Thursday, 15 October 2009

And So the Chemo Ends

So at last, I’m off to Harley Street for my final chemo session. I get up late, as usual, then stagger about getting dressed and making cards for the nurses. I like to print my own photographs as cards for special people.

Nick Skypes: “I just want to tell you that I love you and I hope it all goes well today.” I have to say I’m feeling very emotional.

I have been thinking about an appropriate gift for the nurses. I know that they get inundated with cakes and chocolates. Yet it’s difficult to think of another gift that they all can share. I recall bringing them a bunch of flowers once to cheer up their front desk. They thanked me but the flowers were quickly ‘disappeared’ without ever being unwrapped. I guessed that they must have fallen foul of the no flowers rule that is often in force in intensive care units, chemo units and such places. Apparently flower pollen can cause infections. In the end I’m not imaginative enough to think of any alternative gifts. Paul does a lovely gift box of mini macaroons. Four of each in six different colours. They’re elegant and merely a mouthful. As much a treat for the eyes as for the stomach. If I had the energy I would go up to Harrods and get the Ladurée ones that Iris is always raving on about. But I haven’t. Anyway, the ones from Paul are pretty damned delicious.

Macaroons on board, I pop up to Daunt Books and buy cards to replace all those that I left on the table at home. I don’t admonish myself anymore. It’s just chemo-brain.

The unit is quiet today. I’m thankful for that. I don’t feel like being surrounded by drama on the last day. Nurse Cara does my observations: weight, blood pressure, temperature and oxygen saturation. Nurse Karen looks at my feet. "Crocs n'Socks will soon be on the runways," she observes.

Karen wraps my arm in a heat blanket to aid the manifestation of a vein. The veins in my arm are pretty well worn out at this stage. But I’m truly thankful that at least one of them has held up to the end. I haven’t had to have a central line installed in my chest, as I’ve seen many have. All-in-all, I feel that I have had a pretty easy ride of it with chemotherapy. I have read, heard and seen some real horror stories. It’s been difficult and miserable at times but never intolerable. I haven’t suffered major organ damage, I haven’t been admitted to hospital, I haven’t had to have a blood transfusion, my fingernails have not fallen off. What more can one ask for?

With a few inadequate words of thanks, I hand over the macaroons. With eloquent and gracious words of thanks, nurse Karen accepts them. Then she gives me a big hug. One might get the impression that this is the most beneficent gift that they have ever received. I am sure it is not.

The chemo itself is uneventful. Sandra comes by and gives me a deeply relaxing reflexology treatment. I will miss those. Karen offers me a macaroon. I recline in the big armchair, eating a macaroon and having my feet rubbed. “It doesn’t get much better that this,” I remark. “Well you could have George Clooney bringing you a glass of champagne,” observes Sandra. “You’re right,” I sigh, “I knew there was something missing.”

Finally, the chemo is finished. Nurse Karen unplugs me and it’s time to leave. She hesitates a moment before applying the mini plaster to the spot where she removed the needle. “We just have to be a bit careful,” she says, “sometimes people have gone off and then come rushing back with blood pouring down their arms.” “I’m sure that won’t happen,” I say. “It’s never happened before.” I put on my jacket and hug them all. I will be happy not to have chemotherapy anymore but very sad not to see these nurses. “Goodbye, goodbye,” I have to blink back tears. Then, as I reach for the doorknob, I feel a trickle on my hand. I rip off my jacket and throw it to the floor. Blood is pouring down my arm. I rush back in for a final dose of care and attention. It’s a psychosomatically induced blood spout, I’m certain of it.

My last stop is to see Suzy Cleator. It may be difficult for you to comprehend that one can be genuinely pleased to see an oncologist. But I am. She has become a good friend to me. She is heavily pregnant now and will soon be stopping work, so the end of my chemo treatment is an appropriate moment to hand me over to the new oncologist, Dr Coulter.

Suzy confirms my opinion that I have tolerated the chemotherapy very well. I have to say that that is very much due to her expertise. The weekly regime of Taxol has been a big success. I hand over her card and start to choke up again.

Honoria pops in. She is heavily pregnant too. I will, however, be seeing her again. In two weeks time when I come for radiotherapy ‘planning’.

Suzy raises the subject of Tamoxifen. It’s a hormone therapy that she is recommending that I take every day for the next five years. I shift uneasily. I’ve read and heard all sorts of conflicting things about Tamoxifen, many of them quite scary. Of course I haven’t got any of my facts straight. “I am concerned about the side effects,” I say, in an embarrassed tone. “It is highly recommended for you. Your tumour was oestrogen receptive. So if there’s still any lurking about the Tamoxifen stops it being fed with oestrogen. You can try it, and if you find it too difficult you can decide to stop,” says Suzy. “I’m worried it will cause bone loss,” I reply. “Tamoxifen has a bone protecting effect,” Suzy rejoins. “Oh, I don’t know. Of all the therapies, this is the one that I feel most uncomfortable with,” I say, unconvincingly. Suzy clears her throat, “Of all the treatments for breast cancer, surgery is the most important. The next most important is Tamoxifen. Then chemotherapy, then radiotherapy.” I study the floor. “I think the best thing,” says Suzy with one of her indulgent looks, “is to discuss this after you’ve had the radiotherapy."

She sure has learned how to play me.

I wish both Suzy and Honoria all the best with their births, bid them goodbye and leave.

Then I step out into Harley Street and into my future.


Anonymous said...

Ah, you have given me a great idea about how to thank my chemo nurses.

I have been giving my hand-made jewellery to each set of medical staff once I am done with that phase (surgery ward nurses, surgeons and anaesthetists).

Rather then sending a package this time, I will take a bundle of female/male jewellery to my last chemo session - I'll give the nurses first option and then offer whatever is left to whoever is having chemo at the same time!