It’s the Monday of cycle three, week one and things are going well, here’s an update of what’s happened so far:
Preparation: the ‘Dexa’ was consumed on schedule, but my biggest concern (at the moment) for this cycle was the weather. It was still very hot on Friday, fortunately the hospital had good plans for managing this and, although the ward as at about 25 DegC, it was comfortable enough with the aid of a mini-fan – sourced by my gorgeous daughter.
Treatment: given the heat, the cold capping was great – after the initial five minutes. Then I had the ‘Doce’ at full rate from the outset and I certainly noticed the impact as soon as is started, my head started to spin a little and I had a strange feeling in my jaw – most curious. It was all over in less than a minute, before I could speak with a nurse and it never came back again. My meds arrived mid-treatment, a large bag with my Daraluamide (second-string hormone treatment), Domperidone (for nausea), Prednisolone (a steroid) and Omeprazole (to mitigate some of the side-effects). However, the nurse informed me that in my last blood-test, my neutrophils were borderline for proceeding with the chemotherapy and my consultant had prescribed a granulocyte-colony stimulating factor called Filgrastim (or ‘Filly’); the G-CSF stimulates the bone marrow to make more blood cells, and increases the number of some types of white blood cells in the blood. The nurse informed me that Filly was in the fridge and would be administered by injection. I asked if the injection would be before I left, then she told me that I would have to administer the injections myself, or with the help of my partner – this started the brain-cells buzzing, I’d never given myself an injection before! The nurse was very kind, she patiently explained the procedure and where to find information on-line, it was reassuring, but this felt like an escalation in treatment – Sunday would be my first injection, then the two days following.
Day 1: this time tiredness started earlier, late Friday evening, but not as severe. I slept quite well, despite the heat, I was not feeling the fatigue on Saturday morning, so I did a couple of hours in the garden – quite light work, but fun. In the afternoon / evening I managed my sleeping carefully so that I would be awake for the England game at 10pm; a satisfactory England effort (a two-goal win over Panama), but we need to up our game for the knock-outs.
Day 2: through the day, just some sleepiness and mild fatigue. A very slight dryness in my mouth and a hint of a taste change, but very minor. I took it slowly and prepared for the ‘injection’ event! Before that, I checked out the side-effects of ‘Filly’. The nurse had recommended injecting it in the evening and then taking OTC pain-killers, apparently the stimulating of my bone marrow could be painful in my bones – back to my pre-diagnosis symptoms I thought. The list of common side-effects was long and pretty much overlapped with the potential side-effects from my other medicines. An additional element, less common but concerning, was the risk of a stroke if the G-CSF over-stimulated the production of WBCs and affected the viscosity of my blood; Shirley and I reminded ourselves of the stroke acronym – FAST: Face, Arms, Speech and Time!
The on-line instructions for self-injecting were quite long and detailed, I read them a number of times, and then set-up my clean-area. The ‘Filly’, was stored in the fridge next to the Red Leicester (my favourite cheese), but it had to be allowed to reach room temperature before injecting. So, the time arrived, alcohol swab ready, I removed the syringe from its packet. The nurse had assured me that it was just a little needle, I removed the cap, my definition of little was clearly at odds with the nurses’. To be fair, it was probably only about 1.5 cm long, but mild-anxiety clearly magnifies things; there was a significant pause as I re-grouped. Don’t think about it too much, I thought – the irony! Swab deployed, area cleaned, pinch an inch (or two) and then stab! It was ok, noticeable, but not really painful. I released the pinch and injected the ‘Filly’, the automatic safety spring on the syringe clicked and withdraw the needle – done.
Day 3: well after all of that, I’ve woken up on Monday morning, with no change in status, still very mild chemo side effects. I took some OTC painkillers for the ‘Filly’, but I had no pain overnight. Overall, excellent news, although I do have two more injections to go. I’ll continue tomorrow …
Day 4: amazing, no reaction to the ‘Filly’, I’m still a little tired and the anaemia is noticeable, as it was last time, but other than that I feel good. Acupuncture today, I think it’s benefitting me, the hot flushes I certainly less, but they were subsiding anyway. Whatever the case, the acupuncture sessions are wonderfully relaxing anyway.
Day 5/6: pretty much back to normal now, with the exception of the low WBC. This is great news as we are off to the New Forest Folk Festival today. It’s an outdoor event, lots of space and a relaxed atmosphere, perfect for social distancing.
