Sorry to disappoint, this is not the best Country and Western song that you have yet to hear.
It’s now day 21 of 35 of my chemo-radiotherapy treatment. And things are just a little different to my previous, rather jolly, entry on day 8. Well, quite a big amount different.
There have been a few tough days, culminating yesterday with being admitted to the Acute Medical Unit, as I recorded a rather chilly temperature of 35 after several urgent appointments with our newly renovated bathroom. I had been cautioned that side-effects can be cumulative, and I had been taking each day at a time and celebrating each day ticked-off without incident as a small victory. I got to the end of day 15 in fairly good shape. Then the side-effects decided to jump out of the shadows where they had been quietly gathering to give me quite a beating.
My treatment consists of a dose of radiation every weekday and 3000mg of Capecitabine tablets every day. 25 radiation doses and 35 days of tablets. Three tablets after breakfast and 3 after tea.
Day 16’s breakfast pills had scarcely reached my stomach when a very urgent visit to the toilet was needed. This was the lower of the two explosive digestive exits that meals can make. Another episode followed an hour or so later. I took some Loperamide, and my tummy settled down enough for me to attend my radiotherapy appointment. Back home, a third episode. This is ‘red flag’ territory now and I phone the cancer helpline. Chemo and radiotherapy patients are vulnerable to infections and sepsis; our white blood cells can be massacred by the bombardment of toxins and radiation. We have a ‘traffic light’ protocol to follow when side-effects increase.
The helpline nurse ran through her triage procedure. She advised continuing with the Loperamide after each episode and to phone back if a fourth episode occurred. Days 17 and 18 were a weekend and my tummy settled down; I had the usual ‘heavy’ feeling immediately after the pills but managed to get out and about. Day 19 and back to hospital for radiotherapy, and I had an OK day with as close to normal toilet visits as I have come to expect during treatment. 16 days to go, well over halfway through. The end is not quite in reach, but we are past half-time and I’m hanging in there OK; to follow the sporting analogy a step further, a nil-nil draw will be just fine for my Minehead FC team in their cup tie with cancer’s star-studded Man City.
Day 20 dawns, and team cancer pulls a blinder on me. Day 16’s big, bad, brother arrives, with attitude. Three stomach cramping explosive episodes in just over an hour. I pop the loperamide and drink plenty of water. Radiotherapy is scheduled for mid-afternoon, 25 miles away in Taunton. I sit tight and give my tummy an hour to settle.
Episode four. It’s truly uncomfortable. This is a red flag. Make the call. Leave the call back request and dig out the thermometer. Several temperature measurements get me a maximum temperature of 35.5 and a minimum of 35. I do feel cold and quite battered.
The nurse calls. She runs the triage assessment. ‘I am admitting you to the AMU. How soon can you get there? They will assess you and liaise with radiotherapy to decide whether you are well enough for treatment’.
Before Christmas, I had three months of chemotherapy and a group of friends teamed up to provide me with lifts to and from hospital. They all promised to provide transport during the radiotherapy. The first phone call enlists a willing driver and later on a message arrives from another ‘how are you getting home? Let me know time and I will pick you up; this turned out to be somewhat later than we initially thought.
I pack a sandwich, fill my water bottle, and am chauffeured to the hospital. The AMU admi me and there follows 8 hours of mostly waiting for actions or waiting between actions. I am given antibiotics, give blood and am given sandwiches. An oncology registrar arrives and assesses me; my temperature has returned to a more normal 36.3, my blood results are good and a top to toe triage questioning and prodding confirms that I do not have an infection and that I am experiencing side-effects to the chemo and radiotherapy. She tells me to stop the pills and continue with the radio. My radiotherapy is back on and a porter comes to wheel me there by chair; protocol, not allowed to walk until AMU have assessed and discharged me.
After the radiotherapy, I am wheeled back to AMU. AMU is a really busy department. During my several hours I observe at least one staff member continuously working the admission desk without a break of any sort; continually fielding numerous and varied queries. Truly impressive but I worry about burn-out and a possible mistake caused by overwork.
Now, here’s the thing, I am an AMU patient, and I can’t be discharged until I am assessed by their doctors, despite being cleared by Oncology. At around 8pm I am assigned a bed and wheeled to my on on-suite room. More sandwiches, tea and waiting. AMU doctor does a triage questionnaire and another top to toe physical; he concludes that I am good to go and disappears to clear my discharge with his consultant. An HCA appears ‘Have you had an echocardiogram yet?’ ‘Er no, and I’m about to go home’. We agree to wait a few minutes and chat about 60th birthdays; her recent one and my very imminent one and I outline my plan for the big day; returning to the hospital for more radiotherapy!
The consultant appears has a chat and clears me to go. The HCA walks with me to where my driver has agreed to meet me.
Quite a day to finish my fifth decade on.
Now about those panty liners. You may not be surprised to know that my bottom is not so reliable at the moment? There can be an occasional, minor, and unnoticed emission. Protecting my underwear with discrete sanitary towels has become part of my normal wardrobe during treatment cycles. A top-tip for other males out there who may be thinking of using these; the sticky side is for securing the pad to your pants…do learn from my experience, they do say that every day is a school day!
Now, I best get back to my Country and Western song writing career,
‘It’s a long hot Summer in Carolina, my pappi was a ‘49eer, tough days and….’
Why’s Dolly refusing my calls?
31 January 2024
