Monday 12th August
For a while there, I didn’t think I’d make it to round 2, but I did. I was greeted by the nurse who I’d seen when I was admitted the week before and I explained to her that it seems it was a reaction to maxolon. I was escorted to my chair in the naughty corner and was disappointed to see that I had been separated from Karine, my newfound chemo buddy who I’d met a fortnight ago. Did we talk too much? We vowed we’d make sure we were next to each other next time. She only had three more sessions after this one. I still had 10 (all going to plan). If I sound jealous it’s because I was!
A nurse put an intravenous cannula in (got it in first time) and took some blood to be sent to pathology. I then went upstairs to see my haematologist. It was a pretty quick appointment, which commenced with me saying, “I’m becoming a bit of a handful aren’t I?” I can’t even remember what his response was but I don’t think he agreed. Very polite. He asked if my itch had gone. I said it was better but not gone. I told him I was pretty sure the lymph nodes in my neck were smaller. He felt them but didn’t say anything. Would he even remember what they felt like three weeks ago? I asked a few questions to clarify things some of the nurses had told me. Can this chemo regime be given every three weeks? One of the nurses told me it could but that I was probably getting it fortnightly because I’m young and fit. I didn’t think that was right. He confirmed that saying she had obviously got her regimes mixed up. Am I supposed to have antibiotics for viral respiratory tract infections? One of the nurses told me I need to have antibiotics straight away to prevent a secondary bacterial infection. That one really didn’t make sense to me. Having antibiotics for a viral infection pretty much ensures any secondary bacterial infection will be resistant to those antibiotics, which cannot be good in someone with a weakened immune system. He told me we didn’t need to be silly but needed to treat any bacterial infection early.
He asked if I’d had a blood test that morning. I said I had and asked if he had the results. He didn’t have the results and he said something along the lines of that not being an issue because I was having chemotherapy regardless of what the blood tests showed because I was well. The most important blood test was that which measured my white cell count, in particular my neutrophil count. Neutrophils are one of several types of white blood cells in our body that fight infection, particularly bacterial infections. Normal counts are between 2-8. The nurses had told me they don’t give chemotherapy if the count is less than 1.5.
I went back downstairs for chemotherapy and soon after someone slipped a piece of paper into the basket on the trolley next to me and said “Here are Melissa’s pathology results”. Of course, I had a look at them. Doctors always look at their own test results. Neutrophils 0.5! That is low. I let out a chuckle and said to Jenni, “Ooh, the nurses are not going to like that!” I told the nurse next to me and she asked if my doctor knew. I said he didn’t but that I knew he wouldn’t care and he’d say I’m having chemotherapy anyway. She asked another nurse to give him a call and as expected he wanted to push on with chemotherapy.
My haematologist popped down a bit later to discuss my neutrophils, which in his words were “a little low”. “A little low?” I asked. “Almost non-existent”. He didn’t think so. I think zero would be considered low in his books. He explained that sometimes the first chemo is a bit of a shock to the bone marrow and then it realizes it has to work a bit harder but if my neutrophils were still low before the next chemo, I’d need nuelasta (or G-CSF, granulocyte colony stimulating factor). This is an injection that stimulates the bone marrow to produce more white blood cells. I was also informed that in young people (that’s me!) it can cause pretty bad bone pain. The good news just keeps on coming! Go you good cancer!
The rest of the chemo session was pretty uneventful. The nurses snuck through the first three drugs without me realizing and the fourth one was up before I knew it. That one is infused over 1.5-2 hours. It had to be slowed down initially as it was stinging but they sped it up again and I was out before afternoon tea. I had a lovely nurse looking after me for most of the day. She usually works on the ward but was helping out in the day infusion centre that day. She was also the nurse Jenni had spoken to when I had my ‘bad day’. She said I needed to book something like a girls weekend in the near future so I had something to look forward to. Sounds like a bloody good idea to me!
OK, those quotes are a bit too deep for me so I won’t finish on that note. I’ll tell you about Bali. I mentioned in an earlier post that we had a family holiday booked at the beginning of September. My haematologist advised me not to go. Initially I thought I’d still be going, maybe for a week instead of two. I thought if I got sick over there, I’d just hop on a plane and come home. When I was sick after the first round of chemo, it occurred to me that if I was sick, I would actually be sick and possibly not capable of just going to the airport and jumping on a plane. So, at that point, Bali was off for me. But then I recovered and felt pretty good, almost normal, in Queensland, so I was going to Bali again. After turning up for round 2 of chemo and finding out how low my neutrophils were, common sense prevailed and I decided it really wasn’t worth taking the risk of getting sick over there. With virtually no immune system, the risk was high. My husband was still keen to go with the kids and I started thinking that two weeks at home with no husband and no children sounded like a bit of a holiday too. Oh, apart from a little bit of chemotherapy.