Wednesday, 25 November 2009

Big C's little c

I am not sure if you have noticed, but I haven’t spoken about ‘it’ in my last two blogs. ‘It’ being the Yukky Lump of course. This was intentional, on my part, though I am not totally sure why. Perhaps a bit of me thought you might be getting a tad bored with it by now and that I should lay off it for a while. Maybe it was my way of attempting to say that although cancer has taken over part of my body it hasn’t taken over my life. Though of course that sadly isn’t true ... I can’t even convince myself of that one.

I still think about ‘it’ every morning when I wake ... and every night before I go to sleep. I don’t get that horrid sinking feeling that I got at the beginning, after what would have been a restless night, but I do lie there and think sometimes: why me?  Yes, I still say that.  And, other times, I fantasise optimistically about the future. The day when people greet me and ask how I am and the day when I am not tempted to say: “Just fine. Fortunately, I managed to shake off that sniffly little cold I had. I just now need to get rid of this huge cancerous lump in my breast.” I lie there and ponder when the time will come when I will meet with friends and the BC will not come up at any point during the conversation. The day when I look and the mirror and am surprised because I have momentarily forgotten that I HAVE hair. When all the treatment and surgery is done and when I can go back to work and participate in crucial discussions on life changing decisions ... you know, like which new shoes to buy, which of the latest diets to try ... big drawers vs little knickers, Brazilian vs Hollywood ...

I hate the term ‘The Big C’. It makes it sound like a national favourite. You know, up there along with Big Ted, Big Ben and Big Macs. And I guess if cancer is the 'Big C' then chemotherapy must be the ‘little C’. I have this weird thought. Well, you know me ... that vivid imagination and everything. I wonder what responses you would get if you were to ask one hundred people what they think of when someone says ‘Chemotherapy?’. You know ... Family Fortunes style. Vernon is standing there centre stage, his two contestants with their hands on the buzzers, and then he says “We asked one hundred members of the public: What do you associate with chemotherapy?”

And what do you think? I reckon most people would reply sickness and hair loss. Funny enough, I don’t suppose many would say “It hopefully kills cancer”. I don’t think many would suggest that the side effects include diarrhoea; constipation; dehydration; heartburn; headaches; joint pain or pink wee ...

I know this will sound a little odd, but last time I had chemo I was really excited. In fact, I was counting the days down ... as if I was going on holiday. The reason? Because it was my fourth session. Four out of eight. A big milestone. After the fourth one I would be able to say I was half way through. Not half way through the whole treatment, only the mid-point of chemo, ‘cos after this the lovely Drs Jordan and O also have surgery and radiotherapy lined up for me. I give it to those guys, they are really keen to get rid of this Yukky Lump and any little venturous cells that might be looking to set up camp elsewhere in my warm and accommodating body. Either that, or they really don’t like me ...

But the fourth session didn’t turn out to be the mini celebration that I had anticipated – in fact it was a mighty anti-climax. Why? Not sure. I think part of it was that we turned up at the hospital on time, and they called me in about 20 minutes later, but I ended up waiting over an hour for the chemo to come up from pharmacy. I had been warned at the beginning that this can happen, but it hasn’t happened before and the waiting bit is the stressful bit. Once they are actually administering the drugs then I am OK but it is the hanging around that does my head in. The other thing is that I am having two lots of chemo. Four of one and four of another – and the second one is ‘more aggressive’ with possibly more painful side effects. I think that at the beginning I thought that getting through the first four would be like standing at the top of the mountain and looking down at the remaining four on the other side of the mountain. Actually in reality, once I had got there, it felt that I had climbed the first stage of the mountain and that I was now looking at the steeper, tougher ascent. The north face.

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. My first chemotherapy was a combination of two drugs called Epirubicin and Cyclophosphamide – EC – quite a common drug which a number of women with BC receive.

As well as the usual things that we relate to chemotherapy such as feeling sick or actual vomiting, tiredness and hair loss there are a number of other side effects. Like most chemotherapies, EC can reduce the production of white blood cells by the bone marrow, making you more prone to infection. It can also hammer your platelets, which help the blood to clot, so you can experience rashes, as well as bruising or bleeding, including nosebleeds or bleeding gums. A sore mouth or/and ulcers are also quite typical and a number of people say that they get taste changes and suddenly can’t tolerate their favourite foods, or get cravings for certain things. Diarrhoea and in particular constipation are also pretty common.

So far I have been quite “lucky” with EC and the side effects. Each of the four cycles have been different, but none of them really bad. The things I have experienced are varying levels of tiredness, as well as some nausea, a bit like sea sickness or morning sickness, but not actual vomiting. It also makes me a bit ‘spacey’ for about five days, so much so that I don’t feel safe to drive. This is possibly down to dehydration and I have to make a real effort to drink lots of water. The other problem is that when I have a cold, or a bug as I did a couple of weeks ago, then it take ages to shake it off. Oh, and Epirubicin is blood red and makes my wee a pinky-orange for a day or so. But all and all for the side effects from the actual chemo I would say 2 or 3 out of ten.

But now I am moving on to a to a second regime, a chemotherapy called Taxotere (Docetaxel). A number of the side effects are the same as EC but some are very different. When I saw the Oh-so-luvverly Dr O a couple of months ago he said that I would need to be monitored as Taxotere can effect on the nerves – including peripheral neuropathy. PN is a term used to describe damage to nerves that are outside of the brain and spinal cord. Symptoms can include pain in the joints or muscles. It can also cause burning or pins and needles, as well as numbness and sensitivity. Hands and feet are particularly vulnerable to this, and I have been warned that my nails may crack and discolour and may even fall off. Doesn’t sound great does it? But there is still more. On top of that my steroids have been increased – increased massively. Up to now I have taken steroids for a few days after my chemo. With Taxotere I have to start taking the steroids the day before. During my last visit to the hospital, whilst we were kicking our heels for the meds to come up, the chemo nurse mentioned that it so important to take them the day before that if I failed to do so then they would not administer the chemo and it would be delayed a week. Up to now the most I have taken in tablet form is 3mg ... which have caused me to have depression for three or four days of each of the cycles. I now have to take 8 tablets daily (which amount to a massive 16mg) for three days so God knows what I am going to be like by the weekend. The pharmacy guidance does say "If you feel suicidal ...."

Now the thing with my types of chemo is that more often than not you lose your hair. Everywhere. Upstairs, and downstairs, and in my lady's chamber. And the chances are I am going to lose my hair ... once more. Now, a friend of mine called a couple of weeks ago and said “I see from your blog that your hair is growing again. Is it like a crew cut?” Err ... no ... I had to tell him sadly not. I am actually being very possessive of very little. The hair on my head is more than a 5 o’clock shadow but it is very sparse. My eyebrows have thinned but still look pretty normal, as do my eyelashes though they are not as long and thick as they used to be. And Sod’s Law ... I had to shave my legs yesterday. But by next week it could be all very different ... when I start Killer Chemo ... a nickname my Ugly Sister Number One hates.

Now, if I am the ultimate Cinderella, banished to home with my lovely frocks and dancing shoes, then it is only right that my two younger sisters are the ‘Ugly Sisters’. Of course I can only get away with calling them that as they are of course far from ugly ... both prettier and thinner than me ... though we do have some similar features such as dark hair and dark eyes.

Many years ago I went to the local Indian restaurant on a Saturday evening, following a few Mad Dog 20/20s. Do you remember Mad Dog 20/20s? A horrid revolting concoction that probably had a worse impact on my body than the chemo. Three was the golden number. Why? One Mad Dog and I was tapping my fingers along to the jukebox. Two? Two and I was dancing on the tables. Three ... after the third one I would be on the floor admiring the ceiling. So returning to me sitting in the Indian. I was there one particular night and someone I used to go to school with happened to be sitting at the next table. “How are you?” Fine, I replied. Which was true ... at least I was until the third 20/20. “And your sisters?” Mmmm ... I faltered quizzically ... they are fine too. “That’s good”, he replied. “You know, you always used to remind me of The Corrs.” Oh yeah right. “I used to have this thing about The Corrs.” For goodness sake, how long does it take to get a prawn balti around here? “All three of them girls. Obviously not the brother. The bloke whose name nobody ever remembers.” Which got me thinking and temporarily forgetting my curry ... perhaps me and my siblings were missing out on a trick. We could make a bit of money from being a tribute band. ... I even have a brother to make up the complement and could pretend to be the 4th Corr ...“the bloke whose name nobody remembers”. We would call ourselves Hard Corr ...

Oh, I forgot to mention ... the biggest problem with Mad Dog 20/20 was that it wrongly led me to believe that I could suddenly sing ... at least chemo doesn’t do that. Well, it hasn’t yet ... and if it does ... then we are all in trouble.

So back to Killer Chemo. My response to my disapproving Ugly Sister is that it I call it that because hopefully it is going go in and finally finish off any of the cancer crap that is remaining in my body ... not because it is going to kill me ... though admittedly having read the possible side effects there is the chance that it might feel like it is having a go. In my mind I have this image of Killer Chemo storming in and kicking ten bales out of anything still lurking in there and terminating it. In fact, if the previous chemo was little soldiers charging in and atttacking Yukky Lump then we need to order them to step down. We are now calling in the Marines.  As Aunty Gok would say ...

“Hey si .. s..ter! It is time to send those Big Boys in to go and sort them gorgeous Big Boys out”


  1. If you can laugh in the middle of it, you'll do fine, sistah!

  2. Hey Paula -- to prevent or slow the progression of peripheral neuropathy, you can use glutamin powder in cold beverages daily. My holistic MD doc at UCLA has me taking 2 tsp, 2-3x/day and it is really helping a lot. I was on Taxotere (plus Cytoxan) for 4 cycles and and am now on Carboplatin and Gemzar for 4 (total of 8, with last one being this week)...and these caused the tingling hands/feet but the glutamine powder put a stop to the progression of it for me. Hope that helps!


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