The seven days before the actual transplant are what they term the conditioning phase, where they are preparing my body to receive the new bone marrow. This they do by killing the existing stuff.
Two methods are deployed to this end. On days -6 and -5 I am to be given chemotherapy. Day -4 is a rest day and from Day -3 I am to receive twice daily sessions of radiotherapy. One final session on the morning of day zero and then I receive the new marrow later that day.
That's the overall picture. Here's the details that I can recall. It being 9 years ago I'll have surely forgotten some of them but I think I remember most of it.
Before any of the seriously nasty treatments begin I have my pulmonary output measured. I measure 550 on the peak flow meter. It's at this point that I get my first treatment to prevent me from getting the more dangerous types of pneumonia when my immune system will be suppressed.
Just before I get my first dose of chemotherapy, the nurses check my blood pressure and all the normal things they check and it amuses me that I measure an absolutely perfect 120/80. It makes me wonder instantly about how different a ward this one is. They take in patients that in many cases don't look all that sick (they obviously are but just don't look it yet) and then they systematically make them sick as a prelude to making them better. It takes a very specific sort of doctors and nurses to have a specialty like that.
Within a few minutes of starting the chemotherapy I was massively sick. I had been given anti-emetics (in fact I had been given the newest, and generally most effective type) prior to starting the chemo to stop me from being sick but for some reason they weren't working on me so they rather rapidly had to get a doctor to prescribe me a different type so I could get some respite. This all happened in the exact hour my mum had came to see me in there for the first time and I spent nearly all of it in the bathroom throwing up with more force than I had ever done before.
It wasn't exactly how I wanted it to go. Normally when I know people are coming to see me I organise things around their visit so they get to see me at the best I'm likely to be which often involves quite a lot of strategic drug taking. Where chemo regimes are concerned though you need to take them at specific times and it doesn't matter if you've got the Pope visiting, you're getting your treatment there and then.
Luckily the new anti-emetic managed to calm things down and being honest I had very few problems with the short regime of chemo I had. The radiotherapy is really something else altogether though. I recently (and I have to say stupidly) calculated that over the seven sessions of radiotherapy I had I received a dose of radiation that is equivalent to 105,000 chest X-Rays.
That first morning when I had to go across town from the Royal Infirmary to the Beatson I felt pretty fine, if a little tired. The nurse that was going across town with me was most amused that we were born on the exact same day but totally freaked out when the nurse on the other end at the Beatson also had the same birthday. I was thinking about other things, like the fact that the kids going in for radiotherapy never look scared but all the adults look terrified. There's not much eye contact made between patients there except for the kids who all happily go about their business. There must come a point where we learn just how scary this thing that we're about to do is. The kids are of course just as drained after treatment as any of the grown ups are but they still arrive for their next stint the same way as they had the last. It's inspirational in its own lovely way.
So I lay in front of a radiation source for six minutes before, and I kid you not, they turned me round to do the other side. I felt like I was in my own giant microwave oven and that the whole thing was going to be concluded by a 'ping'. I don't know if this is maybe something I've convinced myself of but I always felt that during those sessions I could feel parts of me behaving differently, like my internal organs were all grumbling because this radiation was making them vibrate or something. I even felt warmer after it and you could see that my skin had reddened.
After the first session I got the ambulance back to the Royal and walked back to my own wee solitary room for a rest before repeating it all that afternoon.
By the second day I needed someone to hold on to whilst walking out for my lift across town and by the third I was wheelchair bound for it. After every session I just made it back conscious before completely conking out on my bed still fully clothed from my wee trip outside.
It was roundabout then that the most draining aspect of all these treatments began, the torrential diaorrheoa. Most Cancer treatments have side effects based on the fact that they kill cells that grow rapidly. Most people know about hair loss, nail damage and mouth ulcers but perhaps understandably less is mentioned of the other parts of the gastrointestinal tract that are destroyed by radiotherapy like the TBI that I had. It destroys all the mucous membranes in your whole digestive system which quite simply means that it can't cope with food of any sort really. So on top of the drugs I was taking intravenously I was given fluids and put on a fluid control chart where every ml in and out of the body is measured. It's not a whole lot of fun as a patient and also not much fun for the nurses but it gives them a quick indicator of how well your body is coping with all that's being thrown at it.
By the time of my seventh and last session I felt as weak as hospital coffee and just slept from the moment I got back until they woke me up mid afternoon to tell me Clare was back from surgery and that the Bone Marrow was away being radiated and I could get it later.
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