Monday, 2 May 2011

The Right Trousers

On Tuesday 26 October 2010 it was to time to see Dr M, the haematologist, again. No visit to such a specialist is complete without a prior blood test and on this occasion my samples bore good news and bad news. There was a modest rise in my haemoglobin to 9.9 which was a good sign. Not so hot was a very low neutrophil count of 0.31. My other white cell counts weren’t looking too clever either, so it was time for a tactic new to me, but which the wise Dr M had no doubt foreseen all along. I would need a course of daily injections of granulocyte-colony stimulating factor (G-CSF), plus weekly blood tests in order to ensure that my counts remained sufficiently robust to be able to continue the current schedule of chemotherapy every 21 days. As the good people at Macmillan put it:

“White cell numbers are usually back to normal by the time the next dose of chemotherapy is due. But, sometimes, if the levels of white cells are still low, the chemotherapy has to be postponed, or the dose lowered.”

As my mercifully brief September stay in hospital dealing with a stubborn chest infection had highlighted, my immune system was at the time of diagnosis significantly hampered by heavy infiltration of my bone marrow by malignant B-cells. These useless malformed entities just clog everything up and so cause harm by sheer force of numbers (I am sure there is an improving moral here about the evils of neglecting regular spring cleaning). As the system was therefore being suppressed both by my disease and now from the battering of chemo, it was time to call in reinforcements in the form of a manufactured version of a naturally occurring bodily protein that would stimulate production of neutrophils.

I assumed initially that I would have to present myself at hospital each day for an injection but Dr M assured me this was not the case: either I could find someone at or near home to administer the injections for me (my medical son sprang to mind) or I could inject myself (eeek!). It was no necessary to make the decision right away as I would have the first injection there and then and could see what was involved. Time therefore to go to the Day Unit for my initial jab, where Nurse S, my excellent take-no-prisoners key worker, offered me a choice of injection sites: arm, thigh or stomach. The latter appealed to me least, but she assured me that it was often the best one to go for because of the volume of fat (modest in my case, naturally—ahem!) available to pinch together and pierce relatively painlessly. Sceptically, I agreed. She showed me the technique to use, assured me how easy it was and proceeded to sting me like a bee. Rebuking me for flinching like a wuss, she sent me on my way with a supply of pre-filled syringes and a “sharps box” to put said implements in once used. What fun the next few days were going to be…

The sharps box, made of robust plastic.
Once the lid is pushed fully shut, the box can not be reopened. When the box is full, you return it to the hospital for incineration.
Also visible is my water filter and a bottle of laxative syrup (you will learn more of this deceptively sweet stuff in due course)

In filthy weather my wife and I left the hospital and drove to Portsmouth to see my mother for the first time since my diagnosis. I had been a bit apprehensive about seeing Mum this time, but in fact we were both relaxed in the face of my strange disease, me now bald again like the baby I once was.

We ambled over to Gunwharf Quays, a significant “retail destination” situated between the ferry ports for the Isle of Wight and cross-Channel destinations, and treated ourselves to lunch at Pizza Express. While enjoying my meal I kept looking over at my reflection in the large mirror on a far wall, not quite believing that the shiny hairless pate clearly visible centre-screen was truly mine.

The Spinnaker Tower that dominates the skyline above Portsmouth Harbour.
170 metres high, it offers views of up to 23 miles on a clear day.
A different sort of needle.

Gunwharf Quays contains a large number of “outlet stores” for major brands, selling seconds or discontinued lines at come-get-me prices. Both disease and exercise had shrunk my waist size from 34” to 32” and I was looking a bit lost in my trousers. Thank heavens then for M & S and its reasonably priced lines. I bought three pairs of trousers in my new size: charcoal grey jeans and two pairs of chinos in contrasting shades of greenish.

Back to Mum’s for tea, but not before we had seen this:

No comment necessary or, indeed, advisable.

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