving my crotch a good scratch. I can’t do any of these things because I am plugged into the machine and I am also embarrassed. The nurse is asking me where the pain is and what it feels like. All I can muster is that it’s “Like fire ants, in my front bottom”. I feel infantalised. Front bottom? Am I three years old?
But as soon as it starts, its over. 30 seconds is all it took. I relax and we talk about why / what / how. I remember that just before passing out on the general anaesthetic for the lumpectomy my anal area suffered a strange prickling sensation. Maybe I was also given ondansetron then? Apparently, it’s possible. Then again, they say this could be a reaction to any combination of the drugs I’ve had for the portocath insertion, and not just the ondansetron. Or a reaction to the first drug ‘down the tube’ of the port. Who knows? It’s slightly un-nerving that the medical establishment does not have a fixed answer for this but I guess if 30 seconds of ants in your pants is all it takes to avoid nausea then I can cope with that.
The next pre-med glides in smoothly with no incident and then we’re onto the ebirubicin. The raspberry liquid is pushed ever, ever so gently into the tube. The nurse takes great care and is watching me closely all the time. This, I guess, is the moment where she may need to suddenly offer me a sick bowl. I suddenly realise that’s why she’s carried the syringes here in so many paper trays. These are the sick bowls.
But I feel nothing. So I carry on breathing quietly, one eye on Zoolander, the other on the nurse. Maybe if I stay very still the drugs won’t get me.
Time passes, ice caps get changed, the raspberry syringes get disposed of. We make it through the epirubicin and move onto the bags. These go in with no problems and suddenly it’s all over. I feel tired (operation, sedation, sleeping tablet – I guess this is no surprise) but immensely relieved.
I have made it through Chemo I. I have not been sick. I feel tired and fuzzy but okay. There is a quiet euphoria about this. I feel like I can do this.
That night the fuzziness and sedation really kicks in. I call and text various people to let them know I am ok and that it wasn’t so bad. In between calls and texts I drift in and out of a half-sleep in front of bad TV. Half an hour after calling my Mum I find myself thinking “I must call my Mum”. I sit there, in the hospital bed, trying to kick start my brain into remembering whether or not I have already called her. I cannot remember and have to use my phone log to tell me. This brings home to me quite how dopey I am and so I have a peppermint tea and resolve to write up some of what happened today before I forget it all. Hence such lengthy posts.
Two days later and some of the euphoria has worn off. I feel tired but cannot sleep without the sleeping tablets they have given me. The steroids make me feel like I’ve drunk far too much caffeine with none of the pleasure of enjoying a decent coffee. I am alternating between wired and tired. My chest hurts around the port insertion. When I lean forward, gravity hurts. Is this because the port is titanium and therefore heavier than flesh? It pulls down on me, making it hard to bend from my middle. And I occasionally get a flash of joint pain (that will be the expensive Neulasta, at £1100 for 6mg, making my bone marrow grow).
I stayed at home today and took hours to read through a document for work that would normally take minutes. The hardest side effect so far is not the fatigue but the fuzziness. My head feels wrapped in cotton wool and the wheels of my brain move slowly. My short term memory is decimated. I start sentences and then cannot remember what point I was going to make.
Tomorrow I will go into work, but who knows how much work I will get done.
at 10:05 pm