Progress Preview

A quick one with the headlines:

  • Blood test (including needle) – done 🙂
  • Review with Dr W2 – done 🙂
  • Anaemia – bit better than Thursday (?!) and almost back to the level it was before Chemo 6 – hmmm.
  • Transfusion – not essential, and fit to fly 🙂
  • Chemo 7 (Taxotere 3) – DONE! FINISHED! 🙂 🙂 🙂
  • Side effects – on their way as we speak……………….
  • White cell booster – tomorrow (with needle – 😦 )
  • Chemo treat – decision made, procurement in process, wait for updates
  • Eyebrows – almost gone!!!  More about those disappearing rascals later…………
  • Fingers and fingernails – numb, tender and a not pretty – more about them later too….

Today, Dr W2 was on great form – very positive and happy with the way things are going.  I still have quite a few questions, but was highly encouraged at how positive he was about my progress.  And trust me, he is very direct and frank (for example about my lymph node involement and the need for a heavy Chemo course) so I know he does not believe in platitudes.  Duck billed or otherwise.

So there were are – 87.5% through the Chemo event and only one more chemo left.  If all goes well that will be on April 4.  Then I will be clambering over the wall and leaving the All Exclusive Chemo Club, and much as I am grateful to it, I never ever want to have to come back!

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The Haemoglobin Limbo Dance

A new factor to feed my anxiety this time is the likelihood of some intervention to deal with the decreasing haemoglobin levels.  They are doing their own limbo dance since Dr W said he would only do one more chemo (that was No 6) and see “how low they can go”. Thursday’s blood test showed that despite incredibly careful diet, piles of iron rich food and very careful attention, they have reached new depths.  Marvellous!

On the positive side, I have been able to find out a bit more about transfusions and the risks involved.  Transfusion is the mostly likely intervention as others are either less effective or carry different and greater risks.  As far as possible I have been reassured about the blood screening and other processes here, although I would still prefer not to be facing this choice.  Decisions are likely to be made tomorrow once a new vampire test is taken and the latest counts analysed.

I would be very suprised if they show any significant improvement which would merit a stay of transfusion.   Furthermore, it is pretty clear that the risk of not transfusing is quite a bit greater than transfusing the way things are at the moment.  For example, every time I travel between Yangon and Bangkok, I need a “fit to fly” letter from the treating Doctor to confirm that I am cleared as well enough to fly.  I learned yesterday that if the haemoglobin levels drop too much then at a certain level you are no longer considered fit to fly as there is a risk of becoming – something that sounded  like “hyperbombastic”!!  Being hyperbombastic on an aeroplane is not good apparently!

This is in addition to the risks which severe anaemia brings and the fact that chemo 7 may not go ahead with these low haemoglobin levels.

And I am not even considering that there could be any disruption brought by the ironically coloured crowds gathering in other parts of the city…………

So let’s see what tomorrow brings and where I shall be updating from at that point.

Number 6

I do get myself into a state before each treatment – the dread and feardyness (Scottish for fear, although it could be a new word altogether?)  make the days leading up to each chemo unpleasant and difficult. 

However, the day itself, though punctuated with many feardy moments (particularly the ones associated with NEEDLES) seems like an unstoppable process and the day is long-ish but I am swept along as time ticks forwards.

So this morning, as usual, we left for the hospital with the necessary appointment slip, numbing cream (for the port area) and the blood test results from Yangon.  I checked in at Counter No 2 and was greeted like an old friend by the nurses.  I handed them the test results as well as the other papers, in a clear attempt to avoid another needle this morning!  I was summoned for the usual Blood Pressure (yep too high again – surprise) and weight checks and sent back to the waiting area without being sent to the lab for a blood test.  Slowly I allowed a little glint of optimism to break through – perhaps they won’t run the tests if they already have one set of results from only a couple of days ago?  I watched Dr W2’s door for clues and activity and sure enough after a short interval I could see the nurse being ejected from his room – she gestured over to me that I would be seen soon.  After a blood test – GRRRR!  But then she pointed upwards – now that can only mean one thing – that one of the lovely and gentle oncology nurses from Floor 5 had been summoned for the test.  I also saw her collecting some vials which must be waiting for me – chitter chitter!

Before long, I saw the white tunic and familiar face of oncology nurse A with her picnic basket.  I reacted with a mix of relief and increased feardyness.  I know she is really gentle, but again there is only way she is going to get that blood, and it will involve a needle.

Sure enough, I was called over and we greeted each other like friends. She did have trouble locating a vein (my arm has a line of bruises down the vein, of varying shades and sizes, which represent the timing and impact damage of the needlework).  She did find one and with her usual professionalism she gently removed what was needed.  She then prodded the port area a bit and put the numbing cream on.  That is another tactic – as well as numbing the area it also reduces the pressure which Dr W2 uses when he presses on the area to check it out!!

Back to the waiting area, a good book and after a while I heard my name called – there was Dr W2 at his door, beckoning me over.

He doesn’t beat around the bush – we had hardly sat down and he told me he was worried about my haemoglobin levels and worsening anaemia.  White counts are ok and clearly were helped by the post chemo shot.  He was pleased that I am making a serious effort to eat the most healthy diet I can, but said that even the best of food (even crocodile and octopus soup he said!!) can’t fight the effects of the chemo on my anaemia and he wants to do something about it.  Each intervention has its risks though so we agreed that he would do chemo no 6 and then see “how low it can go”.  Hmmm.  He said that the chemo is extremely hard-hitting.  Too right!!

So a bit of uncertainty now about Numbers 7 and 8.  Ach well that will mean increased levels of feardyness in 3 weeks time.

Eventually I was returned to the waiting area, a and a little while later a young man arrived in hospital uniform, walkie talkie clipped to his pocket and my file in his hands, and escorted me upstairs to the oncology ward and chemo number 6.

A few hours later, one needle in and several syringes and infusions later it was all over without incident and I was sent to the cashier and pharmacy.

So now I am back at the apartment, kept going by the anti side effect meds which are infused before the chemo, though a bit fuzzy headed as usual (yes, I know, nothing to do with chemo!!)  I have to go back for another needle tomorrow and then just to ride the side effect storm.

In the meantime, I am a bit like a child let loose in a sweetie shop because of the internet access.  I don’t know which site to access first and lurch from site to site, tempted as if they were my favourite sweets!  And I am taking full advantage while I am feeling ok-ish and while I can!