Monday 26th August, 2013
The day started like any other chemo Monday. I took my daughter to school, stayed for assembly, returned home to meet Jenni and off we went to hospital. We were running a bit late so Jenni dropped me at the front door and I went in while she parked the car.
I had an appointment with my haematologist first, so I went upstairs to see him. This was the first time he’d seen me scarved up and without long hair so the appointment started with me saying “I’m looking the part now aren’t I?”. He made a comment along the lines of once you get into the swing of things it’s not that bad and that the fear of the unknown is worse. I told him about my sclerosed and painful vein following the last round of chemotherapy and asked him if I’d need a PICC line. PICC stands for peripherally inserted central catheter, so now I’m sure you know exactly what one is. I’d been having chemotherapy through an intravenous cannula which was then removed upon completion of chemotherapy. A PICC line is inserted peripherally (as opposed to centrally, usually in the upper arm) and goes all the way to a large vein (the superior vena cava) just before the heart. The advantage of PICC lines is that they can be left in for months. My haematologist said that it is not uncommon to run out of veins (because they all sclerose or go hard) towards the end of treatment. He said that my hardened vein may open up again but not in time to be of any use to me for chemotherapy. He didn’t seem to be keen on a PICC line and I asked him why? Was it because it might get infected? He said it was just another procedure I’d have to go through if we decided to go down that path. Many cancer patients are subjected to many procedures so it is sometimes wise to minimise these if they are not really necessary. I felt that I’d been subjected to relatively few procedures compared to most cancer patients.
I’d had a blood test on the Friday of the week before so I asked him how my neutrophils were as that was really the only thing I was interested in. You might need to read the chemotherapy – round 2 post to brush up on your neutrophils. My neutrophils had been 0.5 prior to the second round of chemo. 0.5 is very low but we proceeded with chemo and I managed to stay well in terms of not developing a fever or an infection. My haematologist had said that sometimes the bone marrow (where neutrophils are made) gets a bit of a shock after the first chemo and then recovers so I thought the level this time might be better. Well, it was a bit better; 0.7 – still very low. He said they might be higher today and we’d check them again just for fun.
My haematologist also told me that he’d be away for the next few weeks so I’d have to see the doctor who was covering him prior to round 4 and that I’d see her on a Friday instead of a Monday. He also reminded me of the PET scan I’d be having after round 4. I hadn’t forgotten. He explained that it would be done towards the end of the two weeks after treatment.
I went downstairs to the chemo ward and realised I’d forgotten to sign in to the hospital. Chemo brain. Jenni got the paperwork from the front desk and I signed it so I could be admitted for chemotherapy. I was in seat number 1 and Karine, my chemo buddy had it all sorted so we were next to each other. Karine was accompanied by her mother that day. We chatted about the past fortnight and how the previous dose of chemo had affected us. Karine was happy to hear that round 2 had been much kinder to me than round 1.
We then went through the usual routine of soaking my hands and forearms in hot water to make my veins more prominent. The first attempt was not successful so the task was handed over to the charge nurse. I’m sure she didn’t like me telling her what vein to go for. I could feel a nice big, juicy vein on my forearm and I was telling her to go for that one. I remembered my days as an intern; I must have inserted hundreds of intravenous cannulas, and from experience I knew the veins you could feel were easier to cannulate than the ones you could see. She didn’t like the vein I was suggesting because she couldn’t see it so she went for a big vein in the front of my right elbow. That was going to make texting annoying, having to keep my arm straight. But she missed, or went in and out of that one. This was not going well. Two failed attempts and I didn’t think my veins were that bad. Maybe a PICC line was a good option. Fortunately the third attempt on the outside of the left wrist was successful.
Blood was taken and sent to pathology to see if my neutrophils were higher than 0.7. Nope, they were lower -0.5. A quick phone call was made to my haematologist to see if we were proceeding with chemotherapy. Of course we were! And I still wasn’t qualifying for bone pain causing neulasta (the injection which makes your bone marrow produce more neutrophils).
The highlight of the day was the realisation that I could order a hot lunch instead of having the same old sandwiches week after week. Not that there’s anything wrong with sandwiches but I was feeling sick at the thought of seeing them. I think it’s just the sameness of it. So Jenni enquired with the ward clerk and a nice hot lunch was delivered. Much more appetising than sandwiches. I can’t remember what it was and I didn’t take a photo of it this time.
The rest of the day was pretty uneventful. There was some pain in my arm with the infusion of the last drug so it was slowed down a bit and a heat pack was applied. I was really hoping the vein didn’t sclerose this time.
The week following chemo was actually not too bad. I spent Wednesday in bed, so it hit me a bit quicker than round 2 when I spent Thursday in bed, but this time, I was feeling quite good on Thursday. Friday was my mum’s birthday so Jenni, my mum and I treated ourselves to a pedicure, went to my daughter’s school swimming and then went out for lunch. Uncle Noof (former fav uncle) also came out for lunch.
On Saturday, I had my first social outing as a scarved up cancer patient.
On Sunday, I noticed the vein that had been used to deliver the chemo was becoming painful and had gone hard. So that’s two out of three veins sclerosed. Not good. It wasn’t excruciatingly painful but it was certainly annoying and enough to interfere with sleep at night.
On Sunday, which was father’s day, I also drove my family to the airport for their 17 night holiday in Bali, a holiday I was also supposed to be going on but had to cancel because of cancer. On the way home from the airport I was just thinking ‘Fuck cancer’. I wasn’t sulking because I’d missed out on a holiday, I was just pissed off that cancer had robbed me of the opportunity to spend time with my kids on a holiday. I know, it’s not a big deal in the grand scheme of things but it was how I felt. I drove to Jenni’s house for a father’s day dinner with my dad and then went home looking forward to a sleep in, but I woke up at 6:45 am on Monday morning, and the next few mornings.
On Monday I was feeling tired again. I did some weeding but found myself back on the couch quite often, having a rest. My hair was shedding quite a lot and given that I was wearing scarves everyday, there didn’t seem much point in having the short hair that I had, so I decided it was time to shave it off. On Wednesday 4th September, I went to Jenni’s house for dodgy hodgy chemo cuts 8, 9, 10, 11 and 12. The rest of that first week without children, prior to chemo round 4, was spent reliving my youth (minus the alcohol) with a new found social life, catching up with friends and going out for dinner. I did a bit of weeding, tidying up around the house, had a massage and even went for a few walks. I spoke to my daughter in Bali via FaceTime and I was content that she wasn’t missing me as during one call she was more interested in picking a flower than talking to me. It was definitely a pleasant week with nobody to worry about except myself.