Chapter 19: Chemotherapy - Week 1

“Chemotherapy isn't good for you. So when you feel bad, as I am feeling now, you think, 'Well that is a good thing because it's supposed to be poison. If it's making the tumour feel this queasy, then I'm OK with it.”

Christopher Hitchens

I’m back in Dr. Wheater’s office once again. Dr. Wheater explains that he has checked my bloods and can confirm that all is fine and that I’m eligible for the clinical trial we discussed last week. First however, he wants to remind me of the possible side effects of the chemotherapy drug that he has prescribed. Here is the unabridged list supplied by the drug company:

Condition to look out for:

•       Loss of Speech
•       Change of Vision
•        Seizure (fits)
•        Confusion
•        Bleeding

Very Common Side Effects:

•        High Blood Pressure
•        Diarrhoea
•        Feeling of being sick (nausea or vomiting)
•        Stomach Pain
•        Loss of Appetite
•        Weight Loss
•        Taste Disturbances or loss of taste
•        Sore Mouth
•        Headache
•        Tumour Pain
•        Lack of energy, feeling weak of tired
•        Changes in hair colour
•        Unusual hair loss or thinning
•        Loss of skin pigment
•        Skin rash where the skin might peel
•        Redness and swelling of the palms of hands or soles of feet
•        Increase in liver enzymes
•        Decrease in albumin in the blood
•        Protein in the urine
•        Decrease in the number of blood platelets
•        Decrease in the number of white blood cells

Common Side Effects:

•        Ingestion, bloating, flatulence
•        Nose bleed
•        Dry mouth or mouth ulcers
•        Infections
•        Abnormal drowsiness
•        Difficulty in sleeping
•        Chest pain, shortness of breath
•        Slow heart beat
•        Bleeding in the mouth, rectum or lung
•        Dizziness
•        Blurred Vision
•        Hot Flushes
•        Swelling caused by fluid of face, hands, ankles, feet or eyelids
•        Tingling, weakness or numbness of the hands, arms, legs or feet
•        Skin disorders, redness, itching, dry skin
•        Nail disorders
•        Burning, prickling, itching or tingling skin sensation
•        Sensation of coldness with shivering
•        Excessive sweating
•        Dehydration
•        Muscle, joint, tendon or chest, muscle spasms
•        Hoarseness
•        Shortness of Breath
•        Cough
•        Coughing up blood
•        Hiccups
•        Lung collapses
•        Underactive thyroid gland
•        Abnormal liver function
•        Increase in bilirubin
•        Increase in lipase
•        Increase in creatinine
•        Other changes in in the levels of chemicals and enzymes in the blood

Uncommon Side effects:

•        Stroke
•        Temporary fall in blood supply
•        Interruption of part of the blood supply to the heart
•        Blood clots
•        Sudden shortness of breath
•        Severe bleeding in the digestive system
•        Heart rhythm disturbances
•        Hole in stomach or intestine
•        Abnormal passages forming between parts of the intestine
•        Heavy or irregular menstrual periods (Don’t think this one applies to me)
•        Sudden sharp increase in blood pressure
•        Inflammation of the pancreas
•        Liver inflamed, not working or damaged
•        Inflammation of the lining of the abdominal cavity
•        Runny nose
•        Rashes which may ne itchy or inflamed
•        Frequent bowel movements
•        Increased sensitivity of the skin to sunlight
•        Decreased feeling of sensitivity, especially in the skin

Bloody hell what a surprisingly long list of unpleasant things, on the up-side at least I suppose I will now have a valid medical excuse for my incessant farting. Dr. Wheater explains that some patients are lucky enough not to get any of the above side effects, but most people get just a few of the more common side effects. I should bloody hope so as I’m not sure how I would cope with the full list.

There is a bit of a balance, I’m told, to getting the right dose for my chemotherapy, as I’m relatively young and fit he intends to start me off on the maximum dosage of 800mg/day. Good, I think to myself, I want to hit this cancer with the maximum dose of chemotherapy, I can take. I am also told that I cannot eat two hours before or one hour after taking the tablets so I need to choose a convenient time of the day to take the tablets and then stick to that time everyday. I normally have dinner at about seven, so I decide that nine in the evening is the optimum time to take my chemotherapy, it also means I can get started with my first dosage later tonight. Bring it on.

Before I leave however, Dr. Wheater casually mentions that it would be better if I didn’t drink any alcohol whilst I’m taking the chemotherapy. No problem at all I say. I don’t need a nice refreshing gin and tonic when I get home from work. I don’t need a nice glass of beer or wine with my dinner. I don’t need a nice cooling pint of cider over ice on a sunny day and I don’t need a wee tot of rum on a Saturday night. No problem at all, I’ll just stop drinking altogether then. Piece of cake.

I collect my first batch of chemotherapy drugs from the chemist at the hospital and head home, it’s too late to bother going back to work now. When I eventually get home I remember that Tori is going out tonight. Tori is a Guide leader of the 2^nd Kempshott Guides and tonight she is taking her Guides out on a night-walk with strawberries and cream. I’m allowed to come along too as long as I don’t swear in front of the Guides, I can probably just about manage that. Tori assembles her Guides at the start of tonight’s walk in the village of Oakley (just outside Basingstoke), and checks on her list that all are present and accounted for. We set off with the girls and a few leaders and helpers on our trek. Tori is carrying the strawberries and cream for the girls and I have my newly acquired chemotherapy tablets in my pocket and a bottle of water to wash them down with.

After we’ve hiked a few miles through the countryside we come to a bit of a clearing with a solitary park bench, an ideal place for strawberries and chemotherapy. The girls who cleverly bagged the bench for themselves are shooed off by Phil, one of the helpers, to make room for the cancerous old fart. I happily take my newly cleared place on the bench and rummage in my pockets for my drugs. I’m offered a bowl of strawberries and cream as well, but I politely decline as I’m not allowed to eat this close to taking my chemotherapy. I take two 400mg tablets from the bottle, swallow one at a time and wash them down with a swig of water. I feel nothing, not a sausage, bugger all. Nothing seems to be happening, it’s all a bit of an anti-climax. We complete the walk, hand the girls back to hopefully the correct parents and head back home to Wiltshire.

The next day is Tuesday and it’s back to work as normal. Work is happily uneventful and I go home and take my chemotherapy drugs again at the allotted time and again nothing seems to happen. Wednesday and Thursday are much the same. Perhaps that big list of side-effects was just for the drug companies to cover themselves in the unlikely event that some of their patients feel a little groggy on the chemotherapy, I on the other hand seem to be taking the chemotherapy in my stride.

On Friday morning I wake up feeling like utter shit. I have nausea, vomiting, stomach ache, tumour pains, diarrhoea, sore mouth, loss of appetite and a headache. These must be the side-effects they warned me about. I ring work to report in sick, there’s no way I’m going to be able to make it in today. I spend much of the day lying about the house trying to decide if the bed or the sofa is the comfier place in which to to die. Neither, seem suitable so I drag myself around the house whining at Tori and demanding Lucozade. The pain slightly subsides a little but there is a sort of fog that has descended upon me that gives me a constant uncomfortable and groggy feeling. I’m not overly fond of it if truth be told.

I’m able to make it up and get dressed by Saturday morning. Good thing too because my friend Sean and his wife are having a joint 50^th birthday party this evening at Farnham, so I will be unable to mope about the house like I did yesterday. Once at the party I have to kindly decline my first glass of free Champagne, this is something I need to become accustomed to, in favour of an orange juice. It’s a very pleasant evening with my friends even though I have to take a few time-outs and stand outside on the balcony where I have a clear area below should I need to abruptly blow chunks.

I’m still in a a bit of a malaise on Sunday but I try and carry on as normal, cut the lawns, do the shopping etc etc. It seems like things have stabilised a little and despite still not feeling quite right I decide I can’t really take anymore time off work so I head back to work again on Monday morning. I have asked one of my team leaders to prepare a demonstration this morning of the the capabilities of certain test automation tools we are trialling with our system. The whole team make their way down into the server room for the prepared demonstration. I’m feeling worse than ever this morning so I sit at the back of the crowd trying as best I can to follow the demonstration. I’m having hot flushes and getting deeply concerned that a secure and controlled computer server room holding vital Air Traffic Control systems is not the best place to be when my intense nausea manifests itself in a more physical and colourful form. I therefore apologise to my team and head out to the car park. I spend the remainder of the morning sat half in my car seat with my feet outside and my head between my knees ready to vomit.

At lunchtime I apologise to my colleagues once again and head back home. I make it home and crawl into bed while Tori strategically positions a bucket at the side of the bed. They really weren’t joking about those side effects.

Chapter 20: Salisbury General Again