May Contain Nuts

Pre-assessment call that lasted an hour 

I will be having the immunotherapy drug first, followed by two chemotherapy drugs, Paclitaxel and another one beginning with C (I think) tomorrow. Then for the next two weeks it will be the immunotherapy, which is not as invasive as the chemotherapy. It is being given to help my body make more white blood cells and platelets to fight the cancer. After 12 weeks, the chemo will then change to EC which will be given every 3 weeks for 4 rounds. If everything goes to plan, the 18^th of December will be my last round. Then it will be rest for me for a little while before surgery. Then immunotherapy afterwards with 6 lots every 3 weeks. I need to check that as I thought it was radiotherapy afterwards. 

So, Day 1 (24^th July) will be three drugs. We spoke about a picc line, and I have said that I would prefer one as my veins are not that good, and seeing as it will be a weekly thing, it seems the sensible solution. I won’t have one fitted tomorrow but hopefully the picc nurses will fit it on Day 8. They will request a swab from my nose and groin to check for MRSA. I will have everything through a canula tomorrow. With a picc line, district nurses will come to flush it through and do the blood tests at home. 

I will be given a card that is passport size that will have emergency blood forms and a prescription for antibiotics in it. If my temperature drops below 36 or above 37.4 degrees, I am to call them on the emergency number, and they will advise me if I need to go to A&E immediately (with my emergency card). She said it was so I could jump the queue. 

She advised that I should wear comfortable clothes tomorrow as I will be there for 6-7 hours at least. No need to bring food as they will provide everything. 

I need to check my temperature daily as my white blood cells with drop and a change in my temperature could mean an infection. She said that they want me to feel well enough to continue a normal life, but I need to stay away from big crowds if I am not wearing a mask. If I am with family/friends, I need to make sure that no-one has a cough or cold. 

Mouth ulcers are a common side effect and that 1 or 2 of them is okay, bonjela or warm salt water will help with them. I am to call if I have more mouth ulcers than that and I am struggling to eat. 

Nausea and vomiting are another side effect. I will be given anti sickness tablets to take 3 times a day. If, after 3-4 days the nausea goes, I can reduce the tablets to twice a day, then once a day. Or I could just keep taking all three every day all the way through. I like the idea of not taking so many pills. If the nausea doesn’t go, then I should call and let them know as they may need to adjust the chemotherapy. 

I need to keep an eye on any rashes or spots and call them if there are any. 

They will give me some back-up anti sickness tablets. If I vomit 2-3 times in 24 hours, I must call them. 

Smaller meals little and often are better than 3 big meals. Ginger is good for settling the stomach. 

If I become constipated, I should drink more orange juice, have dates and prunes, drink more water, have cereal with more fibre, and take some senakot. 

If I get diarrhoea 3-4 times in 24 hours, I should take Imodium. 

The side effects of chemotherapy are constipation, the side effects of immunotherapy are diarrhoea, so hopefully they will balance each other out! 

My skin will become sensitive, I am not to use creams with scents, E45 cream is the better option. 

I must keep an eye on my nails. They will ridge and can even come away. If there is any weeping, it could be an infection, so I will need to call them. 

I will become tired, but if I am spending more than half the day asleep when I have been asleep all night, then I need to let them know. 

There is to be no sunbathing. Factor 50, sit in the shade, wear a hat. That’s nothing new for me then. 

The Paclitaxel will cause pin and needles in my fingers and toes in the morning. If they continue all day, that is a definite NO as it can cause permanent damage. Let them know immediately as the drug will need to be reduced. 

The immunotherapy can cause inflammation of the lungs. If there is shortness or breathe or pains in the chest, I must call 999. 

If I need to take paracetamol, I must check my temperature beforehand as the paracetamol reduces temperatures and can mask an infection. Call them if I am unsure. 

I think that is everything. 

Oh no, forget, I must inject myself for 5 days. I can’t remember why, but she said they would tell me more about that tomorrow.

Apparently, the chemotherapy is worse towards the end. Great to know. But at least I won’t be having the immunotherapy. 

She said the immunotherapy is given to get the bone marrow making more white blood cells and platelets, so that will be when my bones ache. So, every week then. Brilliant. 

She was asking what medication I take: nothing. Only the pill years ago. Any supplements? Nope. Good, she said, as that may affect things. 

I won’t lie; I have sat here crying for a while. I have a 23mm lump of cancer, why can’t they just cut it out and not have to do all this invasive stuff. They make everything sound so shit. Will there be anything good about any of this treatment? Not by the sounds of it. 

I know they must warn you about the side effects, but they make the cure sound worse than the disease. I have no pains from cancer, just a lump. 

I hope I read this back in a few years’ time and laugh at the daft cow sitting here crying because she’s not sure she can do all this.