Groundhog Day

Having radiotherapy treatment is very different to having chemotherapy. On the plus side it doesn’t make me feel like I want to lie down on the floor and vomit. It doesn’t make my hair fall out, nor attack the linings of my mouth and throat. It doesn’t threaten to necessitate a blood transfusion.

A person of sound mind would favour radiotherapy over chemo any day of the week, given the choice.

But there are down sides too. The chemo treatment was only once a week, or once a fortnight. And, strangely, I felt more cared for. The whole chemo unit was set up to make one feel as comfortable as possible. There were the big easy chairs to snuggle into, blankets and pillows and, above all, nurses. The nurses were always there to hold my hand if I got frightened or to make me a cup of tea or just to have a friendly chat.

Radiotherapy is more impersonal. I arrive each afternoon. “Take a seat” says the receptionist. Then five or twenty-five minutes later she calls my name and says, “Please go on down.” I take the stairs to the basement and sit in another small waiting area. It is always hot and stuffy with a distinctly medical smell. My name is called again. Every day I see a different pair of radiographers. They are pleasant and professional but they’re not interested in chatting. They see patients every fifteen minutes all day long. The job requires a high level of concentration. There is no room for mistakes yet they must try to stay on schedule. They don't know me at all. My main interaction is with Bruce or, on one occasion so far, Bruce II. The whole procedure makes one very aware that one is on a cancer conveyor belt.

My radiographers-du-jour are Patti and Laura. I strip to the waist and assume the position on the bench with my arms above my head. They reel off their readings, adjusting the bench until my body is perfectly aligned in the crosshairs of their green laser beams. Then they leave the room. Once again I’m alone with Bruce and the ever-playing Elton John cd. It seems just like groundhog day. “Hello Bruce,” I say. Bruce says nothing, just stares at me with its big eye. Elton, however pipes up. In a concrete and lead lined basement he sings to a woman on a bench and a giant machine. At the top of his lungs he voices what, I am almost certain, Bruce is thinking:

“I want love, just a different kind

I want love, won't break me down

Won't brick me up, won't fence me in

I want a love, that don't mean a thing

That's the love I want, I want love”

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.

The Thursday Roundup

I don’t care if it’s cold. It’s sunshine that gives my heart its zing. And today is just the kind of beautiful autumnal day that makes me want to skip to the hospital.

But it is chilly. I really feel for the first time that my head is very cold. Even though I’m wearing a headscarf. It just goes to show how much protection our hair provides.

Standing at the bus stop, tears suddenly spring from my eyes. Lots of tears. But I’m not really crying. It’s an automatic mechanism that kicks in because I’ve got insufficient lashes to protect my eyeballs. I jam on my sunglasses and make a mental note not to leave home without them from now on. Then my nose starts to run freely. This is because all the hairs have fallen out from inside my nostrils. I fish for a crumpled tissue in my handbag. It is all covered in snotty blood. At this point I notice that the girl who was standing next to me at the bus stop has moved away.

I’m trying my best to be Chemo Chic but I have to tell you it’s a challenge sometimes.

I pop in to the Harley Street Clinic. Sister Lottie takes my blood then I skip off down to Marylebone High Street to meet Iris and Flossie at the Providores.

Now, I’ve spent a lot of time singing the praises of this New World Tapas bar. The food is innovative, healthy, interesting and delicious. But one has to order carefully. Some of the dishes really overstep the mark when it comes to the price : quantity ratio.

Iris is a big fan of food fads. Recently she was a Vegan but now she is on the Atkins diet. She chooses her eating plans according to a carefully formulated scientific method: whatever is likely to be most irritating to her nearest and dearest. Not wanting to be outdone I mention that I have just taken delivery of a book called The New Raw Energy by Leslie Kenton. “I’ll give you a week,” says Iris, “I mean it’s all very well when one is trawling the internet eating Green & Blacks at one in the morning. But really, these regimes are just impossible.” Deep in my heart I know she’s right. Iris looks at Flossie. “You should go to the Mayer Clinic in Austria,” she opines, “you’ll definitely lose weight. They give you loads of colonics and no food.” “That sounds awful,” says Flossie. “Yes, but it would be a laff,” whoops Iris, exploding in raucous laughter at the very idea.

Iris orders Tuna Tataki. It turns out to be four tiny pieces of tuna, about an inch-and-a-half square and a quarter of an inch thick, with a few bits of pickled daikon, half a teaspoon of fish roe and some minute cubes of beetroot jelly scattered about the edges. It is exquisite but you’d have to have at least fifteen of them to constitute a meal. At £10.50 a plate it has to be said, they’re taking the piss. Flossie and I do not fare much better. We order Laksa. I envisage a big steaming bowl of noodles in coconut broth piled up with fresh vegetables and seafood. What we get is a small pudding bowl, not full of soup. It’s very tasty but contains only a spoonful of noodles and a few wafer thin slices of squid. It’s a meal for a macrobiotic fairy. £9.80! If you want a proper, big as your head Singapore Laksa, I suggest you try the Makan under the Westway on Portobello Road.

“What was the soup of the day?” asks Flossie, wondering what might have been. “Mushroom and tarragon,” replies the waiter. “Yuk!” exclaims Iris, “I only like beetroot soup.” “I will make you beetroot soup,” I offer. Iris crinkles her nose and looks at me as though I’ve just offered her a bowlful of dog excrement. Now I may not be perfect in every respect – yet, but I do regard myself as something of a goddess when it comes to cooking. “Oh, you are a faithless friend,” I inform her. Iris laughs uproariously. She looks mightily pleased with my assessment of her character.

On the way back to the hospital I pick up my ritual chocolate éclair from Paul. That never disappoints.

Today I’m being tended by Nurse Lindy and Sister Lottie. There’s a whole new gang of cancer sufferers at the hospital. This, I am told, is because everyone is on different cycles. Some come every two or three weeks, some less often. There seems to be one other lady that is here every week, like me. She is persevering with the ice hat, poor love, and seems to be having a pretty miserable time of it.

Two chairs along from me lounges a man. I would judge him to be in his late fifties. His throat is wrapped in a silk cravat. He puffs away on an electric cigarette and blows smoke rings.

Smoking in the Chemo Unit! I am reminded of Marla Singer in Fight Club who always smoked in the cancer support group. What panache. If I weren’t totally bald I would take my hat off to him.

Sister Lottie tells me that she has worked here for more than three years. This is an aeon in nursing careers. It must be a good place to work. She also worked in the NHS. “How does it compare?” I ask. A sad, resigned expression comes across sister Lottie’s face. “It’s really a shame,” she says “Comparing public healthcare in Australia with public healthcare here, it’s much better in Australia.” “That’s very disappointing to hear,” I say, “why do you think that is. They obviously have a lot more money here than they do in Australia.” “Yes, they do,” says Lottie, “but they don’t have the equipment. Everything is in short supply. And they don’t allow treatment with the best drugs. I mean, this weekly Taxol you’re having, you wouldn’t be allowed to have that on the NHS.” This comes as a surprise to me. I have always held the belief that the NHS offers the best treatments and takes care of everybody. Sister Lottie adds that my oncologist and my surgeon are two of the best breast specialists in the UK. Suddenly I feel very privileged and slightly guilty.

Synchronicity is at work. A couple of minutes later Suzy Cleator drops by the Chemo unit. “Did you get my email about the eyelash growing treatments?’ I ask. “Oh, yes,” she replies, “that will be fine. You can go ahead and use them.” I will get onto it pronto.

Everything I Know About Marketing and Distribution

Chemotherapy session number four. I came back from the hospital about two hours ago and I’m racing to get this piece done before I feel too ill to write.

Jamie picked me up from Harley Street with instructions to drive at top speed to Ottolenghi for rose and vanilla cupcake supplies. Then we drove straight home and ate them before I started gagging.

The nausea started mildly in the car but now it is becoming gross. I've already taken three different anti-sickness medications. I’m hungry but I can’t bear to eat anything more substantial than a grape. I feel dizzy. I have a headache. I’m only telling you all this so that you’ll know what a committed person I am, battling against adversity to bring you my blog.

Actually, writing helps to take my mind off how revolting I feel.

I made a radical decision today – not to wear the ice hat. My appointment with Suzy Cleator wasn’t until the end of the day so I couldn’t discuss it with her beforehand. I talked it over with the nurses, trying to weigh up the pros and cons:- It is so painful. It makes the chemotherapy session three hours longer than it would otherwise be. It looks ridiculous. And most of my hair has fallen out anyway.

On the other hand there is some hair clinging to my cranium. Maybe that is worth trying to save? And I still have most of my eyebrows and eyelashes, I definitely want to keep those.

The nurses tell me that, in order to administer the ice hat, they will have to apply barriers of wadding to the most moth-eaten-baldy patches on my head. This is done to avoid scalp burns. They also explain that the ice hat will do nothing to save my brows and lashes. Well that’s the clincher. Feeling comfortable with my decision, I settle into my Lazyboy recliner for a cosy session of hideously toxic but life-saving chemicals and chats with the lovely nurses.

I’m most cheered by the way that, every time I go into the chemotherapy unit, one or other of the nurses compliments me on my appearance. Then nurse Bess usually shouts out “She always looks great”. It is simply the ultimate cherry of flattery on my cake of vanity.

You occasionally read about psychotic-serial-killer nurses but I’ve yet to come across one who was not some sort of reincarnated angel. No matter how grim the personal circumstances of their day might be they invariably manage to put on a bright smile and find the generosity to put me first. They seldom bitch about rude and demanding patients who don’t even bother to remember their names. You hardly ever hear them moan about the shift work, having lunch breaks at four-o’clock in the afternoon, dealing with hazardous, toxic and just plain disgusting substances, commuting vast distances or working obscenely long hours for scant cash. The first inkling anyone gets that the situation is intolerable is when the nurses suddenly leave the profession that they’ve spent years training for.

Bess settles down at my side with her raspberry red syringes and tells me about her plans to start a fashion website when she goes home to Australia. “Eh, what about nursing?” “Oh I don’t want to do it anymore” she replies breezily. I am torn between wanting to encourage her in her venture yet wanting to discourage her from abandoning her vocation. I have to admit that, for a fashion-loving girl like Bess, the uniforms are a nightmare. But what about the rewarding sense of self-fulfilment?

On reflection, I realise that the whole of society relies on that sense of self-fulfilment – we don’t reward them in any tangible way. I pause for a minute. Would I be a nurse? No, I would not. I am just grateful that there enough young women, and some men, who are altruistic enough to pursue nursing whilst they are still resilient enough to enjoy life with nothing more than an oyster card, pot noodles and beer. And that a few of them have the tenacity to stick it out into the ancient reaches of 30-plus, going on to become ward sisters and whatnot.

“So, that sounds like a good idea. It’s quite ambitious. Have you thought about marketing and distribution. “ I say, hedging my bets. Luckily for me, Bess does not reply: “No, please tell me everything you know about marketing and distribution.” I quietly let the topic slide.

Later on Suzy Cleator looks at me across her high-end specialist’s desk in a kind yet pained sort of a way. She is, after all, my consultant. I’m aware that I’ve just changed my treatment plan without consulting her. “Oh well, I can always start the ice hat again next time” I blurt. “You will probably lose your remaining hair this week.” I do admire her matter-of-factness. This is not a situation where soft-soaping is required.

Going Home

Mr Hadjiminas doesn’t have any days off. He’s in the hospital every morning. But on the weekends he visits wearing casual consultant attire: an open necked shirt; chinos and, you guessed it, boating shoes.

Today I am going home. It feels disconcerting. After a week, the hospital feels like home. And home feels like a scary place where I will have to cope with doing the laundry, cooking, cleaning, shopping and bathing. To be honest, I only just about manage those chores at the best of times.

Nick is still in London, so I’m going home with him. And that seems disconcerting too. Only four days ago Nick dumped me out of the blue for no good reason whatsoever. I know it was some kind of emotional short-circuit that caused him to freak out. But I don’t know that he won’t do it again. I don’t feel that I can completely rely on him the way I did a week ago. So I’m feeling somewhat ambivalent about going home.

Nevertheless, I’ve been in hospital long enough. There comes a point when one begins to pace one’s room like a caged animal. I’ve reached that point.

Mr H removes the chest drains with the assistance of nurse Tiziana. I keep my eyes firmly averted. We don’t want anymore fainting. “The wound will fill up with fluid now,” Mr Hadjiminas tells me, “you will have to come in to have it drained once a week.” Nurse Tiziana gives me a strong painkiller. I gratefully accept.

Every day brings its own opportunity to try some small thing that takes me forward in my recovery. This morning I will have a proper bath, rather than a sponge wash, for the first time. I turn on the taps and lay out my clothes: the silver sparkly top and black leggings.

Nick won’t be here to collect me until lunchtime, so I slowly begin to pack up the room. I’m astonished at what an accumulation of stuff one can acquire in just a few days. There are cards; an assortment of vases; the crazy clock; an array of Tupperware containers; my laptop; clothes; boxes of teabags, snacks, biscuits and so on. The painkiller has done its work. I happily fold things into perfect squares, making neat little piles whilst I hum away to myself. Some time later I remember to check on the bath. The bathroom is ankle deep in water.

I press the nurse call buzzer. Nurse Sarah pops in. Nursing can sometimes be a thankless profession so I hope that it makes Sarah feel good to know how just much I, for one, appreciate her plumbing skills.