RT and chemo - Head and Neck

9 minute read time.

Day 1 - Tuesday 22nd September

At last. Although I've been full of trepidation, it feels good to have started this part of the treatment. Because of needing further investigations to find the primary, it is 10 weeks since I had surgery.

Naturally everyone at Velindre Cancer Centre is extremely kind. I am reassured that I can swallow, even cough, if I need to while the RT is being carried out. They are treating 5 fields (I realise I don't understand quite what this means - must remember to ask), so it takes 10 - 15 minutes for them to set it up and give it, longer than that today because it was the first time.

Having the RT itself is simply weird, not unpleasant. I'd forgotten that, once the perspex shell is put over my face, I have to have my eyes shut and so I cannot see anything else that happens after that. It is a bit like a party game, where you're blindfolded - voices come and go, people touch you suddenly, or suddenly bang the shell, but you can only guess what is going on. Quite strange.

I've been advised to start using aqueous cream on the skin of my neck straight away, so go to buy some after I get home. I am a bit dismayed to find that I definitely have an immediate skin reaction, with a reddened, warm, slightly itchy area. I think the cream helps slightly.

I'm very focused on eating as well as I possibly can (large salad and tinned fish for lunch) and also trying to eat things now that I may not be able to manage to eat once the sore throat and mouth kicks in.

I'd been looking forward to having an excellent excuse to eat loads of chocolate ice-cream once I have difficulty with solids, but oh no! They told me today cold foods were NOT recommended in that case. Suppose I'll have to make do with loads of chocolate mousse instead ....

Went to the hospital on my bike, but don't expect I'll be able to do that for long. Also, went back to the new term of my yoga evening class tonight -  fantastic to realise there were very few exercises I can't do properly (because my left should has not regained its full strength). And lovely to see the regulars again. And I feel balanced, physically good, despite the numbness, stiffness, tingly skin. Is this the power of the mind over the body?

Day 2 - Wednesday 23rd September

Well, it was much easier than yesterday, of course, because of knowing more what to expect. And I had an extremely nice Senior Radiographer, who explained about the 5 fields - apparently 4 are directed towards the site of the primary and 1 is directed at the area in my neck where the secondaries were found in the lymph nodes. She also said that the treatment takes longer on the first 3 days, because they are taking 'check images', to check that the areas they are treating are exactly those marked on the treatment plan.

Morale boosted by going to Pharmacy for an oral care pack, to find that the pharmacist assumed I was collecting it for someone else: I might be going to look and feel wrecked very shortly, but clearly I look okay at the moment!

I was recommending this site to someone I was talking to in the waiting room, partly for the quality of the information and partly because of the wonderful emotional support everyone offers.

A big 'thank you' to everyone who left encouraging messages for me after yesterday's blog entry, and:

- yes, the aqueous cream seemed to sooth my skin well. When I looked last thing before going to bed, it was actually only the skin around my scars that was still red. Considering it's still healing after surgery, it's hardly surprising if it reacts quickly to the RT.

- thanks for the reminder to drink plenty - I'd taken my water bottle with me to the hospital, but then NOT brought it with me while I looked on-line - I must remember to carry it round the house with me, too, mustn't I? Just been to get a glass of water now!

- and I'll remember the tips about keeping the aqueous cream in the fridge, tinned salmon with mayonnaise, chocolate milk, and chicken noodle soup.

I have to confess I've been treating this as an occasion to go round the local M&S Food Hall, allowing myself to look at things that I would normally never buy, as they're too expensive. E.G. salmon terrine, strawberry milk, tiramisu. Presumably, if you can only eat soft things, it will still be important to eat a variety of different foods, still? I only hope I'll still be able to taste them ..... Meanwhile, I'm making a point of enjoying crunchy salad, salt and vinegar crisps, oatcakes, courgette with garlic, chili and vinegar, while I still can.

No more posts for a few days, as I'm being admitted following tomorrow's RT to have cisplatin IV overnight. Then, once I'm discharged the following day, the plan is that we are taking son up to start at Aberystwyth University, where we'll be the weekend, before coming back from RT Day 5 on Monday.

Day 6 - Tuesday 29th September

So, the start of week 2.

Had the first chemo overnight last Thursday, as planned. Apart from being woken regularly by the alarms as various bags of IV fluids went through, it was very straightforward. 

Unfortunately, although I felt ok on leaving hospital, I was quite nauseous on the journey to Aberysytwth (3 and 1/2 hours drive). I was sick just before we arrived at the place we were staying, and although I took my next dose of anti-emetics and went straight to bed, I went on being sick every two hours or so. Finally admitted defeat at 4.00 on Saturday morning, and got taken by ambulance to Bronglais Hospital in Aber. The paramedics were just brilliant, and so were the nurses in A&E. Basically they gave me an IV dose of one of the drugs I'd tried to keep down orally, checked I wasn't dehydrated, let me have a couple of hours doze and then tried me with toast and tea. Hurrah! it stayed down and I felt like a proper person again.

So, I got to see my son's room and see him starting to settle in, which is all I wanted. Then I went back to the place we were staying, had a shower and slept all afternoon, while my husband and daughter did an heroic job moving all Steffan's stuff from the car then going with him to do a big supermarket shop in an extremely crowded supermarket. I think we all slept well that night.

The nausea has subsided gradually since then, today I'm only taking one of the anti-emetic drugs and feel okay with that. I'm much more tired than before the chemo, though - the thought of cycling anywhere is laughable! I must say, even though I was told that the chemo would enhance the impact of the RT, I still hadn't expected such a dramatic impact - I'd still been thinking that this week would be much the same as last week.

Definitely taking a day at a time. Today was good - met 2 friends for coffee/early lunch on my way to Velindre, which was lovely. Then my RT treatment was on time, for the first time, and even stopping to have bloods taken I was only in the hospital for half an hour.

I realise I will not be able to make blog entries every day, by any means - I was far too tired yesterday. But I intend to make entries when I can.

Sunday 4th October

Horrible night last Tuesday, after last blog post, waking at 3.00 with pain in my abdomen and not getting back to sleep (other than dozing enough to have a vile dream about being in a chemical fire, then waking and thinking I could still taste the fumes in my mouth). Seen in clinic, constipation diagnosed, Movicol prescribed; I took some as soon as I got home, went back to bed and the pain slowly subsided over Wednesday. Rang a friend to ask her to take me to the hospital on Thursday, as I realised I feel I need to be looked after, a bit, and to have company if there's a long wait.

So, finished Day 9 on Friday with huge relief at the prospect of having the weekend off, to recover a bit.

On the positive side, the nausea finally went on Friday, so at least there are more things I can eat, in theory, and I can think about what food I might try without feeling ill. Apparently the nausea is definitely from the chemo, so may recur after the second cycle but then will subside again.

The current challenge is that, since Friday, my mouth has become extremely sore. I am managing to drink plenty, and I had started using the mouth care pack I had been given. Who would ever have thought that Normal Saline could be so incredibly soothing? I've been a nurse for nearly 30 years and, to my shame, had never realised how marvellous it feels to have your mouth cleaned gently!

I am waking a couple of times during the night, but getting 6 - 7 hours sleep in total, in three separate lots - that's okay with me, it's enough to feel rested and refreshed.

Last night, when I was awake, I planned a complete menu for myself, for today, consisting of drinks, soups and very soft food. So today over breakfast (porridge with a lot of milk on it - heavenly) I was able to tell my husband that he needn't worry about what I might want to eat today, he could just sort out meals for our daughter and himself. Feel quite proud of this, for some reason!

Lastly, a big 'Thank you' to the people who left such lovely comments on my last blog posting,  I'm sorry I haven't been in a fit state to respond to each one individually. Please know that your kind comments and messages of support gave me such pleasure and are very much appreciated! Much love to you all.

Sunday 11th October

The idea that I might be able to post regularly to this blog once I started treatment was clearly over-ambitious. This last week my time has been entirely taken up with looking after myself or just resting.

They have not managed to get my painkillers quite right all week, for some reason, so although I have been okay some of the time, it's been very difficult to eat a lot of the time. I have managed to drink and eat enough, but it's been a struggle.

I've left a message for the Macmillan Nurse asking for a visit tomorrow. I'm taking 30 mg codeine and 500 gm paracetamol every 3 hours, plus Voltarol three times a day, but I'm not sure it's quite enough, I definitely need some advice.

Although I would rather be at home than in hospital, I'm finding the lack of support a problem. There's no-one you can ring from Friday to Monday, and no-one actually checks how you are on Friday, before the weekend. 

I'll be half-way through tomorrow, so if it's a mountain I'm climbing, I suppose I'll have reached the summit. Then I'll be able to start the long journey back down - often harder than the ascent, as I know from experience.

Anonymous
  • FormerMember
    FormerMember

    Hi Bronwen, just managed to get on the site for the first time.  Hope your treatment goes well tomorrow.  You sound like you've got a great positive mental attitude so keep it up.  Dad's on his 16th radiotherapy session now, sore mouth didn't really  kick in until about 10th treatment so keep on enjoying your food, the more chocolate the better.

  • FormerMember
    FormerMember

    I had my RT to the brain and was told I HAD TO up my fluid intake, water was best but even cups of tea and coffee count!

    Sorry your skin has reacted so quickly and hope the Aqueous cream does the trick.

    I so remember lying there with my plastic lilac mesh mask on and trying to guess what was going on.......(had eyes & mouth shut) but mostly I'd just listen to the music and next thing you know someone would be saying "you're done for today" and unclipping the mask.

    I hope you get to ride your bike for a good while yet. The yoga sounds fabulous, I can barely touch my toes!!!!  Too much eating, steroids and lack of exercise on my part.

    Hope the RT flies by without a hitch.

    Debs xx

  • FormerMember
    FormerMember

    Well done Bronwen - you might find it's useful to keep the acqueous cream in the fridge, it can be very soothing when its nice and cold. They will keep a check on your skin and if it starts to react very badly they will give you some gel. I actually still use the acqueous cream to wash with around the scar, use it very gently like a cleanser then wash it off in the shower. As you know I has to have a PEG and it was several months before I could eat, but chocolate milk is very nice. The first foods I managed were chicken noodle soup with the noodles strained out - also tinned salmon mixed with mayonnaise so it all slipped down smoothly. I also still take a multi vitamin tablet every day. Good luck with the first chemo too. Lots of love and thinking of you. Nina

  • FormerMember
    FormerMember

    Pleased to hear that the RT went well. A step further on............onwards and upwards!

    I can't tolerate cold things for a few days after my IV chemo as it affects the nerves in my hands and throat. Quite frustrating when you crave a solero or just a nice icy cold drink.

    Angela x

  • FormerMember
    FormerMember

    Pleased that you got to see your son settle at Aberystwyth. It really upset me when my son was getting ready for uni a few weeks back and I couldn't help him. My sister helped get his things together and my husband took him to Cardiff. These would have been things I would have done if I'd been feeling okay, but I just couldn't do a thing.

    Sorry to hear that the chemo made you so poorly. Feeling or being sick is a real phobia for me, so you have my sympathy. Will they be able to give you anything else to help with this? I hope so.

    Good luck with the rest of your treatment.

    Angela xxxx