Monday 23 April 2018

Breathy

We know you feel the world is too heavy, but you can turn it all around if you want. Oh yes, you're in charge of what you feel
It's All Good - Superorganism

It's a bit of a soap opera. In hospital, out of hospital. On treatment, off treatment. Well, unwell. It's hard to keep up!

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I was about to post something last week. It would have told a story of recuperation, body and mind. But before I could post it I had a sudden onset of pain in my chest, and within 24 hours I had had my chemo delayed, again, and been readmitted to hospital and put back on all the IV. I was suddenly feeling very unwell and in a lot of pain. Pleurisy - I don't recommend it. So... I've had another 4 nights in here, and I'm feeling a bit better again. I can return home today, and we revert to the plan.

Keep out of mischief. Recover. And next week, I hope to be back on the chemo.

2018, for me, is fundamentally an ordeal to be endured. I'm OK with that. But this succession of delays - being repeatedly knocked off the plan - has really challenged me. It's been rough, physically and mentally. And none of us is at our best, mentally, when we are at our worst, physically. Today I feel optimistic. But my mind, like my body, has fluctuated.

This last week, I've been sharing a ward with three other guys, all dealing with similarly severe medical challenges. There's been a nice sense of camaraderie. Plus I've felt like the old hand, having been dealing with this all much longer than any of them. It's also enabled me to observe, as others grapple with it, quite what a big deal it is - blood cancer and bone marrow suppression. Maybe I will cut myself a little slack.

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That's all you need to read in order to know how and where I am. (I'm OK. I'm at home. Until further notice.)

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Last week, I went to the brand new Cancer Centre at Guy's Hospital. There's a Complementary Therapy Centre there, to which I have referred myself for a sequence of treatments. First up, I had some reflexology. I'm a pragmatic sceptic, when it comes to these kinds of things. Enough of a scientist to reject the premise of homeopathy, for example. But I'm also sure a bit of pampering can have positive health benefits. Having someone massage my feet was certainly relaxing and soothing.

I found the experience quite emotionally intense, which in large part was a product of feeling so respected, valued, accepted. The Cancer Centre there is really wonderful. It's obvious from the moment you check in that the whole building has been designed with patients in mind. The waiting area is divided into lots of little booths - you can sit and wait in a modicum of privacy, rather than in rows of seats. You don't have someone next to you coughing over you, either. And the decor and furnishings... these things matter. King's is a fantastic hospital in terms of quality of care. I'm very grateful to be treated here. But the Haematology Outpatients dept exudes a very old school hospital aesthetic. After all these years, it would be wonderful if my regular visits could be liberated from the worst excesses of hospital-land.

But the feeling of respect went further. When I went in for treatment, the guy began by asking me a load of questions about my diagnosis and my medical history. I've been for a few massages and visited a few spas, these last few years, and they quite often ask medical questions. Those questions tend to feel prying and impertinent. Why would I want to discuss this with you, stranger? And they also feel like a screening process. At any moment I'm anticipating that too much honesty from me will result in the therapist refusing to treat me. On this occasion, of course, it felt very different. I knew he understood. I felt accepted, for who I am. It was fantastic.

Some of you are probably a little sceptical about Complementary Therapy on the NHS. Should this really be funded out of tax? But for me, there was a value in the holistic-ness, far beyond the fact that it was free. As a token of that, I decided to make a £100 donation to charity - the money I might have otherwise spent in a spa. I have chosen to support Basic Needs - a charity working in mental health in Africa and Asia, in recognition that the benefit to me is as much about mind as body.

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While we're on the subject of good places to donate money... I was asked recently to write something for Myeloma UK's quarterly magazine, Myeloma Matters. I wrote about the challenges of myeloma and parenting. Here's a link, if you're interested:

Myeloma Matters, Spring 2018

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And finally, facebook keeps reminding me that a year ago I was in Japan, which has cheered me up no end. (facebook might be an unspeakable monopolistic unaccountable tech giant, partly to blame for trump and brexit. But it can also bring joy.) Next year... who knows where I'll be.

So, in homage to the wonders of Japan, here's a picture of my own cherry tree. In bloom, right now, like me!


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Monday 9 April 2018

Breathless

[Instrumental] *
Breathe this air - Jon Hopkins 

Some scores (not all in the same day, fwiw) ... KFLC = 456 ... Hb = 7.4 ... Neutros = 0.75 ... 

A lot went down, these last few weeks. My light chains went down, fairly dramatically, as a consequence of the chemo. This is good news (and somewhat offsets everything else). But, at the same time...

As anticipated, my red blood went down too - I’ve needed EPO injections and in the end a blood transfusion. Both of which can make an improvement in the short term, but it will take a while for my bone marrow to recover and start doing its job - and we won’t wait that long before I start taking the chemo again, which is in part the cause of the problem. I assume I will totter on with nearly-dangerous anaemia, for a good while yet.

And my immune system went down too. There’s not much that can be done about this. I had some G-CSF to stimulate neutrophils. But it is the adaptive/ acquired immune system that I am really lacking, and all I can do about that is to wait for better days and to try to avoid infection. Myeloma suppresses my immunity, and so do anti-myeloma drugs. After all, myeloma cells are malignant immune system cells. It is going to be an ongoing problem while I’m in treatment.

To top it all, I caught flu, which progressed to bacterial pneumonia, and I lost a significant chunk of my lung function. I was admitted to hospital last week where my blood “oxygen saturation” - which should be 98% - dipped as low as 74%. No wonder I was feeling so shit, the last few weeks. Insufficient oxygen in my too-thin blood, plus an excess of infections overwhelming my impoverished immune system. It has been a miserable experience. Frightening too: this is one of the more likely ways that myeloma kills.

So I spent 7 nights in the haemo ward, on a variety of antivirals and antibiotics as well as a nebuliser to open up my lungs, an oxygen canula up my nose, and all manner of other pills and jabs. They let me out on Saturday. I’m a lot better, though still very neutropenic and anaemic, and I’ve been warned to expect it will take weeks for my lungs to recover.

I think I’d been brewing up my infections for 3 or 4 weeks before I was admitted to the hospital. At the same time I had had some real problems with neuropathy (induced by the chemo), and muscle spasms (which seem to be my body’s panic reaction when things go wrong).

I’m now taking baclofen as an anti-spastic, which has improved my symptoms. But baclofen is a drug with a truly terrifying list of potential side effects of its own. Not least its potential for severe physical addiction, which I will have to attempt to navigate when the right time comes and I want to stop taking it. Medicine is a wonderful thing, but I do hate the fact that whatever befalls me, the answer is always another prescription. The list of things I’ve swallowed or had injected, these last few weeks, is quite staggering.

All in all, it’s been a pretty grim month. As lousy as anything myeloma has ever served up to me. Painful, debilitating, quite scary. And I’ll be keeping a low profile for a while as I (hopefully) recover. I’ve missed at least 3 weeks of chemo, but I should be well enough to start again in another week or so. I can hardly contain my excitement!

* When it’s like this, there are no words