Tuesday, 28 June 2011

All your broken gold

Welcome then to the new, current Blog 2.0, coming to you on Tuesday 28 June 2011. The weather has been sultry, humid and overcast: conditions conducive to headache and mild nausea.

First on the to-do list today was a trip to the GP to have a small mole on my hip removed. It had irritated me once too often and its game was up. Soothing anti-stress music played in the background as the doctor took less than a minute to inject local anaesthetic and slice off the offending tissue: "gone for ever", as he put it.

It was spotting with rain as I walked home. There was just a brief time to put my feet up before I was due to meet my brother at the station. He was going to accompany me to the meeting at UCH (University College Hospital). Both he and I were on time and we were glad that the air conditioning on the train to Waterloo was working, as the outside air remained stuffy after the brief rain. 

After a change to the Tube we arrived at Warren Street Station, in the shadow of UCH, which looms green and white like an iceberg in the midday sun. 

In August I hope to be able to enjoy the view from the top floor.

The lung function test, due first, would be delayed as there had been a failure of the equipment. We had arrived with plenty of time to spare and so made our way to the hospital café that looked out on to the traffic and bustle of the Euston Road. On the other side of Tottenham Court Road I could see the hotel where my wife and I would be accommodated, courtesy of the NHS, in August if all went to plan. Piece by piece I was adding different meanings, structures and resonances to a part of London that I had passed through many times, either to visit The British Museum, buy electronic goods or to have a meal. I have vowed, if side effects do not clobber me first, to spend some time in The Brit. Mus. when receiving chemo in August.

In due course it was time to leave the mothership and make our way to the satellite, that is to day The Rosenheim Building, to which you were introduced yesterday. I was about to get to know the first floor of this rather better, having hitherto only been there briefly to have blood drawn.

Having waited for a short while in reception, as a thunderstorm raged outside, I was called by the Clinical Nurse Specialist (CNS), who first of all took me to the more familiar second floor for a meeting with the consultant, who led me through the whys and wherefores of the forthcoming chemo and injections designed to mobilise my stem cells for harvest. Things to look forward would be: (possible) bone pain as my marrow became crowded with the volume of cells brought to birth by the injections of G-CSF; hair loss (again!); low blood counts and concomitant risk of infections; bladder irritation (for which I would be given a prophylactic called Mesna). I signed the consent form for the next stage and shook hands with the consultant, who passed me back to the CNS for a full explanation of the harvest and treatment leading up to it that would begin next Monday.

The reading matter sent out by UCH to brief me on the forthcoming procedures.
Consent to the mobilising chemo is the open form on the left.
Quite a bit to digest...

I will not go into much detail of this briefing as I aim to take you with me (lucky, lucky readers) as I go through the various procedures themselves. The possible complications and how they would be addressed were explained to my satisfaction and along the way I learned that cranberry juice was a useful aid against bladder irritation. The rigours of the high-dose chemo due in August were also touched on, although I would be getting a fuller briefing on them once I had been through the harvest. Nine blood samples were taken from my veins for various tests, including infection screening, and I signed two further consent forms relating to the storage and future use of my stem cells. There was even time for some small talk. I was given plastic bottles in which to deposit my urine over the 24 hours before my Monday appointment: from this rather large sample the efficiency of my kidneys would be assessed.

On the brief tour of the first floor that followed my brother and I remarked on the constant activity of the various divisions in the department. We also learned that the apharesis (harvesting) machines were named after The Spice Girls. I wonder if anyone chooses Scary... 

My weight and height were measured for the purposes of calculating chemo dosage. I was then free to go. 

It having been decided that a lung function test would not in fact be necessary as I was not a smoker, my brother and I made our way back to the main hospital for me to have the echocardiogram. As the machine used was more whizzy and modern than the one used on me at my local hospital last October I did not have to contort myself to look at the screen and the procedure was also considerably quicker than before. My heart was pronounced fit and well.

My brother and I went back to the ground floor for coffee and a bit of a debrief before beginning the journey home. The train back to Twickenham was airless and hot, the air conditioning having failed. My brother gave me some more encouraging words and we hugged before I left him on the platform to continue his journey home. 

A dose of Wimbledon tennis when I reached home was just right to counteract the exhaustion I now felt and take my taxed mind and emotions to another place. For supper my daughter cooked us a delicious risotto with roast butternut squash and bacon (the rosemary in this was an especially nice touch).

Today a leaflet came through our letterbox proclaiming "WE WANT TO BUY ALL YOUR BROKEN GOLD". Quite possible it advertised a dodgy enterprise. However, as I walked home from the GP surgery this morning the poignant notion of scattered pieces of precious metal and damaged opulence came again to mind. My health is compromised; I have a disease that I will never be able to ignore or forget; the treatment now only a relatively short time ahead is at this moment scarier than the disease. Nevertheless there is a dedicated team of compassionate experts seeking to knock this wonky system of mine back into shape and set me on a surer footing for however long is granted to me. As my brother and I sat in the café at the end of today’s meetings I was able to acknowledge that, amid the anxiety I feel about the high-dose chemo and its inevitable side effects, every so often the sun shines in my mind and I am given a glimpse of the healthier life that lies beyond treatment.  I dare to hope as well that another craftsman is at work on the twisted metal of my inward life.

May it be a good night, everyone.

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