Tuesday 25th October - Chemo!!

Tuesday dawned and my day of chemo arrived, I can honestly say I was dreading what was coming. We arrived at half eight and sat patiently in the waiting area until we were called through at quarter to nine. My nurse assigned to me for the day was named Mindy "Should I tell her she has the same name as my cat do you think?" I asked Lee and we both grinned, (I have three cats Mork and Mindy who are brother and sister and were named by the cat protection league, not me, I hasten to add. And Felix an old boyfriends cat who's lived with me for seven years now.) Mindy asked me to follow her and showed me to the comfy recliner chair... the exact same comfy recliner chair I'd been shown to on my very first  visit to start my chemotherapy. I was hit by a touch of de ja vu and the memory of Sue standing in front of me complaining about her burnt finger sneaked into my head and I stifled a laugh. Lee sat on the chair opposite me next to the window, and Mindy pulled up a stool on wheels and sat to my left.
"Right Loraine what I'm going to do first is run through everything with you and explain exactly what's going to happen today what drugs we're going to give you etc. Did we give you a folder to read?"
"Yes you did and I have glanced through it, but in all honesty most of it went over the top of my head and I figured I would understand more about what's getting done if I saw what you were intending to do rather than just read about it".
"That's fine what we're going to give you is a mixture of two drugs Gemcitabine and Cisplatin which is why its going to be such a long day for you. Now, first question have you had some bloods done?"
"Yes I came from them last week prior to the PICC line being fitted" I told Mindy.
"Good, that means we can get straight on with things then. Now there are side effects that we need to make you aware of before we start treatment. But I need to know first if you are taking any other medicines at the moment other than the ones you've been given by us. So if you give me a list of what it is you are taking at the moment please".
"Yep no problem I brought them with me as instructed" I told Mindy. "Lee, can you pass me the brown bag please its got everything in".
"Yes darl here you go".
"Right first things first Mindy I'm asthmatic I have Serevent, Becotide and Salbutamol inhalers, although I'm due and asthma review to be fair I hardly use them anymore".
"OK" Mindy busily scribbled the information on the form.
"Right at the minute I'm on Zomorph which is 40mg and I have that twelve hourly, then I've got Oramorph liquid I'm roughly taking about 15ml of that during the day but that varies depending on the pain I'm getting. I'm also taking Cyclizine to stop the nausea caused by the morphine. Then there's paracetamol I'm taking 500mg of that, two four times a day. Then there's cetrizine my antihistamine I'm taking that on a ratio of twice a day to combat the itching, Because the morphine makes me itch if I don't."
"Okay is that it?"
"Yep that's it".
"Okay and have you got your list of emergency numbers?"
"I have yes I pulled it out of the folder and showed it to Mindy".
"Okay right I can't stress to you how important these numbers are going to be to you from now on Loraine. Obviously there are side effects of the treatment that we are going to be giving you. Now, if any of these symptoms begin you need to ring us. There is a risk of serious infection after your chemotherapy because obviously it reduces the number of white blood cells you have. Your white blood cells are used by the body to fight infection  and when your white count falls below a certain level  the bugs or bacteria that are normally kept at bay by your immune system can cause infections. You can be vulnerable to while you are having chemotherapy but it can happen between treatments and when you are recovering from treatment. So you will need to look out for warning signs of an infection, especially a temperature (fever). Have you bought a thermometer?"
"Yes one of those electronic ones that beep".
"That's good now some of the side effects you need to look out for Loraine are bruising or bleeding from the gums. If you notice bruising or bleeding you need to ring us straight away.  It can cause you to be Anaemic so you could start to feel more tired than usual or lightheaded. If this happens we could have to give you a blood transfusion. Now sickness is the biggest one Loraine when we begin your infusion today you will be given anti-sickness drugs intravenously as well and we'll give you more alongside your cyclizine to take. If you start being excessively sick we need you to give us or your Macmillan nurses a call.  Now with the GEMCIS drugs you might get thinning hair, have you asked about a wig?"
"Yes I asked at my pre-assessment I haven't heard anything yet though"
"Well if you haven't heard by this time next week when you come for the Gemcitabine then mention it and we'll chase it up for you".
"Okay".

"Non existent in all honesty but I'm drinking loads".
"Okay we will weigh you at pre-assessment you will come for a pre-assessment appointment the day before your treatment every week. If you start loosing too much weight then we can always get a dietitian to see you. You could get tingling or numbness in your fingers and toes. Now if it does happen don't worry about it can last throughout your course of treatment but it will come back with time. Now the big one is the effect of the treatment on your Kidneys . Before each treatment you will come for a blood test to check how well your kidneys are working. Now you've got a stoma bag is that right?"
"Yes it is" I nodded.
"Okay well I won't ask you to measure your output or anything but whilst you are here I just need you to keep an eye on it. Now obviously we know that you don't have full kidney function of 100% in each of your kidneys, so to protect them what we will do is give you lots of fluids today. The actual chemotherapy the GEMCIS that we give you only lasts for three and a half hours today.  The Cisplatin takes about three hours to go through and the Gemcitabine is approximately half an hour. The rest of your treatment today is made up of anti sickness and normal saline to flush your kidneys through and help protect them so the first thing through your drip today will be Saline, followed by your anti-sickness medication that's followed by the Gemcitabine so up until the chemotherapy starts you are free to move about around the hospital and take your drip with you, after that I wouldn't want you leaving the ward okay?"
"Yes okay"
"Right lastly with the effects any problems with regards to a dry cough or breathlessness let us know because there is a small chance of the GEMCIS effecting your lungs. Its very rare that it effects your liver but it is possible if it does you may become itchy or your skin might become yellow. Right now very rarely some of the drug can leak out of the vein whilst its being given to you via your drip. So if, whilst, you're on your drip the area where your HICC line enters your arm becomes  red or you see any signs of it blistering you need to give me a shout, okay?"
"Yep that's fine."
"Right so I've got the saline ready I just need to take the dressing off the HICC line and hook you up to the saline obviously feel free to move about the ward and the hospital up until we start you on the chemotherapy"
"So what time will that be about?"
"I imagine it will be about one before you are ready for the Cisplatin but I'll keep you informed and tell you what I'm doing every time I come to change anything over on your drip".
"Okay so what sort of time will it be do you think that we finish approximately just so I can let my daughter know?"
"Well lets see if we start the Cisplatin at one it will be four before that finishes then the Gemcitabine for half an hour that will take us to half past four followed by another half an hour of anti-sickness so that takes us to five and then another hour and a half of saline so it will be approximately half six before your drip stops then we will need to re-dress your arm so about ten to seven".
"Okay".
"You'll be given lunch today Loraine and Lee if you want tea or coffee you will be offered it but you won't get food provided Lee, sorry".
"That's fine I can go to the canteen or get myself a sandwich no problem", Lee told her.
"Right so that's you all hooked up Loraine. Is there any questions you have or anything you need before I leave you guys?"
"There is one thing because I had the PICC line fitted yesterday I'm supposed to put a heat pad on it, I've brought one with me".
"Yes that's fine, do you want to use ours though its like a flat electric blanket you can keep it plugged in it will probably be more comfy for you".
"Oh yes okay then".
"At some point one of the kitchen staff should be around to ask about what you want for lunch I know the menus have to be in by half nine so she shouldn't be long".
"Okay thanks".
"You okay?" Lee came over and gave my hand a squeeze.
"Yep I'm fine, let the boredom begin" I smiled.
"Why don't you try and get your head down you didn't sleep much last night did you?"
"No, but then I never do its okay I'm going to read that magazine for a bit".
"Do you mind if I go for a cig?"
"No off you go get some fresh air and something for your lunch".
"Hi, Loraine, I'm here about your lunch I didn't realise that was you sitting out in the waiting area otherwise I'd of asked you, but the menus have to be in by nine thirty so I've ordered you a plain jacket potato and a ham salad followed by a yogurt. Is that okay?"
"Well can you change it?"
"Erm, no".
"It'll have to be then won't it" Lee looked at me and I looked at him and the woman disappeared.
"That's not right Loraine, I'm gonna speak to Mindy".
"Make sure you do love" the lady in the chair next to me who had arrived a half hour ago piped up. "You are here all day you can't survive on a plain jacket potato and a ham salad. They should be giving you a hot meal. You are supposed to get a choice love of what you want she shouldn't be filling your menu in for you".  Mindy arrived back just at that point. "Mindy, she's doing it again.."
"Who's doing what?" Mindy asked.
"Her in the kitchen she's pre-filled in Loraine's menu for her, guess what she's having? A plain jacket potato and a ham salad". Mindy looked at the woman and then at me.
"I'm sorry Loraine, I'm going to have a word with sister. She's done it with everyone this morning and ordered all of you a jacket potato with cheese and a ham salad."
"I wouldn't mind so much if she'd ordered me cheese with it Mindy but who wants a plain jacket potato with no filling, certainly not me, not if I'm here until seven and I can't stand salad so that was definitely a bad choice for me. The only thing in her favour is the fact that I have no appetite at the minute anyway to be honest I've been living on smoothies, milk and soup the last couple of days".
"I will have a word with sister now and I'll make sure she doesn't do it on your next visit" Mindy apologised.  "Would you like me to sort out a cuppa soup for you?"
"Yes please if its not too much trouble that would be nice thanks".
"Beef and tomato, plain tomato or chicken?"
"Tomato thanks".
"Leave it with me I'll get that organised for you. Oh and I'll sort out that heat pad, back in a tick".
"Thanks Mindy".
"Right I'm off for that cig".
"Okay see you in a bit. Oh and can you give my mum a ring let her know how late we're going to be, but make sure you talk to my dad cos you know and I know she might forget".
"Okay its done".

I was sat in that seat until seven o'clock that night I dozed off a couple of times but every time I did you could guarantee the lady next to me would start chatting or one of the nurses would be over to see how I was. It was a very very long day and although that chair was comfortable I felt stiff from sitting in it all day and I would have done anything to crawl into my own bed. And as soon as we got in that's exactly what I did do. I gave Lee a kiss and a cuddle said night to Jenna and headed into bed.