There's no better way to prepare for Round 1 of Chemotherapy than watching the 'Red Wedding' episode of Game of Thrones. That puts you in just the right frame of mind. I didn't know. I DIDN'T KNOW!
I was feeling OK, if a little tired and nauseous, the morning of Round 1. I had an outpouring of support on Facebook which really galvanised me - I was ready for a fight. My knowledge of chemotherapy was from TV and film - people sit in big chairs with a drip in for a few hours. They go home. Their hair falls out. They go back. Repeat for a while. There's more than that, and one of the reasons for this blog is to help with understanding the medical tests and procedures used in the diagnosis and treatment of cancer.
Upon arrival you head to the luxuriously named Chemotherapy Suite. In my hospital this was a line of 4 large wipe-clean comfy seats and a bed. I bounded in with my brave boy face on, and I can only assume the general consensus from the four other exhausted looking patients was 'who is this chirpy twat in a Captain America T-shirt? We'll soon wipe the smile off his face'. I was sat in my chair for the duration - opposite the door. This meant I could serve a double purpose as a grim reminder of the fragility of life and as a helpful tour guide for lost patients hunting for the exit.
I met so many patients during my 12 rounds of Chemo. We rarely spoke to one another other than a grim smile or a friendly goodbye. The majority were breast cancer patients. I believe that aged 33 and with 4 hours of Chemo I was a double record holder there. Lucky me. Reality hit home when I was sat next to an older lady who, throughout her treatment, clutched to a cuddly toy and wept. Most patients faced down their treatment with a degree of positivity or stoicism, it was the scared relatives who got pushy or angry with the nurses. In many ways, it's harder for them. They feel powerless in the face of the disease and strike out in frustration at their impotence and unfairly take things out on beleaguered medical professionals. Whoever the patient and whatever the condition, they didn't deserve this illness, and I think about them often and where they might be in their treatment now.
Once I'd eased my lumbering 6 ft 4 frame into the (for now) comfy seat Karen broke out a big yellow courier sack with a toxic symbol on the front - it looked like all my lethally poisonous Christmases had come at once. She spent 20 minutes preparing the labels and checking off the details - 'Nicky Boardman, expires November 2013', she said. I told her that was alarmingly specific and not to write me off before I'd even started. I think I'd made her feel bad.
What does a single course of Chemotherapy look like before it goes in? HOLY CRAP IT LOOKS LIKE THIS -
...and in it goes. Almost all via the PICC line (prick line, more like). A feed of anti-sickness. Then a feed of your first drug. Then anti-sickness tablets. Then your next drug for an hour. Then an injection of atropine (the stimulant they stab into Uma Thurman's heart in Pulp Fiction and/or Nicolas Cage near the end of The Rock - yay, I'm a film star, no I'm not, I'm a sickly douchebag). Then the worst of all -Irinotecan, AKA Sweaty Betty. Lastly, out comes the type of syringe only clowns can buy. A syringe the size of your arm to be somehow squeezed into your bulging veins over 10 minutes. Then you're done.
Except Colorectal cancer is the gift that keeps on giving. For 48 hours, after each round, you're attached to a '5FU Infusion'. A pink baby bottle that is left hooked up to your PICC Line (prick line, more like) and decants 2ml of drugs every hour. It means that if you hoped to start feeling better from the Chemo you could have an extra little kick in the nuts every so often. Lugging it round, sleeping with it, etc, is a pain in the ass, and you have to work around it. My solution was to moan a lot and hide in the bedroom. Karen was insistent that a bum bag would help with carrying it around. A FANNY PACK. I'd leave the hospital with it then wrench it off as soon as I got home, hiding it for the next two weeks. Sorry, Karen.
Now to ride out the side effects. Chemo can be cumulative and I found things changed over the months (wait until you hear about the conga line of shit, pals!) but here's the way it generally panned out -
- I'd sweat for 4 hours immediately after. Like a UKIP Member taking a mini break in Brighton for Pride.
- I'd also wee lots.
- I'd sleep most of the afternoon
- As the sweating wore off, nausea would kick in and stay for the next few days. As would the tiredness.
- With the pump disconnected, you start to feel better by days 3/4. Your appetite starts to return.
- Day 5 - the Chemo hits your bottom. All sorts of astonishing things happen. More on that to come, poo fans!
- Day 7 - it's out of your system, your appetite returns, normal sleep patterns kick in.
Sadly, that wasn't quite the case following my first round, and I thought things might be over before they were even started.....
Coming (Very!) Soon - Chapter 10 - Things Get Worse. Then Much Better.
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