Well it’s been a while since I last posted so I feel I should bring you up to date.
My second chemo pretty much followed the same pattern of symptoms as the first, though thankfully this time around I was better prepared and able to manage them a bit better. The usual suspects turned up, heartburn, mouth ulcers, constipation and my dear friend nausea, though they didn’t hang around as long as the first time and did the decent thing. One thing that did make a return, and disproved my theory that forgetting the Clarityn/Loratadine was the cause, was the horrendous lower back pain. Right on cue a week after chemo and on the last day of the Filgrastim injections it set in. I believe this is down to the injections that are designed to help the bone marrow to make new white blood cells. Having read some of the symptoms described by others I think I get off lightly as I only seem to suffer for a day/day and a half. Needless to say I won’t be stopping the Clarityn any time soon to see whether the effects are worse without it.
The Hickman Line
With the chemo out-of-the-way, my main concern was having the Hickman line fitted at the end of November. While I knew it would certainly be advantageous, I was still not comfortable with the idea, or the fact that the procedure is done under a local anaesthetic. When I was given the booklet explaining the procedure I had to read it in stages. If you’re remotely squeamish like me, it’s not pleasant reading. A Hickman line or to give it its technical name is a central venous catheter. It’s a long fine hollow tube with an opening at each end. One end is outside your body, the other end is situated in a large vein in the chest. It can remain in position for several months or years.
The central venous catheter is inserted by a nurse specialist or a doctor. A local anaesthetic is used to numb the area where the line is put in (with optional sedation so that you are drowsy and relaxed throughout the procedure for very anxious patients). Once the line has been inserted there may be one stitch at the base of the neck (this will be removed after 7 days). This is called the ‘insertion site’. There is one stitch at the exit site where the line comes out of the chest, which can be on your right or left side. The line has a small Dacron cuff around it. The tissues heal around it under the skin to help prevent the cuff from falling out. The stitch at the exit site, holding the line in place, is removed after 3 weeks.
My procedure was scheduled for 8am which meant I was up at the crack of dawn, which is never a good start to the day. My hope was I’d be so bloody tired I might not need sedation! We arrived on time, despite the rush hour traffic and was introduced to the nurse specialist almost immediately. We were taken into a little meeting room to go through the usual procedures, making sure I was the right person, emphasising the possible problems – don’t ask, and getting my signature on the consent form. It was then time for the inevitable and I was led away to my fate. I declined a chaperone, largely because a) OH was desperate to get some breakfast and b) I figured you’d need to be a pretty desperate and stupid individual to get your kicks from ogling/touching an aging, bald and by now very much awake feisty Yorkshire lass. Anyway by this stage I’d sussed out that my nurse was not a threat. He was a lovely, warm, friendly, approachable chap who also understood my sense of humour.
The actual procedure only took about half an hour and the worst part was the 4 very stingy, painful local anaesthetic injections. I bravely or stupidly didn’t ask for sedation, while I was anxious, I don’t think it was any worse than most people would be feeling and I was more concerned about pain. My nurse, kept me informed of what he was doing at every stage of the procedure (something to be honest I could probably have done without). It was a bit disconcerting when he said “I’m just about to cut your carotid artery let me know if you feel anything” – Ha, don’t worry mate, you’ll know. It was an odd sensation feeling tubes being inserted and pushed and pulled round your chest, but it wasn’t painful. We even managed to have spurts of normal conversation while things were progressing. Turns out my lovely nurse was Spanish, so no problem finding something to talk about.
Once it was all over and I was stitched up, it was time to sit up, get dressed and go. Aaargh that was when it became exceedingly uncomfortable. The plasters on my neck and chest felt tight, I could feel the tube in my neck and it was difficult to swallow. When I tried to cough I thought I’d choke. How on earth did I think this was a good idea. Of course when the anaesthetic wore off my neck and chest wound site was also bruised and sore. My chest wound had also bled, which looked unsightly. Going to bed that night I was terrified of turning over and ripping out my newly transplanted line. Why had I agreed to this? Needless to after a couple of days at most, I couldn’t feel the tube in my neck, I’d lost my fear of sleeping with it and apart from the plasters occasionally pulling, I’d soon got used to the line.
The reality of how practical the line was to be, was soon put to the test as my third chemo was due 5 days after insertion. First stop the blood department and it was an absolute dream. The nurse changed my bloody dressing, before screwing her sample tube onto the end of my line, quick draw of the syringe and it was over. End of my line cleaned and re-bunged and I was done. No scrabbling for veins, no painful attempts to get blood out, just a simple unclamping of the line and affixing of a sample vial. Chemo followed a similar pattern and because the line is slightly bigger than a vein, takes a little less time. So was it worth the anxiety of having it done and the couple of days of discomfort, well on this showing, most definitely. It does need cleaning once a week and currently the District Nurse comes to do that at home. I’ve had that done twice now and it’s proved to be a fairly quick and painless procedure.
My 3rd chemo was the last cycle of this current dose of ‘poison’ and I won’t be upset to see the back of it. It marks the halfway point of my treatment which means when I have my 4th cycle on Friday I’m more than halfway through the tunnel and much nearer the other end.
This last cycle, not unsurprisingly followed the usual pattern, though this time it seemed to take longer to shake off the effects and my symptoms were that little bit worse than previously which has meant several prescriptions for more effective medication. The first symptom that definitely worsened was the heartburn, which was really affecting my appetite. I’ve been eating really well during the process (or should I say eating well once I’ve decided what I actually fancy) and I wanted to keep that up. My chemo nurse at the last session, was surprised at my blood results as they were really good for someone on my regime at this stage of treatment. I firmly believe that eating well has contributed to this and didn’t want to hamper that going forward. I was also concerned that acid reflux and heartburn, while in my case due to the chemo, could, if left untreated become a problem in its own right and result in another set of problems I didn’t need. A quick call to my Breast Cancer nurse sorted the problem, as she contacted my doctor and got a prescription sent to my local chemist, so OH just needed to pick up my medication. My other major problem started life as a simple sty on my eye. Only it kept growing and growing. It was exceedingly painful as it was pressing on my eye and also giving me headaches. Despite hot compresses, eye drops and Golden Eye ointment it was not getting any better. When the District Nurse came to clean my line, she said she’d never seen anything like it and took a photograph to take back to the doctor. By the afternoon I’d got another prescription despatched to the chemist for antibiotics. I’m delighted to say, it has partially burst, and is now looking and feeling far less painful (not to mention unsightly).
So that’s me up to date. My regime change on Friday will no doubt bring new challenges and a different set of symptoms to navigate my way through, but I’m hoping that I’ll continue to cope as well as I feel I have so far. I’m not expecting Christmas to be a jolly affair, but a peaceful, quiet Christmas would be my preferred option anyway, and who says Christmas dinner can’t be eaten at New Year when hopefully I’ll be feeling better. In any case I’ve already had a Christmas dinner this year. My one ‘dinner’ date I was desperate to make was with my Walking Group friends on 8th December and I’m delighted to say I made it. So I’ll leave you with a picture of my Festive outing, complete with wig.
Here’s wishing you all a peaceful, healthy and relaxed Christmas with all best wishes for the coming year.