Still Working

I tell people I am getting chemo every two weeks, but that is not entirely true. 

I am often tempted by my innate tendency to divilment, to write things that are not fully veracious, just for the giggle. I could tell people I have been cured by angels, or that I take ivermectin every second day, or that tequila slammers have been the key to my recovery.

None of those things is true. And in the spirit of full disclosure, I am not actually getting chemo. I am getting cetuximab, which is a monoclonal antibody and therefore known as a targeted therapy, rather than a chemotherapy. 

Collectively, the various gunks that they administer to knobble cancer are called Systemic Anti-Cancer Treatment, or SACT. 

As in, your cancer gets sacked. Out on its ear. (Unless you have ear cancer, in which case out on its something else).

Redundified. Severanced. Forcibly quitted. 

Or, if you are of a more medieval mindset, pillaged. Ravaged. Destroyed.

That is the plan anyway. 

"Medieval" comes to mind when I feel the teeny but acutely painful paper cuts around my fingernail as they greet an unexpected drop of lemon juice or try to press on an unyielding remote control button. Persistent, consistent, insistent shoots of pain all day and night, from pathetic little scars that look so insignificant. 

This is the main side effect from the cetuximab. Other little joys include ridiculously long eyelashes which brush off the inside of my glasses, and a lovely pustular rash on my face, back and chest. I may have mentioned this before, but don't at me, as they say. 

It doesn't cause my immunity to drop or make me particularly tired. It takes about 4 hours to administer and I pop into the lovely "chemo" ward people every two weeks where they sort me out. (I think the chances of them changing the name to the SACT Ward are small). 

I had scans before Christmas which show a sustained improvement in my liver tumour and nothing new anywhere else, so all is good. 

I have come to accept the likelihood that I will need to stay on some maintenance treatment into the future; like, looonnnggg into the future. I was ferociously lucky to get away without it before. Nearly every other Stage 4 bowel cancer patient I know has needed some kind of ongoing therapy to keep them ticking over. I was special but now I am definitely not.

It's fine, like. 

It messes a bit with my thoughts about returning to active duty as a GP.  I will have to ponder that. 

For the moment, I am delighted to keep working with the wonderful people in the National Screening Service, while the wonderful people in the Mercy University Hospital are still working to keep me alive and well. 

Update

So I left ye hanging there after my last post. Apologies. 

Since then, I have had six doses of Folfiri chemotherapy, one hospital admission for neutropenia (low white cell count which made me vulnerable to serious infections) and  at least 14 boxes of Leonidas chocolates. 

I have walked 82 miles in a month for charity, because I misread the advertisement and thought it was going to be kilometres.

I am still getting chemo every two weeks, but just fluorouracil and cetuximab now which are easy peasy compared to irinotecan. 

I have lost about 80% of my hair and I am getting skilled at the comb-over. I bought a cheap wig which I immediately had to return because it was so hideous. (It is hard to describe just how hideous it was).

I went to Belfast for the weekend where we held our annual WiMIN conference, with 120 other lovely women in attendance and a few dozen more tuning in over Zoom. 

I had a scan a few weeks ago which showed that my liver tumour has shrunk quite a lot, which was excellent news. I am due to have another scan soon to see what’s next. It seems likely that I will continue with some kind of chemotherapy on and off for the next while, just to be on the safe side. 

I am well enough now to return to work, because the chemo regime I am on now doesn’t cause fatigue or low immunity. Also, I will lose my mind if I don’t have something to keep my brain busy, so work is therapeutic for me. I am very thankful to have an understanding employer (in fact, any employer – the last time I was off sick I was self-employed, and the luxury of a PAYE job has become very clear to me in the last few months). 

I find myself getting irritated by vapidity, and then I remember that Instagram is a choice and I can just delete the app. 

I still cannot bring myself to look at the videos from Gaza. And now there are videos from Lebanon to turn away from as well. I am a coward and, therefore, complicit. I just don’t know how to cope with the inevitability of it all. They will not stop until everyone is dead. I don’t see any alternative future. 

I wish the world was different, but I am glad that I am looking out at the autumn leaves in the low October sunlight, and I am healthy (relatively speaking). 

Here We Go Again

I am catching up on various emails and tasks that I have been ignoring for the past few weeks. 

I opened my diary (an actual physical book, not Outlook) and the silver ribbon is firmly stuck in the week of Wednesday 22nd May. Nothing has been written in it since then.

That was a good week. I was just back from a gorgeous few days walking a teeny tiny bit of the Camino de Santiago in Spain with two mighty women. This had been preceded by a fantastic 24 hours in Madrid with another raft of fabulous females, which had come just after the Medical Women's Federation conference in Cambridge where I met loads of lovely people. 

I had been showered with gifts and cakes from work colleagues, as I prepared to do a little job-crafting and switch back to more GP-ing and less laptopping. 

Life was good and I was in control. 

Funny how the scanxiety that plagued me for years had miraculously disappeared, and I had almost forgotten the CT that I had had two weeks before. I tootled into my oncologist's office with absolutely zero expectation of anything other than a nice catch-up and a natter about our mutual areas of interest. 

I couldn't figure out why he looked so bothered in himself. Must have had a rough clinic, I supposed; a family of 4 had gone in before me, and that is never good. Still though, he usually perks up when I come in, because he gets to show me my scans from November 2014 and compare them with now and we both applaud the wondrousness of the miracle that is my recovery. 

This time, though, he didn't show me the old scan. He showed me the new one. He started talking about my liver, and saying words like "unfortunately" and "sorry". He still wasn't smiling. My brain began to make a bolt for the door. I realised I couldn't follow after it. I had to stay and nod and agree and pretend I was fully engaged with this fascinating conversation, which was clearly about someone else. Poor divil had got me confused with another non-miracle patient. He thought I was a person who had to have chemotherapy again, but sure of course that wasn't true. 

Well, clever clogses, you guessed it. It was of course true. It was me, my liver, up on that screen, with a blob of stuff in it that shouldn't be there. It needed to be doused in toxic gack, soused and marinated and drowned in nuclear waste until it accepted its fate (again) and scuttled back into its little corner. 

Trouble is, the rest of me gets soused and doused and marinated too. And even though I had only vague memories of what that was like, I knew that it was going to put a very large spanner in the exciting works I had planned for myself. I had to slam into a sharp reverse on my route to the next stage of my career. I had to let people down, and ask for favours and forgiveness. I had to tell my family that their summer would be spent looking at bleeding pustules on my face, while I veered from steroid madness to abject fatigue. 

But onwards and upwards. None of this is new, or surprising. There was always going to be a day when I would have to deal with this again. At least now I know when that day is. 

It's today. 

I put it in my diary.