Cycle One Day One

Yesterday was day one of the first cycle of chemotherapy. I had been dreading it. Silly, really, because it spoiled the two days beforehand (an effect exacerbated by having finished a piece of work and not having got my act together to resume another) and would not have made the experience any better.

As it happened, the experience was not too bad.

I soaked my arm in warm water to bring up the veins and was attached to a drip by a nice woman called Amanda who sat with us and added in various drugs - 3 in all - explaining to me what each one was and what to watch out for. This was sitting in a comfy armchair and after having swallowed an anti-nausea pill.

Essentially, chemo is poison that stops cells replicating. This includes the cells which renew my hair follicles, which maintain mucus membranes, which produce white blood cells to fight off infection, and which reproduce like mad things and turn into tumours.

Obviously, only one of those effects is desirable: it's a poison that likes the cancer cells even less than it likes the rest of me. The other effects are unfortunate, but can be got over: they will recover. The cancer cells, at the stage I'm at, may well not recover, though it is likely to take six rounds of chemo - six whacks at the rat with a chemical sledge hammer - to get the point across.

One of the effects is risky - white blood cells, which are the cunning little chaps that see off infection. Without them, my immune system is up for grabs. I've got to monitor my temperature every day, and every time I feel bad, because in the absence of white blood cells I can easily get infections which normally I'd knock out in a couple of days - and which can kill me! So the magic number is 37.5 - any higher, and I call the emergency phone line. They recover, though - by week 3 they should be back up and running, thanks to the superb powers of my bone marrow. Just in time to get whacked again in round 2: hey ho.

I sat in the chair chatting with B and Amanda, and felt, basically, fine - a little light-headed, but I hadn't slept much. A heat pad wrapped around my arm to keep the veins wide was very comforting. The only odd thing it was having my right arm immobilised - I'm right handed, but the lumpectomy and lymph removal was on my left side, and it's better to put the chemo in on the opposite side.

One good thing was to be warned that one of the drugs gives you red pee - like beetroot does - and a terrible shock when you see it for the first time. Lucky she warned me.

Then pills to take at home - anti nausea. Some to take at fixed times of the day, some to take at will. Oh, and laxatives - the anti nausea pills freeze the peristaltic waves, so stop other things than vomiting. (I've always thought that Perry Staltic and the Waves should have been a 50s surf band. Unfortunately unlikely to have played on the same imaginary bill as Death Metal band Synapse Collapse).

By 11 we were all done. Next to me a lady in an elegant black and white turban was completing her 6th and last round of chemo with her daughter by her side.

B and I got the bus back to town and went for lunch at a fave cafe, Olives, which does root hash with scrambled eggs, and spiced apple warmer. Yum, yum. I was feeling fine. Then we wobbled up the road to cruise some charity shops for headscarves and hats and books. I bought two hand made pillowcases in thick linen with lace edging and handmade buttons for £6.

Slight sensation that my mouth does not taste the normal way.

Home, take temperature (35.7) drink ginger tea, check Facebook. I've been getting so much love and support and good wishes from my FB friends. Update that I'm feeling fine. And I kind of am.

And then - oooops! Sudden extreme vomiting. Not enough warning to get to the loo. Damn. There goes lunch.

Strip bed, change clothes, wash floor, shower, brush teeth, swill mouthwash.

Bleeaaah.

Take an anti-nausea tablet. Get bucket and retire to bed. Both cats come and cuddle me. B does too.

More ginger tea. Hmmm. How am I? Not sure. I nap and read, and listen to Keith Jarrett.

B starts cooking spicy soup for supper... smells wonderful.

Take some pills with a sip of orange juice and water.

Sudden vomiting... though I managed to get it in the bucket.

Bleaaah!!!

It was mostly ginger tea this time - but a distinct sensation of the pill I had only just swallowed coming up too. Hmmm.

Read the information leaflet. If you take more than the recommended dose you can have all kind of horrible effects, including disrupted vision and distressingly irregular heart beat. However, I decide I can't really have taken the pill first time around, as it wasn't in long enough to digest. Decide to risk it and take another one.

Went to sleep without supper... no problem.

Dreamt Nigel Farage and Nick Clegg were debating, but both wearing extremely thick-framed, square, totally black dark glasses. Convinced that neither of them had eyes... Bleaahhh!!

So, for nausea read vomiting.

But, like in Michael Rosen's "We're Going On a Bear Hunt" - "Can't go round it. Can't go over it. Got to go through it."

This is one down, five to go, and I can cope.

The New News: Hair today and bald tomorrow

Thirteen days ago some highly skilled people injected me with a combination of drugs that made me unconscious and kept me like that while other highly skilled people cut me open in two places, put their hands inside the cuts, and took pieces out of my body.  Some of the bits they took out were located by earlier injecting me with radioactive material, and then using a small geiger counter, ticking away like an insane watch, to trace what they were looking for: the sentinel lymph gland in my armpit. 

Then, while the surgeon was rummaging in my breast for the original lump, some other highly skilled people with astonishingly advanced equipment studied the gland to see whether this cancer I’ve got had spread. It had, and so they concluded the operation by removing all thirteen lymph glands from my armpit. Then they sewed up both the cuts they had made,  and I was awake and back home by 8 that same evening.

“I am fearfully and wonderfully made” says the psalmist. Yes, the fearfulness quotient is increased when one has cancer, and knowing that it had spread as far as my lymph glands ratchets up the fearfulness considerably. The lymph appears to be a kind of distribution network for the body, with the lymph glands as the central sorting office from which unpleasant parcels of tumour cells can be dispatched to all locations. If it has reached there, where else has it got to?

So, two days ago, more radioactive material was pumped into my arm and a few hours later (I made a flying visit to the Norfolk Community History Club in the meantime) I lay fully clothed but with empty pockets on a gurney while a flat screen in a box hanging from a gantry clanked and crunkled its way very very slowly from my head to my toes. It started off about a centimetre above my nose, so close that the cross-hairs on the black screen blurred out of focus, and made adjustments (clunk) and shifts (crunkle) as it edged along to keep the same distance throughout. The point of this was to scan my bones, which the radioactive material would show up, in order to find out whether any cancer cells had set up shop there.

Now, bone cancer is easily the most frightening possibility I’ve had to contemplate so far, in this little vortex of “how bad can it get?” that we have been living in since December. Bone cancer is pretty fucking bad. So it’s extremely pleasing to report that the scan shows I don’t have it. (It shows I’ve got arthritic knees, but that I knew already).  Hurrah.  (Amazing how one’s perspective changes: in October 2013 I’d have been horrified to be told I had cancer: by February 2014 I’m delighted not to have a worse one).

This pleasing news was delivered to me yesterday by Mr Pain, the wonderfully-named surgeon who did the lymph and breast cancer removal. He’s wrongly named, too, because not only are the scars extremely neat and unobtrusive, I’ve had surprisingly little pain and my arm is fine (there’s sometimes loss of movement after lymph removal, but not for me).

Since then he’s been looking at the bits he cut out, or talking to the people who have, and the news is not so bad. 3 out of 13 lymph glands had cancer cells, and I still have to have a CT scan to check that those busy little distribution centres haven’t distributed them anywhere else. The cancer itself was about the size of the top joint of my thumb: it was medium aggressive, and responsive to oestrogen, which means, as I’d already been told, I’ll have to take an oestrogen blocker - but that it should help.

First though I’m going to have to have chemotherapy, starting quite soon. It’s going to make me feel like crap, I’m probably going to lose my hair, and we can’t go to New York in March as we planned, dammit. But it has a good chance of killing off the remaining cancer cells lurking about the place. After that I’ll have radiation on my breasts, and an oestrogen blocker to take for the rest of my days. 
But - and this is important - we’re still in the territory signposted “curable”.

So quite soon, probably before the end of this month, I’m going to cut all my hair off and shave my head. 
My hair is, at this present moment, waist length, last cut by someone other than myself in September 1985, when Sarah Peters trimmed my fringe for me before a job interview, and it will be strange to be without it. I was last bald in 1960, when I was a few months old, and I suspect my nut on my shoulders will look like a pea balanced on a drum, but there it is. It may regrow some day, though it will quite likely come through white this time.

Oddly enough, shaving my head has been a fantasy of mine for some years. I intend to keep my hair, plait it, and sew it into hats and things. 

I may also get a tattoo on my scalp, just for kicks. 
Gotta do something.