Ding, Ding, Round Four
I started three months of Chemotherapy on Monday 18th September 2023. It is now Thursday 7th December. And the last day of scheduled poison pills and the start of a proper detox. Well, truth be known I am actually now over 24 hours into the detox, we can come back to this.
My scientific brain and being organised default setting requires me to put this into numbers.
80 days. 60 days of being actively poisoned with a total of 20 days of detox between each of the four rounds. 9.4 litres of Oxaliplatin drip and 201,600mg of Capecitabine tablets (448 tablets). The drip is accompanied by 30 steroid anti-inflammatory tablets over 48 hours and 5 anti-nausea pills.
If you have read my essays on each of rounds 1 to 3, you may have noticed that I have found each round harder than the previous round?
Well, round 4 was no exception to this rule. In fact, it came to the party with its bovver boots* on and knuckle dusters firmly slotted onto gnarly fisted fingers. And went on to beat me up pretty badly. (*bovver boots - steel toe-capped Doc Martin’s, I grew up in the era of football hooligans)
Chemotherapy is cumulative. The 6 day detoxes between each round are insufficient to rid your body of the cytotoxic chemicals. The idea is to keep the toxin levels as high as possible and batter seven shades of poop out of the cancer. Pushing the patient’s body almost to the limit of what it can tolerate. The gamble is that the cancer gives up before the patient. There have undoubtedly been, and continue to be, amazing advances in all areas of medical science. And we are truly lucky to live in a peaceful country where medical services are free at the point of delivery. And it is also true that for the patient, treatment of a serious illness can be truly gruelling.
Prior to this round, in all my essays, I have avoided the ‘war’ and ‘battle’ analogies that are often used in describing people’s experiences of cancer. We read of someone ‘bravely, fighting cancer’ or ‘losing their battle after a courageous fight’. War is a truly horrific thing, we are witnessing two international conflicts as I write this, with millions of lives being impacted across Ukraine and Gazza. Pointless and cruel conflicts created by populist idealogues. To use the same language to describe my experience of an everyday illness and when I am being cared, for free of charge, by caring professionals seems trite and somewhat self-indulgent.
I am going to avoid ‘war’ and ‘battle’ and ‘conflict’ and ‘enemy’ (hope, I haven’t used them already!) but I am going to use fight. Because that is what round 4 has been. So, how has the fight been with my resident hooligan and the toxins we are throwing at him?
At the hospital, I was roped in by the staff to share my experience with a ‘newbie’ having their first session of the same programme as me. Well, I guess, I am now a veteran at this. I hope I was helpful and that my transformation from quite upbeat, fit looking person to battered wreck was not too disconcerting for them! To be fair, they left after their first session looking a lot livelier than I felt and they did not experience any of the arm discomfort that I get. As, we know, everyone’s cancer experience is different.
Left arm’s turn this time and, yep, it hurt. For several days. Back home, the weather was quite cold, and the bizarre electric-shock cold sensitivity was very bad. I have managed one walk during this cycle. It’s just too uncomfortable. Outside activity has been limited to feeding the garden birds and bringing in firewood – I get our lovely log burner going by mid-morning each day. I had the usual two days of constipation following the drip, countered by drinking the soapy loxidol mild laxative. Ugly sister number two then stepped in with squishy pooh for the rest of the cycle. So far, so similar to rounds 1 to 3.
In each cycle, I have experienced a low level, background, and quite mild stomach-ache and an almost, but not quite, feeling of nausea. I have simply put up with this. This time, the dial was turned up several points. The stomach discomfit was much higher, and the poops were mildly explosive, accompanied by a quite seasonal trumpeting wind. Fortunately, this was accompanied by an overwhelming fatigue – allowing me to snooze through large parts of the day and helping to pass the time. I have never experienced tiredness like this, I will be reading, doing something on the laptop or watching the TV and suddenly an hour or two has passed and I wake up zonked out on the sofa.
Chemo veterans will know that we have a protocol to follow with our symptoms. A list of potential side-effects and a traffic light system. A single red light, and we phone the 24 hour support line. Two ambers = a red, make the call. Greens, monitor and make the call if the symptoms progress through amber to red.
On chemo day 79, I made the call. I like to complete things. This felt a little bit like a fail, just short of the finish line. On an endurance event, this is where you dig deep or a friend gets you on their wheel and drafts you to the line.
Lesson for me, chemotherapy is not a multi-stage bike ride or a big hike. It’s just a little tougher and not a place to be a hero. During this round, I have had some really tough days and some OK days. Day 77 was OK and I thought I was on track to complete the round. Day 78 was awful, truly awful, followed by an early hours unpleasant trumpet solo. Dawn on day 79, several ambers and no way, am I taking those vile pills.
The chemo nurse on the end of the phone, talked through my symptoms with me and gently chided me for not calling a day or two earlier. She agreed that stopping the pills was the right thing to do. 48 hours short of 1,920 hours is pretty close. Numbers again, I got 97.5% of the way, that’s an A* at least. Not sure if there is an Oxbridge for chemo patients? If so, I’m in.
One of the Colorectal nurses phoned after the chemo call and updated me on next steps. Which are quite significant. This week I am having an MRI scan and a CT scan. These will be reviewed next Monday and on Wednesday 13th we are going in to see the consultant and see where we are and discuss what’s next. Has the cancer lost seven shades? Or has the hooligan spread, have I got Blakey marks on other organs?
I am quite apprehensive now. My prognosis back in September was not positive – ‘this type of cancer often does not respond to chemotherapy’. The lump at the top of my right leg is still there. Death itself does not phase me, the thought of leaving the people I love fills me with sadness. Yes, there are things I will not get to experience but it’s much more that I won’t be there to help with all the everyday events, crises and chores. It feels like I am baling on the people who need me.
We are going straight from the consultation to Somerset’s beautiful pocket-sized city of Wells. Two days of unstructured time together; staying in the lovely old Swan hotel, Christmasy experiences and, hopefully, a starling murmuration at Ham Walls. Thursday 7th December 2023.
