So chemo day two arrived with my temporary sojourn to Guy’s a distant memory. Back to Queen Mary Sidcup. As I had my entire first round at QMS it almost felt like home from home. They had even left the chair I used nearly every time during my first round vacant and ready to use. The only problem is that they have two wards for chemo. The first has no windows. The second has a lovely view of the rear of the main hospital. Not quite the view from Guy’s ( who would ever guess that being able to possibly see Croydon was a positive? ) but nevertheless a view of the outside. I have only ever used the first ward.
The bustle of the nurses then begins. For the first of approximately 11 times they ask for your name and date of birth. As a laugh I once gave a false name and date of birth. On another occasion I purposely looked at my wrist tag and read my name and date of birth from it, trying to give the impression I didn’t know who I was. People don’t understand how fun chemo day can be? They work in tag team formation, one undertaking the interrogation the other taking notes on a wheelable computer station. They then leave you in peace for about 3 minutes at which point a nurse comes back with the torture tray. The dreaded blood pressure machine tuned to crush your upper arm but just not quite hard enough to leave any permanent bruising or broken bones. Whilst your full attention is on the pain emanating from your mangled upper arm they perform a deft double strike with your temperature being taken from your ear using a thermometer designed to not quite pierce your ear drum and then the blood oxygen finger monitor that irradiates your finger at a gentle 170 degrees. They then take any blood left from your blood test three days early. At which point things threatened to turn ugly.
You will recall in my previous post that I mentioned blood platelets and neutrophils. The blood they take pre-infusion they then take to a machine that gives various bits of information including platelet and neutrophil levels. The next thing I know a nurse comes up and says ‘oh I’m very sorry but weren’t going to be able to proceed because of your blood test results’. I shoot back one of my best quizzical looks and casually asked which blood test result was causing the concern. Her reply explained that my blood platelets had returned a level of 98 and that the pharmacist won’t let us proceed with a level below 100. Armed with the results of my recent consultant’s appointment I manged to mention in an off-hand manner that they could safely proceed as they could administer down to 75-80. “On no” she replied. “The pharmacist says no”. At least it was a human interpreting the NHS rules, procedures and policies in a rigid and inflexible manner and not a computer. Still maintaining the air of someone not in the slightest bit phased I gently suggested that the nurse contact my consultant and enquire what his view on the matter was. Off she went. Whilst visibly calm I’m not sure what the cruel arm death crusher from hell would now be reading if still attached. Taking my brief moment alone I sprung into action whilst not moving from my seat and rang my clinical nurse specialist hoping that she would also be able to help in case my favourite French consultant was not in the office or else having a garlic baguette break. Roughly 25 minutes passed before my nurse trotted back with a pot of pills. “We sent your consultant an email and he has replied saying we can proceed with a level down to 75-80 (note: the units for blood platelets is 10*9/L. 75,000,000,000 sounds like a lot of platelets to me). She apologised and explained my consultant had inadvertently left off from my notes the minor detail of the level they could go down to and still proceed. He was probably busy training some asthmatic ants (ad passim).
They were aware that at my first chemo session, two weeks earlier, that they had to inject me with a needle, the size of an 18 inch nail, full of atropine to deal with the side effects and the perfuse sweating. I suggested she could hold off until the infusing had begun. No need to stab me if the side effects were reduced. Let’s wait and see I thought. Whether it was a communication issue or something more premeditated, whilst I thought she agreed with my suggestion the next thing a knew she had slipped in behind me and stabbed more swiftly than an Olympic épée fencer shouting incoherent gibberish whilst trying to skewer their opponent. En Garde, as they say in Sidcup. The deed was done and the infusion began. Except it didn’t. My nurse had set up the infusing pump to pump at the required rate and then was called off to another patient. About ten minutes later I noticed that my pump was not making the highly annoying beeping noise that they make to indicate that it was pumping the toxic drugs into you trying to kill you, but not quite. A further 5 minutes passed before I could catch my nurse’s eye. When she noticed me waving frantically like a genie in a bottle seeing someone passing his lamp for the first time in 36 years she dutifully returned. Rather sheepishly I asked if it was all working as intended. On closer inspection she noticed that she had neglected to press the start button. And we were off.
Whilst not one of the most glamorous sides of chemotherapy, being in the hospital for over 5 hours does necessitate using the toilet. As most chemotherapy drugs side effects include loose stools and diarrhoea added to the fact that my colorectal consultant removed almost a foot of my colon, this is not as trivial for me as it may sound. In fact I can probably tell you the number of steps and estimated time it takes to get to each of the toilets with an accuracy of, give or take, 0.23 seconds. When you do go you unplug your chemo pump and take it for a walk with you to the toilet. Not quite as difficult as wheeling a shopping trolley with a stuck wheel, but not far off. Anyway, by the time I have settled down on the toilet my chemo pump began issuing its warning siren. Audible across a whole ward and even louder when located 2 foot from your ear when locked in a toilet. Anyway, I thought, nothing to get excited about. The battery will last for the time it takes me to downgrade my weight and return to my chair. Wrong again. Before any movement was felt down below the pump waved goodbye and turned off. Sometime later, once my ablutions were finished, I returned to my seat at a slightly elevated pace and plugged my pump back in. Waving energetically, once again, at my nurse, she came over and once I explained the situation she restarted the pump. Three more visits to the toilet later, the score was a clear 4 trips v 4 pump restarts.
Then it was all done. Once the pump finishes it announces the fact with its stringent alarm and, eventually, my nurse appears and turns off the pump. I am then hooked up to my external chemo pump in its own little pouch that now hangs off my neck with a strap for the next 3 days. I am then loaded up with 5 different drugs and, as if I haven’t been stabbed enough, a selection of needles so that I can stab myself for 3 consecutive days 6 days after my chemo day. I’m not sure you can ever get desensitised to inserting a needle longer than the circumference of the earth but boy do they try!