Thursday 27th October, 2011

Chemo Infusion #4 - A Very Positive Day

Today involved an early start. My consultant wanted me to have an echo-cardiogram before starting the administration of the chemotherapy drugs. Apparently, there is a risk that one of the drugs they use can damage the heart, and fluid retention could be a symptom. I was at the cardio unit at 8am. Lying on my side for 10 minutes was very uncomfortable (English understatement for "it hurt"); as far as I could tell, they found a heart and there were no problems.

Getting back to the main hospital meant a trek along an underground corridor. I was offered a wheelchair and porter, but decided that the exercise would be good for me. In the end, the corridor was much shorter than I expected.

My appointment for chemo was originally 9am. My consultant asked me to get there by 8:30, so that they could make an early start, to ensure that I could fit in the intrathecal before 5pm. It is now 9am and there is no sign yet of any activity.

Every time I come for chemo, I understand why hospital customers are called patients. Patience really is needed to avoid getting stressed. At 9:30, the cannula was installed, and the nurse explained that they were waiting for my drugs to come from the pharmacy. At 10:30, I was still waiting for drugs from the pharmacy.

At 10:30, I took my water tablet. I can expect to get a lot of exercise over the next couple of hours! The drugs have arrived from the pharmacy, so the process gets underway with the pre-medication.

The actual infusion of chemo drugs got started with the Rituximab at around 11:30 and predictably the frequent trips to the loo also started.

At 1:15, Sue arrived bearing coffee and paninis.

Just after 2pm, the Rituximab was finished. Once the last of that has been flushed through the drip, the rest of the drugs could be injected through the cannula. By 3:30, the rest of the drugs had been administered, just leaving the intrathecal (lumbar puncture) to be done.

I haven't had any contact from the consultant, so I assume that yesterday's chest X-Ray didn't show up any problems.

The intrathecal was done just after 4pm. Once again, the hold up was getting the drugs from the pharmacy. I was amazed to discover the strict rules surrounding any lumbar puncture, following a number of accidents where people died after the wrong drug was injected through what is effectively the barrier between the bloodstream and the brain. Once again the procedure was virtually painless (4 out of 4 .. a tribute to the skills of the doctor).

The person in the bed next to me was going for his first lumbar puncture. He was very worried, because the only experiences he had heard about were bad ones. Hopefully, I managed to reassure him a little. He returned smiling and told me that I was right .. it didn't hurt much at all.

This time, I only had to rest on my back for half an hour. We were at home by just after 5pm. This was the last intrathecal, so next time the chemo should not take the full day.

I did manage to do some work on my tablet computer while I was waiting around, particularly in the 2½ hours it took for the Rituximab drip, so the time was not completely wasted.

I need to have a blood test at the end of next week to ensure that the new medication I was prescribed yesterday has not had any adverse effects, but I won't need to see anyone. They will phone if there is any problem. Otherwise, I don't need to go back to the hospital for almost 3 weeks.

Another sign of progress. I have started to move around the house without crutches or a stick, including going up and down stairs. Despite the medical people telling me that my hip fracture won't heal until the cancer has gone and bone has grown back, I get the distinct feeling that at least some healing has taken place. After all, at least 70% of the cancer was gone 3 weeks ago.

I realised tonight that I am able to walk around without pain and in fact without any discomfort at all for the first time since March.

When I go outside, I still need to use crutches. I don't have enough strength in the muscles that hold my hip joint in place to go far. The path from the road to our front door is about 40m. It gets very slippery when it is wet, and my crutches slip away from me. That was about as far as I can go without crutches.