Chemo has started again.
Having braved the procedures last year, was it easier to walk through
the doors of the chemo ward? The answer
to that is, unsurprisingly I’m sure, both yes and no. A friend who had not accompanied me before
was at my side for this first of three FEC chemotherapy treatments. Whilst FEC is a standard breast cancer
treatment, this day would be new to me and I felt something like a first former
having moved up a year, the walls of the classroom were the same but the books
were very different. To add to the
novelty, my appointment was for a Friday at 3pm rather than a Wednesday at
8.30am. I wasn’t one of the new patients
for the new day: the rhythms were well established, the comfy seats occupied
and the biscuit basket had made many laps of the ward already.
I find myself ‘over explaining’ about this chemotherapy,
partly because of the splendid results of the first treatment cycle and
surgery. This second cycle of chemo was
never optional, even if I’d had a grade 5 response to the first chemo. This is the protocol that has been tested and
has found to give the best results, so I must follow it. However, those who have a kind but not
detailed interest in my treatment look worried when told I have started chemo
again. The way cancer is reported and
remembered in the press and public memory is as a battle that you will ultimately lose. Cancer patients are ‘survivors’
and ‘fighters’. You can see in a moment
the thoughts that fill a mind when someone is told you have started chemo again;
‘oh no, it’s not back is it?’ Thus, I
find myself explaining that I’m doing very well, this is as it should be and
I’m looking forward to getting back to work.
The kind friend usually nods with relief, but you can see the doubts
that fill their mind: ‘she doesn’t really know, but I hope she’s right’.
I don’t know the reasons for the two different types of
chemo, and to be honest I don’t care. If
you could have heard me at my oncologist appointment reciting the results of my
treatment to date, to the surprise of the observing registrar and resigned
acceptance of the consultant, you’d be astonished at this attitude. If you see me in a consulting room,
especially one when I’m particularly anxious, you’d think I’d need to know the
research behind every treatment I’ve ever had.
If you’ve been following this blog from the initial diagnosis, you will
know that not knowing all that I was facing was an important coping tool, and
that rubric is still valid as I plod wearily through this next phase. Yet, I do have to admit to pottering through Google
Scholar every so often, to see if I can find anything on what has happened to
me. Usually my concentration goes as I
realise there is so much more than I can grasp; these files do not assist me in
dealing with the day to day tribulations of chemotherapy. That management has to be my focus, that
‘living in the moment’, but at the same time I find myself more reflective on
who and what I am: a very ordinary person in a very unremarkable situation. This is not false modesty, okay maybe a
little bit, but life and death are everyday things, and, unlike weddings, they
can only happen once to us and so the imminent arrival of either is quite a
drama. The inevitably of my demise has
been forestalled by medical intervention and, whilst I have moved on from the
‘why save my life?’ thoughts, just watching the bulbs push through the winter
earth has given me a deep joy I find hard to quantify or even comprehend. Yet it isn’t all over yet; I have more to
endure. I hope it would not surprise you
to learn that the pleasure in receiving pain has long mystified me, so I
haven’t greeted this process with any form of content. But how much has it hurt and how much is felt
largely through expectation as that is what chemo ‘should be’? Or to put it in less flowery language: what
does chemo feel like?
If you are followers of this blog you will probably be able
to chant at the screen ‘it’s different for everyone’, and sadly that unhelpful
phrase is true once again. Therefore, I
intend to tell you how it feels for me, as that is the only reliable data I
have available. Let’s start with what
they did after I lowered myself once more into the comfy chair on the chemo
ward. This process used a cannula again,
but into the side of my hand as it would seem the vein on the top of my hand
has taken something of a beating and wasn’t up to the job of holding it. One down, a few more to go, not quite ready
for a central line or PICC line yet. A PICC
line is a peripherally inserted central catheter and according to NICE guidelines
I have just googled, are indicated when IV treatment of two years or more is
indicated. A central line is a skin-tunnelled
venous catheter, or Hickman line. Used, so it says, if it is difficult to get
needles into your veins or you don’t like them.
I see quite a few people with Hickman or, PICC lines on the chemo ward. It must make life easier, but in my mind I
see them as a badge of courage. People
walking in and taking the medicine that usually makes them feel worse in order
to relieve pain, or give some respite.
Quiet courage, that everyday choice from those in the comfy chairs.
My nurse was to stay with me through the whole of the
treatment as it was to be given in a series of big syringes. Fluid was slowly injected into me with the
nurse watching to see how my body responded and checking the potential adverse
effects that can happen if someone less skilled were doing the job. My nurse was the standard chemo nurse:
cheerful, expert and calm. Presenting a
positive, friendly front, whilst all the time aware of what might not be right
in the medicines, or what questions are best answered, or gently diverted. I felt completely safe in her hands. The first two syringes consisted of fluorouracil
(aka 5FU), the second two were the red coloured epirubicin, and finally the
last two were cyclophosphamide (if that means anything to you; they are just
difficult to spell words to me, but I liked being accurate). The flush was pumped through for about five
minutes afterwards, then it was just an anti-sickness tablet, boxes of meds to
take home and the MRSA test and I was out of the ward just an hour and twenty
minutes after I walked in. No sleeping,
no discomfort, and no trip to the loo with the pump in tow (which looks like
you are trying to guide a drunk across the room). I felt great, not too hyped up by steroids,
no pain, with only a pad and bandage on my cannula point to suggest I wasn’t in
tip top condition.
Steroids and anti-sickness medication lasted for three days
and kept me quite buoyant, even if I didn’t sleep that much. The fourth days started fine with the
steroids still in my system; however, by lunch time I felt a bit like a sagging
souffle. Headaches appeared, despite
drinking about 3 litres of water a day since the chemo as instructed; my
concentration waned; I didn’t want to sit up when I could lie down. Sickness ebbed away but breathlessness was
more of an issue, as was swallowing. Paracetamol,
carefully stock piled so I didn’t need to go out to get some, were sought out,
and I sank into flu-like symptoms, except with a very low temperature rather
than a high one. A quick phone call to
the acute ward reassured me that things were on track and I snuggled onto the
sofa with a duvet over me. The next day
I didn’t get up, didn’t sit up, and was counting down the hours until I could
take more painkillers. However, 8 days
after chemo, I am up and dressed and have been out to have tea with a friend. The storm really was teacup-sized this time,
which is a great relief. I am not ground
down by the pain, and hopefully will escape that grinding before the end of
this treatment phase. I am resolved and
determined. The glimpses of my new life
that came my way before this chemo started have reinforced in me a
determination to relish and value the life that I have now, to find joy in a
life given back to me, not before the chemo, or radiotherapy, ends but
now. I have a very long way to go to find
‘full health’, and I can never be what I was before the cancer. How I find who I am now, and how I am going to
live my life, are the questions that bubble up in front of me as the pain eases
from this first round. I’m still far too
close to contemplate any answers; still too relieved to be here to be anything
other than very grateful. Pain or no
pain.
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