Expresso Love

6 minute read time.

High Noon was the end of part one of my cancer journal, covering the first 8 months of 2023 and my transformation from a fit, healthy and active 59 year old to having cancer, with secondaries, and a bonus heart condition. And a poor prognosis..... Part two will cover the 4 months to the end of 2023, dominated by a 'best chance' bout of chemotherapy - the medics throwing the metaphorical kitchen sink at me; because I'm young(?) and fit and they think I can take it. 

 Expresso Love.

Well, not really. At least not at the moment.

On Monday 18th September 2023 I started my first round of chemotherapy. The first strike back at the cancer. The start of the medical process of giving me the ‘best chance’. For me that phrase carries too much nuance. It is really quite different to ‘odds on favourite’, ‘probably’ and ‘dead cert’. In football terms this feels more like Minehead Towns chances of turning pro rather than Man City’s chances of collecting silverware each year.

Why the Dire Straits song reference? I really like good coffee. Back in 1988 the Peugeot Citroen dealership that serviced my work car, invited me to test drive the new Citroen AX. With the bribe of a free coffee cafetière. I was very young and still persuaded by free stuff. I used that cafetière for several years and have not drunk instant coffee since then. Coffee became my main hot drink, with maybe an afternoon cup of tea.

Well, not anymore. Coffee is one of the many foods and drinks that I have developed either an apathy towards or an almost visceral and visual revulsion.  I still have my first morning cup of joe but the thought of it during the rest of the day? Nah. My brain is telling me that my stomach won’t like it.

But the coffee antipathy is nothing compared with my reaction to salad. I used to really enjoy salads. Mixed leaves, cucumber, sweet peppers, walnuts and a vinaigrette or balsamic dressing. I can’t look at salad vegetables now without feeling quite queasy and my brain is saying very clearly ‘you eat that, and you will be sick’. I don’t think I could even manage one slice of the innocuous and harmless cucumber: the definition of gentility, crustless sandwiches on the vicarage lawn.

Almost all fruits get the same reaction. There are some becoming over-ripe bananas in the kitchen that I can’t look at. Apples? no thanks. A pear tarte tatin with clotted cream? My stomach is saying ‘how did you ever eat this?’ I know, how is this possible?

Rather counter-intuitively, cooked vegetables are really rather tasty. I have cooked a couple of really nice casseroles with plenty of carrots, squash, onions and other vegetables. With mashed potatoes, this has tasted fab. And if I have a not-huge portion, my stomach tolerates this well. Almost, there is the constipation thing, we can come back to that.

A truism that I have learnt, is that everyone’s cancer is different. And I expect that all of us undergoing treatment will experience different side effects. My reactions to food are a side effect that were not mentioned and do not appear in any of the pages of side effects listed on the drug packets.

I was given two options with my chemotherapy (three, if you count no treatment!). Both use the same principal drug – Oxaliplatin. Both options are delivered over a 3-month period.

Option 1 is a 48-hour drip with a permanent line inserted into a vein for the 3 month treatment period. Fortnightly infusions of the drug and 12 days drug free to let it work and to recover from the toxic hit. This teams the Oxaliplatin with another cyto-toxic drug called fluorouracil.

Option 2 is a 3-hour drip with no permanent line and then 14 days of pills at home. Followed by a drug free week and then restart. Oxaliplatin’s partner this time is capecitabine.

I went for option 2. Primarily because I was quite squeamish about having the permanent line. Max wimp points here. And considering the numerous bottom incursions that I have endured this summer, maybe I would have been OK with this? 

Monday 18th was day one. The responsible adult was allowed to attend the first session and we drove once again to Musgrove Park hospital. We can have free parking for the chemo sessions and the Beacon admin staff provided us with a permit. Yet another, caring professional took us into the day unit and showed us around. My paperwork stated a zone and bed number and the units senior nurse and myself were soon engaged in a conversation on this, to the momentary confusion of the nurse looking after me. ‘You will get used to him’ the responsible adult reassured her. I think the senior nurse and I are going to get along just fine.

Over the next three hours, 3 bags totalling almost 800mls of Oxaliplatin are dripped into me. Along with a flush and some extra fluid when the drip got too uncomfortable. Prior to the drip there were some pre-meds. My responsible adult is a senior health professional and has since told me that this was a mega-dose of strong anti-inflammatory steroids and anti-nausea medication.

The first bag went in with no issues. Bag 2? The very odd and uncomfortable feeling in my left arm started. This continued for the next 48 hours and now, a week later, has pretty much gone. The nurse brought me a heat pad and I tried to rest my arm on this and also wrap the pad around my arm. Bags two and three were an ordeal. You are allowed to drive yourself home after chemo sessions. Maybe I could have managed a couple of miles but the 25 miles back to the West Somerset Riviera? No, I was way to beat up for that.

I found the lump at the end of May and since then have had numerous procedures and this is the first time I have felt truly and completely and almost defeatedly ill. And this is because of my ‘best chance’ medicine! It has a taken a while, but I do recognise now that I am properly and seriously ill. That term ‘best chance’ carries huge significance.

Chemotherapy is poison. Best case scenario, they whoosh around my body killing the cancer cells. They stop it spreading, they shrink the tumours. They give us other options for further treatment. The drugs also mess up your body at the same time.

This may explain the bizarre food reactions and the constipation.

So, one week on from my tough hospital day and I feel bright enough to write this nonsense. And laugh just a little at what is going on. I do cry a bit as well. I have to take the tablets, 8 a day, for another week and then I get my drug free week. I really can’t wait. And I think this has to my approach, take it one day and one week at a time. I have three more cycles to come and if each one consists of a pretty horrible week and then feeling a chunk better then I think ‘I’ve got this’.

Unanswered questions. Poonami? This morning, thank goodness. The free cafetière was sadly broken during one of many house moves. I did not buy a Citroen AX.

(25 September 2023)