Chemo days are long. They start in the middle of the night, 6 hours before the appointment, when I have a lonely midnight feast with a handful of steroids. Middle of the night feast, of course, not midnight. Do you remember those midnight feasts when you were little when you and your friends would hide away a bundle of sugar-hit goodies, and of course it was a secret and your mum didn’t know, but then you couldn’t last until midnight? Either you tucked in to the goodies at 10 o’clock, torch under the blankets, or you woke up in the morning and it was all still sitting there.
Anyhow, back to the chemo. My appointments at the moment are Mondays, and have moved from 9am to 11am. The 11am bit means I can get up at 6 to take my tablets, rather more civilised than midnight. Why not 5? Unfortunately the Monday bit means I have to get my pre-chemo bloods done on Friday, three days ahead, rather than the preferred 24 hours before. The way this drip-drip poison works is to kill off every fast growing cell it can find. Subtle, eh? Fast growing cells include lots of quite critical stuff that sloshes round the body in the blood – haemoglobin, platelets, white blood cells particularly neutrophils. These last ones are critical for fighting infection and a three week cycle allows time for the neutrophil count to go right down and then build back up high enough for the next dose. The hammering the red blood cells take probably partly explains why I feel like I’m running at altitude if I go for a run these days. It might just be that I’m unfeasibly unfit, of course, and before you all shout at me I know that’s hardly surprising.
Three days before the chemo, my neutrophil count is still very low. Last time round (four years ago), the neutrophils were still low 24 hours before chemo so it seems a trifle unrealistic to expect them to be back up high enough for the next smack down 72 hours in advance. This is where the arithmetic comes in. My counts are guaranteed to be too low so when I turn up at 11am, the first thing that happens is another blood test. I then have an hour or so to wait for the results, long enough for a coffee in the Maggie’s Centre, and lo! the counts are high enough. So you see 6 am is at least 6 hours before the chemo starts and I could probably stretch it to 6.30.
Next up they try to find a vein in my hand that’s still functioning (I constantly look like I’ve been shooting up these days) and plug me into a sequence of drips. Saline flushes, drugs for sickness, drugs to prevent a reaction, goodness knows what else and eventually, sometime later and dependent on how busy the pharmacy is, we get to the chemo drugs. Four or so hours of carboplatin and taxol (see how these names trip off the tongue), a doze in the armchair, a half-hearted attempt at the crossword interrupted by the tea trolley rattle and it’s almost 7pm. The ward was packed when I arrived at 11am; now there are only four of us and a hardy nurse or two left. Time to go home. The nurses have rushed round without stopping all day. It’s time they went home, too.
So the next day, as the drugs really kick in, what to do? It’s Tuesday, it’s half term and, though the wind is blowing a hooley, the sun’s shining. So let’s spend the afternoon measuring sand dunes, of course, for GP2’s Advanced Higher Geography project. What else would I do, after all?
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