Trial By Error? 

It has been a mere 16 weeks since I started my trial, which now consists of fortnightly doses of Daratumamab, steroids and an antihistamine. 

I say ‘mere’ in an attempt to justify the fact that there have been no blogs for nearly that entire period. On the one hand, mere sums it up nicely. The weeks and the doses have flown by and I have nothing to show for it. Looking back on it now, I feel like hardly any time has passed at all. 

On the other hand, I am telling major porkies, for there have been several periods during the last 16 weeks where I would have described the trial as relentlessy slow,  frustrating and exhausting. Perhaps if I shared these feelings with you at the time, I would made things just that little bit easier for me. I could have had mini data dumps on you and off loaded. I was just too tired to put words to keypad.

There is another reason too, one which came into my head only yesterday. On this trial, I am always waiting for something. Waiting for a result, waiting for a clinic appointment, waiting to see how I feel, waiting for a development. Waiting for something that gives me some sort of conclusion to these short stories about my life that I have decided to share with you. The conclusions have not come.  Thus, this has made me feel like any recent story I had to tell about my treatment (or anything else for that matter) would be incomplete. It worried that it would be more of a whinge about how much of my life is about waiting for something to happen with my treatment. At times, it feels like I am waiting for everything. I do not wish to come across that way. I like to think I am realistically positive, but can that be interpreted through my writing when my brain feels less able than it was when I started it. 

I like a story with a beginning, middle and and end, featuring as little ambiguity as possible. Don’t get me wrong, I do not need to be spoon fed (drugs permitting) and I can withstand the test of endurance that is a modern day Terrence Malick film, or in fact any film that is described by a film critic as ‘meditative’ but personally, I prefer just a little bit more clarity. And my life of late has been left severely wanting in that area.
So, here I am. There is no end to this story. All I can say to you is that I am not dead. Not yet. To those of you who were concerned that I may have passed to the other side, I thank you for thinking of me and for worrying about my absence. I am back. It does seem like a lot is going on at the moment, so I will have many a half finished tale to tell you. Fingers crossed.

Yesterday, the 17 August, marked my five year cancer anniversary. It was a loaded day. There is so much to remember about this period, and Daratumamab accounts for just 5% of the five years. You would think that I would know by now that I rarely get an end to my stories. Only occasionally have I been able to announce an end; the end of a chapter, or an end of volume have been my particular favourites. In reality, I know I should just face the facts that my life from now is ongoing, until it stops. And thus, I have no excuse to not share what is going on with you. You are, after all my cancer diary. 

Getting back to The Daratumamab, the one thing I do know, is that it has not been easy nor straight forward. Has any of my treatments? 

I flew into this treatment after a week’s radiotherapy and two weeks after I had received some very bad news. I was shell shocked and exhausted. I started the treated not knowing what it was and without fully understanding what the aim of the treatment is. I still don’t know and this is because every time it is explained to me, my painkillers kick in and my brain floats off into NeverNever Land.  I just know that being on the trial far outweighs the alternative of not, and for now, that’s okay with me. 

If I have learnt anything important since I started on the Daratumamab, besides from how to pronounce it, it’s that being on the trial is better than not being on it. It may be lonely, my body may be being used as a corporate guinea pig, but I don’t care. I am happy I am on the trial. Scratch that, I am grateful to be on the trial and everthing it encompasses far outweighs the negatives of being on a trial. The negatives by the way, are several, but in the grand scheme of my life, I can live with them. 

It would be really nice if I were now to talk you through each of my treatments. To build up a narrative, and to get you to feel even a little bit of what I feel every time I enter St Bartholomew’s Hospital and the times I am not there, lying in my bed thinking about it. That’s an awful lot of visits to go through and my short term memory is highly questionable, so I am not going to do that. Maybe I will one day. Maybe I will today. Right now however, I’m going to jump straight into what I assume you want to know and that is, how am I doing? 

How am I doing? 

Medically, I had to wait a long time for that to be answered. Two weeks ago, I did have an answer, but as of yesterday, I am right back into the Land of Worry, led by the President of Anxiety with her Cabinet of the Unknown. 

I did not have a clinic appointment for the first two cycles, which for cyber attack reasons, was nine weeks. Before that, I faithfully went in for my treatment each week, without knowing if the trial was doing anything. I went through various emotions during this period and in the end, I had decided that I would prefer to not have clinic appointments and only be informed if something bad was happening. Unfortunately, I didn’t actually tell any Medically Trained People this, so when I was telephoned on a Friday afternoon to say that I had to see The Big Prof on the following Monday morning, great panic ensued. Why now, I thought? Why with the greatest of haste? 

In my panic, I ignored the fact that the appointment marked the end of my weekly doses and the beginning of a new cycle. I also ignored the fact that I had not seen The Big Prof since I had walked into his office eleven weeks earlier and he made a space for me on his trial. I irrationally thought the worst.

This was sometime around the beginning of June and I can confirm that it was not the end. My paraprotein had remained stable throughout the nine weeks of treatment; it had not fallen and it had not risen. As a layman, I would have liked to hear that my paraprotein had gone down, but The Big Prof said he was happy with my results and signed me up for another cycle. I was to return to see him at the end of the next cycle, four weeks later. Apparently, that’s how frequently I should have been seeing him; at the end of each cycle. 

Something happened between my first clinic appointment and the second appointment. Well, a few things. I went on holiday, which meant having a month’s break between treatment and more importantly, pain returned to my body. That’s wrong too, I am not sure why I am unable to say what I mean on the first attempt. Pain is a multiple, but mostly managed daily experience. I do not have a day without pain. The word I omitted was ‘new’. New pain returned to my body. I have only experienced ‘new pain’ in the past when my disease was increasing. So, in this circumstance, I did what any sensible person would do who was desperate to go on holiday. I kept it a secret. I kept it a secret for two whole weeks before I blurted it out to Mamma Jones before we went on our holiday. I do not think I could have held it in any longer without inflicting serious mental health issues upon myself. 

Three to four weeks later, it was clinic time once again and if I thought I had been nervous at the start of June, I do not know what words could be used to describe what I was feeling on 2 August. It was not pretty. I had roped Mamma Jones into this one. I knew I could not do it alone and not surprisingly, my dear Mamma used up a day’s annual leave to come and support her baby during her appointment. I’m not ashamed to admit when I need my Mamma and she is always willing to oblige. I don’t want to gloat, but she does it so well. She even managed to keep me calm during the two hour wait in the most uncomfortable of uncomfortable waiting areas with her small talk and usually, small talk is not her forte. 

I had somehow managed to avoid thinking about it on holiday, despite increasingly bad pains, which just so happened to coincide with too much physical exertion. My holiday is another blog, but for this story you just need to know that I pushed my body to it’s limits, and beyond what I have medically been told I can do, so I could enjoy myself.  Experience it properly. By the end of the holiday, I could no longer put on my own shoes and socks. It was all worth it of course. The new pain, however in my right rib cage, once the excitement of the holiday was over, started to cause more pain than just the physical pain. 

So, having self diagnosed myself, we walked into the Medically Trained Person’s office to be told that everything was okay. I was shocked. My paraprotein still remained stable and despite putting on a bit of weight, I was clinically well. Mamma Jones and I left, I apologised to her for having to lose a day’s annual leave over nothing and I breathed a massive sigh of relief. Or four.

It was not long however, maybe even in a matter of hours, that I realised that I was predestined to have these feelings of anxiety repeated in the lead up to all future clinic appointments. I personally feel like I am hanging on to this trial by a thread, with what happens to me, being completely out of my control. When the bad thoughts creep into my head, I do quickly try and grasp on to a more positive spin. I want to stay on to the trail. I want to stay on and experince more of what this mortal coil (the right term for the state of the world at the moment) has to offer. I would say that in the circumstances, I am as positive as I can be. I’m realistic with it too, so when I feel something new in my body or I experience something that is not quite right, I am bound to worry. I am concerned that there are times that I can be too negative. I have discussed my behaviour with my counsellor and she says that pre clinic anxiety is perfectly normal and that acknowledging my fears is much healthier than behaving like I do not have cancer and I am not where I am in the long line of myeloma treatment.  I’ll take her diagnosis. 

It does feel natural now to worry about my success on the trial, given there isn’t that much out there, drug wise available to me. I can understand why I never truly feel comfortable too. Between appointments, I try to block as much of this out as possible. In my free time, I make sure I do as much as my body enables and that definitely goes someway to refill my faithful old ‘good cylinder’. Since my treatment moved to fortnightly, I have fully embraced getting a week back of my life, and I use it productively to live and not wallow. I have also lost the guilt I felt whilst my treatment was weekly, that I was not living enough. I was just too bloody tires 

In the last few weeks of the weekly doses, I really struggled. During the first few weeks, I had calculated that with treatment including steroids on a Thursday, steroids at home on a Friday and Saturday, followed by the inevitable crash on at least Saturday if not Sunday (and Monday), I was afforded two to three good days before I was back having my bloods done on a Wednesday morning. Then, everything started again on the Thursday. That two-three ‘good days’, days in which I was able to do something like a single trip to the cinema or a trip to the pub were invaluable but fleeting. A ‘good day’ did not equate to A full day. 

Gradually, as the weeks progressed, the number of ‘good days’ decreased and I longed for the fortnightly treatment. I had a week off treatment because my hospital was a victim of the NHS cyber attack, or whatever you wish to call it; I am no IT expert.  That week gave me a taste of what was achievable in a week off, and it felt like  freedom. Realistically, when you count the days I had appointments at UCLH too, I was down to one ‘good day’ by this point. As much as I enjoyed that week’s break, it made the remaining weeks feel like torture. Thank goodness for my Support Network.

I started receiving the Daratumamab fortnightly on the 14 June. To date, I have completed one and a half cycles, which equates to four doses. Technically, I do not require any more doses in this cycle but the next one, will not (hopefully) start for another 13 days. 

All of that nearly brings me up to date. Nearly. Yesterday was treatment day and it was five years and three days since I was admitted to another hospital with an elevated calcium level in my blood, leading to my diagnosis of multiple myeloma on 17 August 2012. Yesterday, I was told that I once again had an elevated calcium level. I am sure there are many medical reasons for this result, but to me, it answered my questions of why I have been experiencing the ‘new pain’, memories of five years ago fresh in my mind.  

The Medically Trained People I saw yesterday were ward based, which means they are not responsible for my overall treatment, if they know anything about my overall treatment at all. They approached the subject part calmly and part like a headless chickens.
The news of a high calcium level was met with my tears. The tears may not have come were it not for the anniversary, but I doubt it. I am so aware of failure that I probably would have blubbered like a baby regardless of the date or regardless of the cold way it was broken to me. “Are you on any supplements?” probably was not the best way to tell me, but that’s what happened so I just have to move on and acknowledge that the Medically Trained People working on St Bart’s daycare are extremely busy. 

As I wrote a few paragraphs ago, the result would answer why I had been experiencing the ‘new pain’ and generally why I have recently been feeling a little ‘off’. I asked  for my paraprotein result and I was told by the doctor that it had risen by a tiny amount. ‘Tiny’ was emphasised by a hand gesture and a closed eye. I asked for the actual figure and it had risen by six based on the bloods taken on 2 August. Is an increase of six tiny? I would have said it was, but then, I am not medically trained. 

So, where does this leave me now, does this story have an ending? In a word, or in four words, I do not know. Yesterday it meant receiving two large bags of fluids, which has left me peeing practically non-stop since. In terms of my long term health?  I do know is still my answer. I will have to wait for my next clinic appointment on 30 August. A clinic appointment where they will thankfully not be working on month old results. I know it will be a clinic appointment where my anxiety levels will once again go sky high. I will try and live next week, but I doubt the next clinic appointment will be far from my mind. 

Last week, I told various people in an attempt to justify my feelings about my treatment and life in general, that I lived month by month. I strongly, most adamantly believe this to be true. It’s like waiting for scraps, accept just with higher consequences…

So, this blog has now come to an end.  Is there an ending? I hope it is not the start of one. 

EJB x

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Out Of Sorts

I have now had two doses of Daratumumab, and contrary to earlier theories, I am struggling to find my feet with it. As I write this, my last dose was on Thursday, four whole days ago. And since last Thursday, I have been feeling, how do I put it… out of sorts. ‘Out of sorts’ is the polite way of putting it. It’s the sort of thing a family would say in a post war drama set in a remote village, who are attempting to shield their neighbours from fact that their matriarch cannot stop kissing the wallpaper. I haven’t been kissing the wallpaper, I don’t have any wallpaper, but I have, as I said, been feeling out of sorts. I do not know what happened during my 12 hour visit to St Bart’s on Thursday, but since then, I have been feeling uncontrollably, unreasonably and inexplicably out of sorts. 

As somebody who used to enjoy a drink or five, I was able to diagnose myself almost immediately. Without any doubt, I can say that for the last four days, I have been feeling uncontrollably, unreasonably and inexplicably anxious. 

Anxiety is not my friend. Forgive me for pointing out the obvious, but it has never been my friend. Back in my pre myeloma life, I was familiar with this level of anxiety. That’s why I know that I do not deserve to feel this way now. Once upon a noughties,    at my very worst, I would have gone out on a Friday night, drank far too much to be deemed a lady, delivered to persons unknown a healthy dose of generous mouth and then rounded off my evening by doing something I should not have done with somebody from my office. I would then have to wait until the Monday morning for everything to be at peace in my mind again. In the meantime, the alcohol I consumed would trick me into thinking that the world, that’s right, the World, hated me and that everybody I knew was laughing at me. Not only was everybody laughing at me, they all thought me a simpleton. At least back in my days of drinking, I would have had, initially at least, enjoyed myself. The alcohol fuelled anxiety was a payoff for having fun. On Thursday, I did not have that type or any type of fun; this feeling of anxiety just engulfed me and it has been my constant companion ever since.

Why I ask? Why, indeed.  I had a counselling session last Monday and I felt fine. I even commented that I felt like I had nothing to talk about because everything seemed to be so, under control. Famous last words. Tentatively at least, I was managing the beast that is My Myeloma. And then, Thursday came…

Thursday’s trip to the hospital was not easy, in fact, like my visit the previous week, the visit was frought with uncertainty. The day before, I was told that the IT system at St Bart’s was down, which meant that once again my drugs could be delayed. The threat of another delay spun my head into multiple directions (that usually happens when one is ‘spun), but understanding that these things can happen, I encouraged myself to stay calm. By the close of play on the Wednesday, I was told that the Pharmacy had my prescription and all being well, and with a sigh of relief, my treatment would go ahead as planned. I arrived at the hospital the following day at 10am, and I could immediately sense the problems this IT issue had caused. The handwritten sign in the waiting area saying ‘all chemotherapy will be delayed by 2-3 hours’ was also something of a giveaway. 

I was shown to my bed for the day 30 minutes after my arrival. By midday, I had yet to have any tests done, seen any drugs, had a cannula fitted or been told anything about the plan for my day. I thought my day would have followed a similar course to my first day’s treatment. I could see that the Medically Trained People were stressed, so I resisted being too much of a nuisance but by 1pm, I had pressed the magical bell twice to see what was happening… It was not forthcoming. Mamma Jones was due to pick my up at my flat at 8.30pm, so I was ever mindful of the time. My friends delivered my lunch around this time. I have little memory of this, but I know what I ate and that they refused to take any money from me. My friends are nice like that. 

It was around 2pm that medical things started to happen. The cannula went in and I was given my pre-meds. Unlike the previous week, where I was under near constant monitoring, okay that was an exaggeration, hourly monitoring, monitoring had significantly dropped off in comparison. My memory is a bit hazy, and I’ll get to the reason for that shortly, but I think the main infusion started around 3-3.30pm. Before my treatment could start, I was told that I had to be booked in for a bed for that night thus causing a further delay, although I was told that I wouldn’t actually need said bed, because they had started too late for me to be treated solely by the Daycare staff. 

Only with the benefit of hindsight can I see that this environment might be the reason I was on edge. I like a timetable, and whilst I realise that My Myeloma is unpredictable,  the timetable I had for that day went out the window before I even arrived. The plan for Mamma Jones to pick me up and take me back to the land of the Fens was by that point on Thursday afternoon also under threat. I remember thinking if that was under threat, would future weeks be similarly uncertain. And then, a panic set in. 

This might be the time to say that prior to last Thursday, if anybody had asked me how I felt about my first dose of Daratumumab, I would have told you a story about how it left me with 3.5 good days a week. In fact, so certain was I of how the treatment made me feel and how it was going to fit into a week of my life; I would have told them about the blog I was writing entitled ‘3.5 Days’. 

My first dose of Daratumumab was on the 20 April (you can read all about that 10 hours of bliss right here https://ejbones.wordpress.com/2017/04/22/day-1-take-2-part-ii/). I suspect it was a result of the 20mg of Dexamethosone taken prior, but for some reason I was extremely tired in the days that immediately followed my treatment.  The 10 hours I was in the hospital would also have played a part in the sleep that followed. By Sunday 23 April, I felt back to ‘normal’. Well, as close to normal as my body allows.

So there you have it, it was all so simple. Based on one whole week of funny feelings, I felt safe enough in my assumption that I would now be giving up 3.5 days of my week to my treatment and I was able to start telling people about it. My plan, my weekly schedule, would all being well, look something like this:

• Every Wednesday morning, I am required to go to St Bart’s for blood tests – 0.5 days

• Every Thursday would be taken up with treatment – 1 day  

• Every Friday and Saturday, I would be in bed getting over my steroids – 2 days  

All in, I had calculated 3.5 days a week given to My Myeloma treatment and 3.5 days a week for myself. I enjoyed how the title of my non-existent blog had two meanings. Depending on how you fill your own cup, one could read the title as 3.5 good days or 3.5 bad days. Evidentially, it doesn’t take much to entertain me. 

Back to the Thursday at hand, and I could see this plan, this schedule I created for myself very quickly, slipping away. 

I do not know if it is a management technique when I get frustrated with things going slowly, or if by Thursday afternoon I was genuinely tired, but I soon found myself snoozing. The environment of a chemotherapy daycare ward, makes for a very broken sleep. This resulted in me confusing my dreams with reality, which as time has gone on, I realise added to my anxiety. Even now, I do not know if conversations I had with my lunch time visitors and a later visitor actually happened, or if I dreamt them.

Sleep normally relaxes me, but my sleep on Thursday, despite making the time go faster threw me into a state of confusion. At the time, I recall telling somebody that I did not know what was real and what was not. No wonder I still feel out of sorts.

I’m not shoehorning it in, I think this nicely brings me on to another cause or should that be contributor to my anxiety and that is my drugs. I am on a lot of medication and although none of these have changed in the last week, I cannot help but think that one or some of them have set my teeth on edge. At the bare minimum, the drugs could be the reason I was in and out of such a broken sleep. The broken sleep has given me that same feeling I used to have after five too many drinks. I feel I was rude to my friends and I feel like they are were disgusted by me. I have checked with them, and I wasn’t rude and I did nothing to create disgust. And yet the anxiety still exists.

Tricks are still being played upon me. Even today, I feel irrational. I could describe my irrationality at length, but I think all you need to know is that I am still out of sorts. 

I wish I could put my finger on the cause. I’m fairly certain that my friends do not think I am a cretin and that those who visited me on Thursday did not leave thinking I was metaphorically kissing the wallpaper. I keep telling myself it is only my medication, much like I do when I am on my steroids and I can feel myself about to blow. This feeling is not me. I am embarrasssed by my uncertainty, and I hate feeling vulnerable. 

This doubt is not me. 

This anxiety is not me.

I wish I could finish this blog with a conclusion, with an ending to this particular story, but this is real life. It’s my life and things do not fit neatly into a box. I can tell you that I left the hospital shortly after 9pm last Thursday and the parting words from the Medically Trained Person was that there has to be a better system for getting and admitting the Daratumumab. For my sake, I sincerely hope for this to be true.  

I need some structure. 

EJB x 

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Day 1, Take 2 – Part II

A Timeline:

07:00hrs – I wake up, once again, I have been waking up on and off for a few hours. At 07:00hrs, my bladder told me that I could not lie in bed anymore. 

07.05hrs – I returned to my bed and took my morning dose of medication including the one that sounds like a mountain retreat. I then dilly dally. 

07.30hrs – Despite my hairdresser’s recommendation to wash my hair every four days, I decide that a wash is completely necessary and I sneak into the shower before Housemate emerges from his room, so I cannot be told off for making him late for work. I’m sure you can work out what happens next, but for the sake of accuracy, I put on the first of my day’s outfits once I get out of the shower. 

08.10hrs – This is an approximation, but Housemate leaves for work. In the time before his departure, I change my outfit once and ask for his expert opinion. He does not offer an expert opinion, so I change out of the extravagant kimono and put a black shirt on over my jeans and body. I thought subtle and comfortable was probably for the best.

08.25hrs – Ocado arrive and I spend the next 15 minutes struggling to get my goods in to the fridge. Said fridge looks magical when I am done, I almost feel like a grown up. 

08.40hrs – I cook my porridge. I then eat my porridge. At this point, I think I have plenty of time and I am convinced I am going to leave as planned at 09.15hrs, to ensure I arrive at the hospital by 10.00hrs. I then decide to watch an episode of TOWIE. Forgive me for that.

09.15hrs – I am not ready to leave on time, but I have managed to locate a cardigan that has been missing for two days.

09.30hrs – I book my Uber, but somehow find the time to take a photo of Bruce.


09.46hrs – I find the time en route to share this wholly necessary piece of information.


09.55hrs – I arrive at the hospital, make my way up to the 7th floor and check in.

10.10hrs – A Medically Trained Person comes to collect me, takes me through to Bay 5 and shows me to my bed to the day. On my arrival, I unpack my bag. I plug in both my chargers, unpack my laptop, kindle and iPad, find a spot for EMan and hang up my cardigan and handbag. I also pull a chair over to create an extra table. I did all of this completely obvious to the fact that the nurse was waiting to do my observations. Despite knowing that I had hours to make myself comfortable, I just wanted to make myself at home right away. I needed order. I didn’t just want to make myself at home by the way…


The first of several obs were then taken. Do not worry, I am not going to share with you every time my obs were taken. That’s mainly because I did not keep track of how many times my obs were done. Just know that they were done on the hour, and then before and after each infusion or change in speed of said infusion. That is a lot of times for somebody to take my temperature, pulse, blood pressure and oxygen. 

10.45hrs – In goes the cannula. My concerted attempt to drink as much liquid as possible all morning, proved worthwhile. The cannula went in on the second attempt on the top of my right hand. Don’t worry, I did not take a photograph of this. I know some people can be squeamish around needles; thankfully, I am not one of them. 

11.23hrs – The pre drugs start. 


They consisted of one bag of Piriton followed by a flush, then an 8mg bag of Dexamethosone followed by a flush. Sometime after that, I then get a 12mg bag of Dexamthosone on the instruction from the pharmacy. Once again, this is followed by a flush. 

This all takes some time and delays the start of the main attraction.

12.43hrsIt starts!


Look at the size of that bag! To begin with, due to the possible side effects, the Daratumumab is given to me very slowly. It speeds up gradually throughout the day, but not for the first two hours.

13.30hrs – Lunch has arrived and I start to feel nauseous. I am also dizzy. I’m trying to fight it, but aware of the warnings that I should report any changes, I tell the Medically Trained People. They do my obs.

13.49hrs – By now, they have discovered that my oxygen is low, and I am given oxygen.


15.00hrs – My visitor leaves me and I am once again left to my own devices. Prior to her leaving, she is kind enough to collect my drugs from the pharmacy, which required three trips downstairs. The first trip was to put in the prescription, the second was to collect said prescription and the third was to pick up my morphine which she was not allowed to collect without ID.  Whilst she was gone, I took advantage of the bed next to me being empty. 


I spent the rest of the afternoon feeling exceptionally hungry. I also started to watch the bag, willing it to empty. 

16.30hrs – the Daratumumab was turned up to maximum speed; with still many, many hours to go. My Medically Trained Person reminded me that I had my laptop with tv programmes on to keep me occupied. I repeatedly promised to turn it on. 

17:00hrs – I am given more drugs to take home. The previous prescription collected by my friend was for my pain management, this prescription contained support medication for the trail. It included Dexamethosone tablets, which I am required to take for the two days after each infusion. 

17.30hrs – By this time, I had turned on my laptop, I really wasn’t paying any attention to it as you may be able to tell from the photograph below.


I now lose track of how many times I restart said programme. I was tired and hungry. All so very tired and hungry. Hunger was controlling my mind. 

18.31hrs – By this point, all the other patients are gone and I am still hungry. I give in to the hunger and do something I would not usually do. 


19.30hrs – More obs are done prior to this, but by this point, the Daratumumab infusion is  over. Finally. The drugs are inside me and there is nothing else to be done. Well, there are things to be done. The Medically Trained Person has things to record, more fluids to give me and obs to take. On a personally level,  I have to pee again. At this time, the sodium docusate I take every day has also decided to work. When sodium docusate works, I cannot deny it. As a result, I spend the next 15 minutes in the toilet. 

20.00hrs – The last obs are taken, I have packed up all my belongings and I am ready to go. The Medically Trained Person asks me how I feel and I respond with ‘tired’. She admits that I do look tired but complements me on the fact that my lipstick is still on. 

I leave, against medical wishes, but I feel confident that nothing is going to go wrong in the next 24 hours (or in the days after that).

20.06hrs – I get into my Uber and for the next 20 minutes, I have to listen to complete and utter drivel from the mouth of the driver. In then end, I explain that I cannot talk to him anymore because I have been having cancer treatment for the last 10 hours. He continues to talk. He gets 2 stars.

20.28hrs – I am Home!


I greet my lads and put my dinner on. I then get straight into my pyjamas. I also investigate the bags under my eyes, to see if I do truly look tired. I can confirm that I looked tired.


21:00hrs – I eat. In bed. I then take my medication.

02.05hrs – I wake up to go to the toilet and find my TV is still on. I appear to have fallen asleep during Masterchef. I turn the TV off and fall immediately back to sleep. 

And that my friends and people of the internet, was my day. You can tell that I became increasingly tired as the day progressed, as I stopped recording my day as accurately as I would have liked. I think I still show that it was an incredibly long day.

Until next time…

EJB x

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Day One, Take 2 – Part I

I woke up on Thursday morning in exactly the same way I woke up the previous day. I did everything I did on the Wednesday morning, right down to eating porridge for breakfast. – Quick interlude, I just let the dog out for a pee and it reminded me that there was a difference on Thursday morning, I had a supermarket delivery arrive between 08.00-09.00. It was due at a more reasonable time, but I had to change it because my treatment was postponed. You might think that this is an unnessary detail, but having a full fridge brings me so much joy. Anyway, back to my story –  If I was following my superstitious mind, I would have shaken the routine up a bit, but for reasons unknown, my brain had decided to behave; I was calm. I did not feel that nervous. I might have had a tiny, tiny bit of trepidation somewhere in my gut, but my predominant feeling was quite optimism. I just woke up wanting to get on with everything. In my flat that morning, I was more of a robot. That said, I did change my outfit twice and I asked Housemate whether I looked okay on both occasions and he responded with a sterotypical boy answer of ‘I don’t know’. I’m not sure why I was getting dressed up for the Daratumumab, I just needed to feel confident. Or at least fool myself that I felt  confident. I might have even fooled all of you.

Once again I felt the need to share my day on Instagram, it had two benefits. As well as sharing with strangers the glamourous and enviable life I lead, it also kept track of the day’s timeline, so I didn’t have to remember them for this blog. I’m thankful for that because it ended up being a long long day at the hospital. I say it ‘ended up’ being a long day, I always knew it was going to be a long day, I just didn’t compute the reality of it. 

If you count my waking hours it was an even longer day.  In terms of hours out of my house, I was out for 11 hours, and in the hospital for 10 of those. I didn’t even do rfar for my friends’ weddings. I woke up at 07.00 and past out at 22.30, so I was awake for 15.5 hours. I’m not normally awake for 15.5 hours and I am even more surprised that I managed to stay awake that long after having some IV Piriton. That would usually send me straight to sleep, but then it was followed by 20mg of Dexamethasone, so that probably counteracted the immediate need to snooze.

As you may have worked out by now, I got the Daratumumab. Pause for your applause. Despite having an hour and 20 minutes of pre meds before the big  infusion, I did, when I was in the seat for a brief moment begin to doubt that I would ever see the drug. Even when the Medically Trained Person told me that pharmacy had called her and said it was ready, I still had  doubts. Completely irrational doubts, but they were doubts all the same. When I eventually saw the bag and confirmed my name and date of birth I was excited. Internally, it was an internal excitement. When the bag was eventually hooked up to me, I sighed with relief. It was a theatrical sigh, but if was the only way I could think at the time, of commemorating the occasion. I was officially on the trial, and apart from the Medically Trained People, I was the only person to see it. 

I should add at this point that Mamma Jones felt (and probably still feels) terrible about not being able to accompany her baby girl for her big day of treatment. Mamma Jones just couldn’t get the day off of work, which I understood completely. Mamma Jones on the other hand felt guilty. I think she must have felt the guilt a lot because she was very apologetic on the Wednesday about not being able to come and then she phoned my twice on the Thursday to say she could come after work if I needed her.  People have to work, and I knew that my Mum would have been there for my first infusion if she could have been. It’s just one of those things, we planned family cover for the Wednesday, but as you know things changed at short notice.

I explained in my previous blog that Big Sister could not come to London for the big day, take two. The lack of family members present did have my two main female family members in a spin. Fortunately for me, there actually exists people who live in London who care about me, so when I found out I was going to be family-less, I contacted the London family and immediately I had a volunteer. I had a simple task for them, and that was, in addition to entertaining me for a period of the day, to bring me lunch. I had seen the hospital lunch the previous day and decided that just would not do. If I was going to be in the hospital all day, I needed to eat well. If in the process of bringing me lunch, my friend wanted to stay and talk with me a bit, then that was okay too. I understand that this offered my mother some reassurance. 

Whilst we are on the subject of food, I arrived at the hospital with a handful of cherry tomatoes, an apple and a flapjack. The flapjack was for emergencies. My friend was arriving at one, and in addition to my actually lunch of sushi (please do not complain to me about eating raw fish, my counts were fine, and I am adult) and a bowl of miso soup, I asked her to bring a punnet of tomatoes because the tomatoes I packed had disappeared into my mouth  by the time my infusion started. Despite a brief feeling of nausea, timed perfectly for the arrival of my food, I spent the rest of the day absolutely ravenous. It was fortunate for my waistline that I was attached to a drip and under such stringent monitoring, because I would have gone on a search for more food otherwise. I probably would have had one of the free sandwiches if they had done a late afternoon visit, such was my irrational hunger. As my stocks dwindled to nothing, I even had to lower myself to a custard cream and I hate a custard cream. You do not need to know, correction, I am unwilling to tell you what I had to eat when I got home. I need to maintain an air of elegant mystery. Next Thursday, I am going to have to rectify the hospital food situation. I am going to need a bigger bag. 

I had heard a lot about the reactions I could have on Daratumumab, which is one of the reason why I had to be monitored so closely. The other reason, I guess, is because it is a trial requirement. I know I started this paragraph talking about reactions, but I think I should just add here that I think I won the clinical trial nurse jackpot, I mean, if there was such a thing. My nurse was probably with me for 4-5 hours of my 10 hour day, and the biggest complement I could give was that I enjoyed her company. I also liked that she brought me drinks and made toilet jokes. Anyway, after yet another brief interlude to the narrative, I can confirm that I experienced no major side effects. 

If I had experienced any major side effects, I can confirm that the hospital was well prepared for them. They even had Mamma Jones and Big Sister’s contact numbers so they could keep them up to date if I became indisposed. I also had the nurses’ bell to hand and my Medically Trained Person’s phone number should anything change. I was well covered.

The only issues I had was some light dizziness lasting about half an hour shortly after the infusion started, which coincided with some nausea, which unfortunately coincided with the arrival of my lunch. My oxygen also went down, so I got to have extra oxygen shoved up my nose for good measure. As soon as I had the oxygen, the nausea and dizziness past and I was able to eat my feast, which if I am being perfectly honest, is what I cared about the most. 

Although I was there, on the same bed for hours, I must admit that the time until about 17.00 went by so quickly. From then on, it went slowly, but this tied in with all the patients in my bay going home, the cleaners cleaning around me and the sun go down. In the last three hours, it felt very quiet and lonely in that room, which is strange because I had spent most of the day mentally lambasting the other patients for making noise, especially the one, who at one point had six very loud visitors. I missed them all once they were gone.

I did not start watching my TV programmes until about 18.00 and even then, I only watched half an hour of one show, that I kept having to rewind because I was distracted by my phones or simply because I was tired and struggling to concentrate. I had to postpone Line of Duty because I was beginning to feel very tired and I felt that I would be unable to give it the attention it deserves. I will have to review my viewing choices before next week. Maybe Disney would be more suitable.

I really do not know how I managed to fill 10 hours of my day, when all I did was sit on a bed. A lot of my time was spent on my phone. I was inundated with messages from my friends and calls from my family, which when added to the two hour visit from a real life human friend meant that I felt well and truly supported. I received my weekly call from my UCLH CNS, a Medically Trained Person who always, I feel, goes above and beyond what is required from her when it comes to supporting me and for that, I am most grateful. I also wrote one of these, which takes more time to complete than you can imagine. On a more practical level, I was also very thankful for packing a phone charger.

The infusion bag was huge, and prior to receiving that, I received a bag of antihistamine, two bags of Dexamethosome, because the pharmacy changed my dose halfway through the first infusion (thus adding a 30 minute delay to my day). Each bag of drugs was followed by a flush. I should have, but I did not record the size of the Daratumumab bag, but just trust me when I say it contained a lot of liquid. On top of the liquid going through my veins, was the liquid going through my bladder. The Medically Trained People kept offering me more refills of water and top ups to my herbal tea. Plus, I had a clear soup for lunch. All this means one thing, and one thing only. I needed to go to the toilet a lot.

Going to the toilet whilst attached to an drip with a cannula in your dominant hand is no easy feat. It is especially difficult if you have aching bones and struggle to get on and off anything. The first time I went, I did not realise that the line was long enough for me to get off the left hand side of the bed, so I had to lift my legs, one by one and squeeze them between a gap mid chair. Such gymnastics was necessary because the table was attached to the bed, cutting the right hand side of the bed in half with a metal pole. Thank goodness two of my curtains were closed when I did this. On my return, I realised I could get on the bed from the left hand side, negating the need to negotiate the pole and more crucially, negating the need to look stupid.

The trial dictates that patients are monitored for two hours post infusion. My infusion ended at 19.00 hrs and as I had had no major side effects, I asked if I could leave at 20.00hrs. This was against medical recommendation, but I was hungry and tired, and the Medically Trained Person said she would not have left me leave early if she thought anything further was going to happen. And so, I left at 20.00hrs, got in an Uber and instructed Housemate to put the oven on, so I could heat my ready made cottage pie, which had arrived that morning.

There isn’t much more to tell you. I was absolutely exhausted yesterday and I do not know if this is because I was out of the flat for so long or because of the medication. I imagine it was a combination of the two. I was the sort of tired where every activity felt like a marathon. I was mortified to discover that I had incorrectly spelt ‘belatedly’ in a birthday card, by brain just wasn’t working properly.  Needless to say it was a flat day. I imagine that today too, is going to be a flat day. 
The reassuring thing, at least I find it reassuring, is that although I am still tired from my treatment, I know that I get to do it all over again next week. For those of you who are interested, I have to go in for tests next Wednesday morning, ahead of my treatment on Thursday. I imagine after a few more doses, my excitement will fade and Daratumumab, like every other drug I have taken will become routine. I just hope, with ever ounce (and there are a lot of them) of my being, that this treatment and this investment does what we hope it will do. 

EJB x

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The Glitch

On Wednesday morning, I woke in childlike excitement ahead of what was my first day on the Daratumumab trial. It’s was Day 1. Finally Day 1. Before waking up properly at 07.15, which is virtually unheard of these days, I woke up multiple times from 05.00. I just wanted to get to the hospital and see the infusion going into my arm. The night before, I had anxiously packed my day bag, even going as far as washing my backpack, so everything was truly ready to go. The backback was full of every possible form of entertainment I could wish to get up to as well as some I would not; I had even purchased a dual headphone jack so that Big Sister and I could spend the time catching up with Line of Duty. So as not as to tempt fate, I had also packed pyjamas and clean knickers in the event of me having to stay in. I was good to go. 

Once up, I made myself a proper breakfast to start such a big day right, which had to  fit in with my morning drug routine of waiting an hour before eating and then once my stomach is full, taking another hefty batch of pills. Were you aware that I had to do that everyday? I also took something called Montelukast, which sounds more like a mountain resort than a drug to relieve allergic reactions, perhaps the patent holders were just being inventive that day. I also did the things that everybody does before leaving the house of a morning, and it seems rather boring to describe them to you here; just use your imagination and know that once I smelt so fresh and so clean, clean and was presentable, I covered my lips in lipstick. 
The only downside of being out all day, is seeing the disgusted look upon the dog’s face when he realised I was not getting back into bed, but this is just something he was going to have to live with. I gave him a guilt treat before smothering him in kisses,  and struggling into my Uber with my extremely heavy backpack and a tightly closed bottle filled with 24 hours of my urine. And off I went to Bart’s. 
I was so excited, and also aware that there would be many occasions where I would be bored throughout the day, that I decided to share said excitement on Instagram Stories.

Exhibit 1: As you can see, the excitement was undeniable and not in the least bit egocentric .

Exhibit 2: Truly this was not in the least bit designed to get people’s attentions and to make them think of me as they go about their respective days. 

So, I walked through those doors, put my body and it’s tapping foot in a seat and waited. I had already told the Medically Trained Person in charge of my care that I was running a whole 8 minutes late, so I waited patiently for her. By that time, Big Sister was on the train from Peterborough and would be joining me by my bed at approximately 11.30.  

To fast forward a bit, the next Story I uploaded, was as follows:


Exhibit C: Yep, it was true instead of arriving home after 20.00, I arrived home at 14.00. Bruce was excited; I was not.

I suppose I have to rewind to the waiting room. My nurse came out to see me and very apolegetically explained that there had been a problem on the computer system for the trial and said computer system was preventing the hospital’s pharmacy from making and issuing the Daratumumab. It was a Glitch. A very annoying glitch. Due to the length of time it takes to give the Daratumumab via infusion, if the glitch could not be sorted by 11.45, I was going home. As have already seen, it is no big reveal to say I ended up going home with my head bowed in disappointment.

I’m not entirely sure of the precise reason for the computer glitch, I was assured that everything had been agreed verbally. I was on the trial and the trial sponsors were happy with my addition. The computer was clearly not happy. There are many reasons for this. One could be that the trial had been closed and reopened for me (I did not know that this was the case) and the compute could not compute this. Secondly, somewhere down the line there had been an admin area. Thirdly, it was just a plain old computer problem that nobody will ever get to the bottom of.

Sorting this problem was time sensitive, which meant the biggest issue the Medically Trained People had on Wednesday morning was the fact the computer glitch originated in the good old US of A. At that time of the morning in UK, there wasn’t many people or should that be the right people to help fix the problem by our deadline in the US. So, despite Big Sister arriving and confirming that she could not come the following day, the kind people at St Bartholomew’s were left with no other option but to send me home when the clock turned 11.45. 

To say I was disappointed was an understatement. Since hearing of the trial and knowing the stakes it has for me, I have been loathe to talk about it too much because I did not want to jinx it. I have no idea when I became superstitious, but it was probably some point around August 2012 when I was diagnosed. The reason I was late arriving to the hospital was because I suddenly decided I need to wear my Granny’s old necklace that says ‘luck’ in Cantonese. By the time we walked out of the hospital, I did realise the irony of my necklace.

Outwardly fine, but inwardly panicking; I asked if this meant there was any chance of me being removed from the trial and I was told ‘absolutely not, I was on the trial’. With that Big Sister felt much better and I felt marginally better. I am not sure if she was trying to calm me or if she genuinely believed it, but Big Sister remained poised and not remotely angry the whole time. It may be a result of her NHS training but she just said that these things happen and she hoped that the treatment could go ahead as planned on Thursday. That my friends, is a calming influence. When I initially called my sister on the train to explain the problem, she said “oh well, it would still be nice to me [blank] (blank is my trial nurse)”. 

Inevitably, at 11.45 we left the 7th floor waiting room and made our way to pharmacy to get some more Montelukast for that evening and the next day. Talking the drug was dependent on me getting a call later that day saying the treatment would go ahead. Once the pharmacy dispensed it, Big Sister and I treated ourselves to some lunch so her day was not a total waste, and then we parted ways. She was heading back to Peterborough and I to my flat and to the dog.

It was when I got back to the flat, alone, clutching my phone with the ringer on the loudest setting, that my irrational panic set in. The silence made my mind wander. Wander is to soft a word, my mind galloped.  I think my concerns were best summed up with this piece of marginally frantic primary evidence:


Exhibit 4 – Irrational panic 

So, yes. On Wednesday afternoon instead of feeling tired, wanting to go home to my own bed, I was willing to feel tired on a disinfected bed. I was also doing mind gymnastics, as shown above. In my defence, when you have had received the amount of bad news I have received, these irrational outbursts can be expected. I was very aware that it was irrational, and I received sympathy and logic from pretty much everybody I spoke to or by text. I didn’t need to be told I was being stupid, because I was telling myself that already. I just needed a gentle stroking, so to speak, not an actual stroking though I might have found that relaxing too. 

At around 16.00 hours my phone rang. I don’t think I gave it the chance to go beyond one full ring but it rang. It was confirmation that the computer glitch had not been sorted, but the folks at St Bart’s had made it very clear to the folks somewhere in the US of A, that I had to start my treatment as soon as possible. Something they agreed to; the human override. 

So, I was to start my Thursday in the same way I started Wednesday. Montelukast, other pills, shower, clothes, breakfast, lipstick, heavy bag, an Uber, and arrival at the hospital by 10.00. The only difference was that this time, I would be doing it without a family member, much to their disappointment. Mamma Jones even phoned me to say she felt guilty, I told her not to be so ridiculous. I had arranged an alternate to bring me lunch and I reassured her that I would be fine. As soon as The treatment started I would be fine.

With slightly less confidence I fell asleep on Wednesday. I still managed to feel some excitement that I would eventually, after what felt like months of waiting, see the trial start and witness the drug I really struggle to pronounce go into my arm. I have small dreams and that was one of them.

What happened yesterday is for another blog, but find some comfort in the fact that I was in the hospital for 10 hours yesterday and I feel extremely tired today. This blog only comes so early courtesy of my need to take some Dexamethosome after my breakfast, and I cannot have either of those things without an hour wait.

EJB x

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The Know It All

When it came to getting my radiotherapy, I was very much in the been there, done that, got the t-shirt, camp. If there is such a camp when it comes to radiotherapy. I bet there are radiotherapy clubs, but this is just me thinking out loud. I do not want to join a radiotherapy club. Prior to my sessions last week, I had had radiotherapy twice before. Whilst my previous experiences were not without their side effects, if you had spoken to me the week before last, you would have heard me say with great confidence “of all the cancer treatments I have had, radiotherapy is by far the easiest one.” One of my dear friends offered to put her child into nursery to accompany me on my first session, another dear friend offered to take a day off work; both offers were immediately rejected as wholly unnecessary and seen as (a much appreciated) overreaction. 

I thought radiotherapy was easy. At least the way in which I have experienced radiotherapy was easy; in the form of a short five day course or as a one off session. I am not naive or conceited enough to think that the people who require weeks of back to back, daily radiotherapy would classify their experience as ‘easy’. I described myself as a seasoned pro, not to a Medically Trained Person, but in my head and probably on this blog. To the Medically Trained People, I somewhat arrogantly sped through the list of side effects and I had very few questions prior to my consent. I just wanted to get on with.

In terms of usage of time (if you exclude the travel), I suppose radiotherapy is easy, and it is more for this reason that I declined the kind offers made by my friends to accompany me to the hospital. I attended UCLH for five days and only one of my visits lasted for more than an hour. On average, I would estimate my trips lasting no more than 30 minutes. The zaps themselves are even shorter, taking a matter of minutes, or even seconds, it’s hard to tell. It’s not like Goldfinger, you cannot see a green laser coming for you. After my first session on Friday 7th, I asked whether that was it when the technicians reappeared, because I was completely unaware of the procedure taking place. I thought that the machine buzzing and moving around me, was preliminary work before the real deal could take place. That expectation is coming from somebody with prior radiotherapy experience; my memory truly is awful. The majority of time my time in the radioactive bunker was spent taking my clothes off and putting them back on again. 

I do not recall experiencing any side effects after my first encounter with radiotherapy. That was just one zap on my right hip and the only thing left to remind me that I had it, after the pain went away were the three tattoos left behind. My second experience of radiotherapy was not as straightforward as the first, but it did not compare to a week’s dose of steroids. Approximately two weeks after the five sessions on my L1-L5, I endured two days of food poisoning like symptoms due to the zaps going straight through my stomach. This side effect, whilst absolutely horrible at the time, was predicted and after a day or two recovering, was quickly forgotten. 

Less easy to forget, but without the severe sweating, was the scar that treatment has left on my back. Initially, I say initially but approximately six weeks after the treatment, the skin on my back appeared to have been burnt. Burning or sores is a well documented side effect of radiotherapy, so I was unalarmed but itchy, I treated it with aqueous cream as instructed and thought nothing more of it. Approximately 15 months later, I developed Graft vs Host Disease as a result of my transplant and I was reminded of my radiotherapy once more. 

I could go on and on about my back, but all you need to know is that as a result of the GVHD, I still have significant scarring on my back. The scarring is in fact so unslightly that it was commented on several times during my most recent week of radiotherapy. One Medically Trained Person with dulcet tones reminded me to moisturise, to which I politely told her that moisturising would not cure this particular ill. I actually wanted to laugh in her face at the stupidity of her comment, given how many doctors I have discussed this ailment with and how all of them have been left scratching their heads. I did not laugh in her face though, because her comment was only stupid to me (and maybe Mamma Jones) who has lived through the saga, or what feels like a strange X-Files-like marking that is my back lower. 


Exhibit A – I know it is gross

Despite my back and the hideousness of it, going in to my most recent treatment, I still thought it was going to be easy and the side effects minimal. Perhaps it is because I did not have the time to think about it. In fact, when it came to asking questions, I asked only two. The first question, given the fact I just wrote two paragraphs about it and shared a rather nasty picture of it, was about scarring. Of the three areas being treated, the one requiring five sessions was on my upper spine and call me vain, because I can be, but I do not want to have a similar scar that would be visible. One scar like the one I have is enough. It’s a story and an occasional show piece. Two scars, with one of them on a visible area of my neck is just unnessary. Only time will tell if history repeats itself. Unfortunately, I cannot apply the cream provided by myself, so I am reliant on the kindness of others to rub cream into my naked body.

My second question was about diarrhoea and whether I would get it again. Nobody wants to get diarrhoea, especially the sort where your stomach cramps constantly and  sweat falls from your forehead to the floor. Flashback warning! I just recalled having to remove all my clothes whilst on the toilet the last time I had radiotherapy induced toilet issues. I cried too. Horrid. So yes, I don’t want that. Unfortunately for me, I had one off zaps to my T10-L1 and my left ileum; both of which could have gone through my stomach. So far, I had three days of cramping that was easily treated by a few doses of Buscopan (never underestimate the power of Buscopan, I’m an advocate and I believe it should form part of any personal drug stash). 

I am yet to mention fatigue. I knew that the treatment was going to make me tired, especially as the doses accumulated. It made me tired last time and I expected no less this time around. I suffer from fatigue daily, so I thought that it was barely worth a mention. Fatigue impacts so much of my life already, it’s as common to me as water. Nevertheless, I prepared for more fatigue than usual. I purchased ready meals and purchased food that Housemate could cook for me. I bought some plants for my bedroom and replaced my broken aromatherapy defuser, to ensure that my room was a serene and calm environment. So convinced was I that I was going to manage it with relative ease… 

You’ve guessed it. I’m eating my words. I’m chewing down on them, masticating slowly before I humiliatingly swallow them and choke. 

I do not know if it was because I had more radiotherapy than I had had previously; or because I am physically weaker than I was when I had the previous my treatments, but I found last week incredibly difficult. I struggled. Put it another way, it was anything but easy. 

Pain. I was in a lot of pain. Hell, that was the reason I was having the radiotherapy in the first place. Unfortunately, the start of the radiotherapy coincided with a deterioration of my pain. A vast deterioration. I had taken to wearing my sling all the time (bar bedtime) to take the pressure off my back, which did alleviate some of my symptoms but there was a time limit to it. Don’t get me wrong, I felt pain whilst wearing the sling too, I was just in less pain. If I was not wearing a sling, I could not stand up straight. The pins and needles in my arm would be constant and my elbow felt like something was taking a hammer to it. I know I am doing a terribly job at describing my pain. It was in my back, my left arm, my legs, I felt it everywhere. It was all consuming.

As the week of the 10th April started, I had  forgotten one crucial thing, and that was that radiotherapy can cause more pain before it relieves it. By the Tuesday, after I had had two sessions on my upper back and the two one off sessions, I remembered. The radiotherapy seemed to enhance every pain I had. The pain in my ileum became instantly worse. It felt heavy and the pain pounded like a heartbeat. My back, well, my back felt like everything was wrong. I couldn’t lift my head or turn it. I had the occasional spasm. I even struggled to get in through my back door because I couldn’t lift my leg high enough. Essentially, I moved like the pre oiled, rusty Tin Man. Sleeping on my side was impossible. Sleeping full stop was difficult. 

My words do not do what I felt last week any justice at all. Know that I frequently yelped in my pain, occasionally I produced uncontrollable grunts. The pain, as does my pain today, got progressively worse as the day went on. Doing something as simple as getting ready for bed had to be broken down, because the act of taking off my clothes, putting my pyjamas on, pulling down my bed sheets and setting up my five pillow sleeping tower seemed impossible feat. 

Despite fighting to be independent and at times, doggedly so, I relied on Housemate heavily. As I could not bend down, he had to get my food out of the oven, fill up my water bottle, add ice to my drinks, put my post radiotherapy cream on my neck and do up my bra. On the Thursday, Mamma Jones had to drive to London after a full day’ work, and drove me back to her house because I could not lift my suitcase nor get myself to the train station. And because I felt so rundown that I needed the Mum Love and I also though that Housemate needed a break.
The above is not solely the fault of the radiotherapy but it definitely played a part. I do not think that this was a ‘woe is me situation’. I really hope I do not come across that way. I was genuinely scared by how limited my movement became; that should be enough to convey how difficult things became.

In addition to my overly documented pain, there was the fatigue. The fatigue was easier to manage. If there is one thing I am used to managing, it is my fatigue. That said, I did manage to fall asleep in the waiting room of the Radiotherapy Departmemt. I walked in, sat down and within 10 minutes I was fast asleep. I know it was 10 minutes because I arrived at 14.30 and the Technican called my name at 14.40. 

I completely underestimated the toll the treatment would take on my body. It’s radiation. I should have put two and two together. In my head, this was just the equivalent to taking a paracetamol. On the Monday of treatment week, in addition to the daily zap on my C5-T5, I had the one off zaps on my ileum and my T10-L1. Oh my gosh, such was the power, I felt instantly felt sick. It was a miracle I did not vomit in the taxi on the way home. By the time I arrived at my flat, all I could manage was to roll onto my bed after finding an Ondansetron (to manage my sickness) in my drugs sack and there I stayed for 90 minutes in the foetal position. I could not move. Everything felt weak and stiff. I believe my attempts to talk actually manifested in a mumble. When I eventually came round, I discovered that I had dribbled on my pillow and chin. There are reasons why I am single. That evening caught me completely off guard. Once again, I found myself panicking, worrying about the cause of the illness, despite realistically knowing that the cause was the radiotherapy.

Finally, in addition to feeling tired, sick and excruciating pain, the radiotherapy made me sweat. Instantly, after each session, I would have a hot flush. By now, I am used to hot flushes but the post radiotherapy ones were severe. One day, on the first day, I sat in the hospital’s main reception for longer than necessary because I was trying to work out how I was going to wipe my sweat off the plastic seat without anybody noticing. You’d think I would have well rehearsed this move by now, but apparently not. I think the radiotherapy had sent me a little doolally. Or perhaps it is my medication. My reactions and my ability to think feels much slower, less reactive.

A week on from my radiotherapy ended and all I can do is wait. I have no idea if I am going to get an upset stomach in a week’s time, or if I am going to get burn marks on my neck or hip. Not only am I waiting for the bad things to occur, I’m also hoping for the treatment to work. At the moment, I can feel my pain improving slowly. Slowly over the last five days, I  have gradually felt the sensation in four out of five fingers on my left hand return! That deserves the exclamation mark. Truthfully, I do not know if the improvement in my pain level is due to the radiotherapy or last week’s increased medication. I just spoke to a Medically Trained Person and she suspects it is the medication. So, wait some more, I shall. 

So much waiting.

Perhaps me saying that radiotherapy was easy, was wishful thinking. If you say it, it will come true. I know that is complete bollocks, but some sort of positive thinking is a good thing. Right now, as I end yet another epic blog and take in that I had a week of radiotherapy and treated it like it was just a regular day, I realise that I am exhausted. Absolutely exhausted.

That much at least, I know.

EJB x

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A Lesson in British Decorum

Please not I accidentally published this blog early because I have limited control over my fingers; this is the final version (unless I reread it during a bout of insomnia and decide to correct my typing errors).

University College London Hospital acted with the greatest of haste following my MRI and all round bad results. Not only did they make sure I was referred to Bart’s within days of our meeting, they also referred me to their Radiotherapy Department. I am not sure of the particulars or what happened behind the scenes, but I do know that I saw my Medically Trained People on Thursday 30 March and I was informed on Monday 3 April that I had an appointment at the Radiotherapy clinic on Thursday 6 at midday. Not only did I have an appointment at midday, but I also had an appointment at 14.30 to complete my pre treatment measurements. The treatment itself was to commence on Friday 7 April. 

Now, I know I just threw a lot of dates at you. In a nutshell, in order to be left opened mouthed with administrative awe, you just need to know that within the week of receiving and telling me about my MRI results, the hospital had scheduled in my treatment, which was to start a mere eight days later. Things were moving fast. Need I remind you, that this was all planned in the same week I visited St Bart’s to discuss and consent to the clinical trial. The start date of which, was dependent on my radiotherapy. All of this was also within a week of being told that I had stopped responding fast enough to traditional treatments. What a mouthful.
It was to my benefit that things were moving so fast. Mercifully, it left me with little time to dwell.
Not having the time to stop meant that I was able to get myself into what I call ‘Game Mode’, without stepping into the usual self pitying pitfalls. I walked in to the Place Where A Lot of People Know My Name on Thursday 6 April, ready to go. My head was high and my lipstick was on. I know that things would have happened around me even if I was not ready to go. Mentally however, it was important to me that I felt ready for the various treatments that were soon to be thrown at me, and there was a lot to be thrown at me. After feeling like I had been hit over the head with a Le Creuset griddle pan for a week, and allowing myself to cry for most of that week, the game was on. I was ready go. 

So, after all that internal fighting talk, Thursday arrived and it was time to sit down with an unknown Medically Trained Person. This was not my first time having radiotherapy; it was my third. I had previously had a one off session on my right hip in the October of 2012, and a five day session on my L1-L5 to remove a mass in August 2014. The purpose of my previous treatments, were the same as this current treatment, and that was to manage and reduce my pain. 

Previously, the Radiotherapy Department came along and zapped said pains away; and it is for that reason that I was absolutely desperate to have this treatment.  It shone through. My pain was worsening day by day. Even before I walked through the door into the Medically Trained Person’s office, my desperation was palpable.

During my appointment I was informed that instead of the treating just the two areas that had been ruling my life, they would be treating three. The main area requiring treatment, the area causing the majority of my pain was a ‘mass’ pressing on my C5-T5. That’s my spine by the way for anybody who thought I didn’t have a back bone.  I think ‘mass’ is a nice way of saying something else, but I did not enquire further. To treat said ‘mass’, I would be receiving five zaps over five almost consecutive days. A weekend got in the way of it being truly consecutive. Anyway, so far, so good. I saw the MRI image of the ‘mass’ and I thought to myself ‘yep, that’ll do it’ as I hunched over once again and grimaced in unbearable pain, wondering if I would ever have full sensation in my left hand again.

Also requiring treatment was my left pelvis, which I knew about, but from that appointment forward, I would only be referring to it as my ileum. Simply because ileum is a great word. My ileum would be treated with a one off blast of radiation. The third area to be treated, and also with a one off blast, was my T10-L1. The doctor said that there was ‘something left over from last time’. Again, despite being in my Game Mode, I chose not to ask any further questions about this. I trust the Medically Trained People, and I was happy to leave all the science and decision making to them.  I might not have known about this particular problem, but what harm can a one off blast of radiation do? The 2% chance of a secondary cancer is hardly an issue for me now.

Such was my desire for my pain to be relieved, if they were offering more, who was I to decline it? So, I fast forwarded through the list of side effects and signed yet another yellow consent form. 

Downtown Abbey has a lot to answer for. Stereotypically, British people are believed to be well mannered. We also apologise a lot but that doesn’t fit into the title and narrative of this blog. On a personal note, if I was not well mannered, I would incur the wrath of Mamma Jones. Thus, I made sure that prior to my departure that I thanked the Doctor not only for seeing me, but for seeing me so quickly and in advance of making the pain disappear. It was not a one off thank you, it was an over excited, cannot believe my luck, repetive thank you.  I might have even squeaked. It was the sort of thank you that could easily be described as embarrassing. I embarrassed myself and probably the doctor. I did not care. I do not have the brain power at the moment to adequately express how much I needed and wanted the radiotherapy without simply repeating myself; I really needed this treatment. 

Next up, in this seemingly never ending blog, was the pre-treatment measurements. Now, I am going to assume that the majority of you have not frequented or required radiotherapy at UCLH. It’s a different world to Huntley Street’s cancer centre. It’s in the windowless basement of the main hospital and every member of staff speaks in soft dulcet tones, to match the soft colour tones of the walls. They also introduced themselves to me at such a rate that remembering their faces, let alone their names was next to impossible. 

There is one word I would use to describe the staff I encountered that afternoon and that word is ‘nice’. Everybody was so nice. I said as much to them. They were all the epitome of nice.

To be measured for the radioactive zaps, these particular Medically Trained People needed to access my hips, chest and back. In order to access these places, I needed to remove my clothes and it is this circumstance in which I encountered British manners at their most uncomfortable. The episode went a little something like this:

Technician: [soft dulcet tone] Now Emma, I just need you to remove you top and your jewellery. 

Me: Okay.

Technician: Actually, can you take your bra off as well? We’ll leave you alone for privacy.

Me: No problem, do you need me to take anything else off? I’ve had a lot of medical procedures so it doesn’t bother me.

Technician: Um [looks at my jeans] can you take your trousers off as well? You can keep your underwear on. We’ll give you a gown but you’ll need to keep it undone at the back.

Me: Sure, are you sure you don’t need me to take my knickers off? I truly don’t mind. After you have to have your mother take you to the toilet and bathe you at the age of 28, nothing really phases you. Well, it doesn’t phase me.

Technician: No, knickers are fine. [The three people working on me then left the room to give me the privacy they promised, something that contradicts what follows]

Me: [Now dressed in an undone medical gown, but still wearing my necklaces, which I could not remove myself due to my pain] I’m done.

[The three female technicians then come out of their office, one helps me to take off my necklaces and they ask me to lie down on the measurement contraption]


And so, I did what I was told. I lay on my back with the gown flapping at either side of me. It was not comfortable. The three technicians started to work over me and described everything they were doing to me in their dulcet tones. They kindly explained that they needed to look at my body to complete the measurements. My naked body.

As the radiotherapy was going to be on my neck, lower back and left pelvis, this translated to looking at my chest, hips and the top of my lady garden. Yes, I wrote lady garden. For information, when I relayed this story to my nieces, I referred to that area as ‘my peach’. 

For my chest, I had to remove my arms from the gown which was then pulled down to reveal my less than pert breasts. After some talking and looking, they drew a cross (I found this out afterwards) on the area known as, if I were wearing my bra and standing up, my cleavage. For my lower back, they were able to use the previous tattoos. 

Now, here comes the best bit. To access the necessary area of my lady garden, they very gently and apologetically pulled down my M&S black cotton briefs so they were resting just below my buttocks, and then covered my exposed front with a piece of hospital issue blue tissue. The process continued to be narrated by those dulcet tones. The purpose of the blue tissue was to protect my modesty. 

So there I was, lying on the machine all but naked were it not for the hospital gown acting as a sheet, my pants hanging below my bottom, and a piece of hospital issue blue paper towel covering my genitals when one of the technicians used something wet, I assumed it was an anticeptic wipe, to clean the top of my lady garden. It was at this point that I started to hot flush. The area was inspected closely, and the tattoo I had there in 2012, unlike the ones on my hips had faded, thus requiring another tattoo. 

After I had been through the machine where I had admired some animal stickers stuck to the top of the machine for children’s entertainment, the ladies returned to the room. This time round, I received one and a half new radiotherapy tattoos. I got a brand new one on my cleavage and the half belongs to the touched up one on my not-to-be-seen. Once that was done, I was done. I just needed to get up off the machine, which in my case, is always easier said than done. 

I cannot get up, after lying flat on such a hard flat surface by myself. It has been four years and eight months and I still cannot do it. So, I very politely asked for assistance, which was willingly given. As I sat up, flanked either side by two strangers, the undone gown still acting as a blanket fell off exposing my breasts and my bare bottom. It was too late to protect my bottom, but I was able to cover what I unaffectionally call my Saggy Maggies by putting my arms through the sleeves of the gown. As I put my legs down and stood up, the blue paper towel that had been protecting my lady bits fell to the floor, and my pants defied gravity and stayed up despite being rolled around my upper thighs. Once up, the technicians once again left the room so I could get dressed in private. 

In private? Really?

As I said early on in this tale, I am comfortable with my body enough to expose whatever parts of it the Medically Trained People need to see. I am not embarrassed by it. I understand it is something that needs to be done, and in the grand scheme of things that I have had to do since my diagnosis, getting naked does not register as remotely noteworthy. 

I did, however find my experience on that Tuesday as noteworthy. In their attempts to be polite, to protect my modesty and to make me feel comfortable, the technicians achieved the opposite. Fortunately, I can see the funny side of standing all but naked except for some rolled down knickers and an undone hospital gown. It just seems strange that their approach to nudity, a very British, hush-hush approach to nudity, made me feel more exposed than if I had removed all of my clothes in the first instance. 

It was an approach that ran through the entire department, despite my attempts to be visibly carefree when it came to disrobing. When I attended for my actual treatment, the room was equipped with a modesty screen for changing, which I chose not to use for anything but storing my belongings and hiding my difficulty in doing up my bra due to my failing arm. And yet, I still went through the same convoluted format. I was not asked to remove all my clothes right away, I was asked to remove them one by one. When it came to zapping my ileum, once again, I was asked to keep my knickers on only for them to be rolled down, at which point my nether regions became reacquainted with a piece of the hospital issue blue paper towel. 

I found this episode to be embarrassing too, not because I was naked but because I had a hot flush during the procedure. I hot flush all the time, but hot flushing whilst somebody I do not know is helping me off a flat surface wearing nothing but pants  rolled down to my thighs with a hospital gown round my midriff is an uncomfortable experience. It is exceptionally uncomfortable when several seconds after standing, a damp piece of hospital issue blue paper towel falls to the floor. At least I made my nieces laugh. And my friends.

And with that, this particular lesson ends.

EJB x


P.S. I made Housemate take a picture of my cleavage tattoo. It probably made him feel uncomfortable, but as you know, I’m down with my naked form. Here it is, nearly naked. It’s only fair that I share it.

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10 Hours In London

Following my latest Bad News Day, I’m not sure if we can classify it as the Ultimate Bad News Day, but after whatever a fortnight ago was, things started to happen very quickly. Last Friday evening, when I had a chance to stop, I reflected that I could not believe so much had happened in a simple space of a week. As you can assume, it was a riveting conversation. A lot happened that week, but for this blog, I am only going to tell you about what happened on Monday 3 April. Firstly, it means you’ll have to read the following blogs and secondly, I enjoy the WordPress alerts that say ‘your stats are booming’. Well done, all 100 of you. I deserve more than 100 of you, but again, that’s not the purpose of this blog.

Mamma Jones and I departed Peterborough on the 10.08 train that day for an appointment at St Bartholomew’s Hospital at midday. At this point in time, I was not entirely sure why I was going to Bart’s. The last I heard was that I may have got into a trial at the hospital and I was going there to talk about it. Initially, I had thought that this appointment would take place a week later, but the hospital wanted me in as soon as possible and when you are dealing in possible clinical trial spaces, I was willing to do whatever the hospital wanted me to do. Even if that meant getting up early and getting a train to London, when all I wanted to do was rest my aching bones. 

The familiarity with returning to St Bart’s was overwhelming. The clinic I was attending started at 9am and my appointment was for midday. On a very practical level, this meant that waiting would be required as the clinic would have had three whole hours to run late prior to my arrival. 

The waiting room in the East Wing had gone unchanged. I don’t know why I was expecting it to have changed. I lie actually, in my absence they had upgraded from lukewarm jugs of water to a standalone water cooler that dispensed more lukewarm water. The room itself, still holds far too much heat and there are still insufficient seats to accommodate the number of people who attend that clinic. People seem to sit wherever they can find a ledge. It looks so untidy, with patients sat incredibly close together on plastic seats, facing various directions whilst other patients sit on the seats fashioned from oversized window ledges that are too deep to be sat on with any type of decorum. Wheelchair uses find space next to the window seats, but there is no designated spaces that would indicate an area where a wheelchair user has stopped on purpose rather than just finding themselves next to a plug in heater in the middle of a corridor. Needless to say, it is an environment that feels cramped and overbearing. My previous visit to Bart’s had been about a year before. Desperately trying not to moan, the oppressive nature of the room, and my imagined but fierce belief that plus ones would never give up seat to a young myeloma sufferer, immediately put me in a bad mood. 

I tried to read, I thought perhaps reading would make the wait seem more bearable. Not that I knew what I was waiting for. Reading proved to be impossible because that room carries sound that I could not escape from. Any conversation that did not originate from my lips on that day, was pure and utter, superficial nonsense. My attempts to read just encouraged me to look at the other patients and declare them evil for interrupting my novel. Housemate dropped by briefly during this time to deliver a much needed packet of Refreshers. They helped. But we were still waiting. 

Maybe I was being too dramatic in wondering why we had been summoned there. Logically, I knew I was there to discuss the trial and hopefully get on to said trial. I know what my problem was, I didn’t want to get in to see the Medically Trained Person only to be told that it was all a gigantic mistake, that I wasn’t on the trial and that I must have misunderstood something four days previously. This trial literally is my chance to prolong my life. I did not want to hear about any mistakes. . 

Irrational concerns about my hopes being dashed after nearly five years of having myeloma, are not so irrational. 

I was eventually called through at 1.25. It was time. Time for what though? We did not have a clue. 


Like I said, we did not know what to expect. Was I going to have to pass a number of tests? Was there a written word exam nobody told me about? Would the Medically Trained Person not put me on his trail if I started to have a hot flush and as a result of hot flush leave a damp mark on his chair? I just did not know. I was not privy to any of the discussions that led me to Bart’s. 

So, up the river without a paddle, I walked through the double doors, followed by another set of double doors until I reached a single door and knocked. The Medically Trained Professional opened that door and  in we went. 

Inside his office, ready to greet us was a Medically Trained Person I know well. He, my doctor throughout my last transplant, was smilin, actually smiling at me which made a refreshing change from the previous week’s tears. I am a simple woman and I appreciated the familiarity. I’m surprised he did not automatically call me ‘Em’, which had had started to do when I was last under his care. 

I would categorise what followed as informal. We did not have an in depth chat about the clinical trial (Daratumumab). I was told that there was around a 30% chance of it working. I reasoned that that 30% was better than trying nothing at all. The word ‘antibody’ was mentioned a few times but not enough that I actually understood why. Then, probably within five minutes of us entering, the Medically Trained Person signed a white piece of paper and said that was his consent for the trial. 

Could it be that without any blood tests, biopsies or an explanation, I was on the trial? Apparently so. Even now, I loathe to jinx it.

And with that, I think I expressed enormous gratitude, and then we were ushered out of the office with a few sheets of stapled white A4 paper containing a very important signature, and that was it. Well, it wasn’t quite it, we still had to go and see the trial nurse, but that was it for our time with the doctor. Clutching the consent form  and looking at my mother in disbelief, we made our way up to the seventh floor of the main building, otherwise known as the cancer centre. 

St Bart’s cancer centre, despite the view was just as foul as I remember. We did not get past the waiting area on our visit but that area was filthy. There was rubbish everywhere and unhappy people sitting amongst yet more plastic chairs waiting to be called through. I do not know if I imagined it, but I am sure there was actual rubbish littering the waiting area and mug rings decorating the tables. I did not imagine that the adjoining toilet I used, was soiled with stains all over the floor and toilet seat. How does this happen by 2pm in the afternoon? I know that people are sick, but really? What does it say when patients don’t respect their treatment area enough to keep it clean? I’m not going to answer that because I am very thankful to be transferring to Bart’s and I think it is a wonderful Hospital. 

This s a blog about how much I love St Bartholomew’s Hospital and not one where I highlight all of it’s faults. I really do love St Bart’s and I am pleased about being transferred there. Honest. Honestly. 

Amongst the debris, Mamma Jones and I read through the literature I had been given and then I signed my life away, consenting to everything they asked me to consent to. A skim read would be the correct description of what I did. I was beginning to get tired. Since I was diagnosed with Myeloma, I have consented to many things and I can confirm that there was nothing exceptional about this form. Let’s hope the subject matter proves to be exceptional, but the form itself? A form is a form is a form. 

After a few minutes, we met the Clinical Trial Nurse. Not that I am picky in anyway nor does she have massive metaphorical shoes to fill when it comes to making me feel comfortable with my care, but I approved. We discussed the practicalities of the trial and I handed over the stapled bits of A4. 

I was then weighed (dropping a full half kilogram from my morning’ weigh in), measured and my blood was taken. And that was it. I was sent home. Practicalities, like the start date of the trial were to be decided once my dates for radiotherapy had been confirmed.

Was that it? Was that all that was needed to get me onto a trial that has a 30% chance of prolonging my life? I do not not know what I expected. I did not even get the chance to express my gratitude to such an extent that it made everybody feel uncomfortable. I didn’t learn about the ins and outs of the trial. I just stipulated that I did not want a semi-permanent line and said I still wanted to be able to go on holiday. 

It’s now over a week since that appointment and I still do not want to do anything endanger my place on the trial. As the rest of our correspondence has been done over the phone or by email, I am afraid that they are going to discover something catastrophic. It doesn’t even need to be catastrophic, it could be something perfectly innocent that could effect my place on the trial. This week I almost took some extra steroids, and even those could have impacted on the trial. 

It cannot be taken away.

On the subject of steroids, no tale of our day in London would be fully complete if I did not tell you what happened after we left the hospital. By 3.45pm, I was absolutely ravenous. By that point I had been on a high dose of steroids for four days, we had missed lunch and I really was ravenous. Well, I was tired first, hungry second but I knew that if we fed the hunger, Mamma Jones would be accompanied by a much nicer me on our journey home. 

We went to a restaurant and I am most thankful that the restaurant was quiet, for I sat down and ate a starter of calamari followed by half a chicken and chips. Once I was finished with my chicken, I finished my mother’s. Mamma Jones’s chicken was not included in my half chicken tally. I couldn’t stop. The least said about this meal the better, but in short, I could not stop eating. Afterwards, we travelled to Kings Cross station where I indulged in yet another banana milkshake. Then, and there was a then, when we eventually arrived home at approximately 8.30pm, I had a bowl of porridge with Jersey milk. Steroids

Steroids are responsible for a lot.

Straight after I ate my bowl of porridge I fell asleep and I stayed in bed for the next 36 hours. Our 10 hours in London, wiped me out. I know that it is understandable, but I was still surprised the following day to find myself incapable of getting out of bed. The exertion was worth it. Meeting with the staff at Bart’s and albeit briefly discussing the next steps made me feel like things were moving quickly and they were moving in the right direction. I know that the odds of this working are extremely low, but I feel positive about it. Well, I feel ready for my treatment to start and I am not going into it thinking it’s going to fail…So, yes, that’s something. 

I cannot quite believe that I am on the trial. I do not know how these things work, but I know that in terms of criteria and timings, I am lucky. I know that Myeloma patients don’t get ‘lucky’, I’m fortuitous. 

I know (because people have told me, not. because I have done any of my own research) that it is incredibly difficult to get on any dartumumab trial in the UK and it is for this reason that I will not let myself fully believe that I am on the trial. I might have signed the papers. I might have  completed the pre tests (I haven’t actually completed the pre tests, I still need to do a 24 hour urine sample). I might have been told that I am on the trial. I just cannot, until I watch a very slow infusion enter my body this Wednesday believe that I am really on the trial. At that point, I might doing a celebratory fist clench and feeling a tiny bit lucky. 

EJB x

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It’s Only Da ‘Roids

steroidnoun BIOCHEMISTRY 

Any large class of organic compounds with a characteristic molecular structure containing four rings of carbon atoms (three six-membered and one five). They include many hormones, alkaloids and vitamins.

Say what?

The above, I imagine after choosing a life of easy culture and civil service instead of biochemistry, is a fairly crude definition of a steroid. I do not know the molecular compounds of steroids. Why would I? Nor do I know the specifics of the steroid I have come to loathe called Dexamethasone. All I know is that above description of a steroid fails, quite dramatically to encompass the sheer power of a drug I have been taking for nearly five years and for that whole period of time has be routinely kicking me in the guts. My quick Google search makes it sound so innocent. I know some steroids are innocent, but ever since I watched an episode of California Dreamin’ where Tiffany became addicted to steroids to enhance her volleyball performance, I have known there are something to be wary of. And wart I have been. 

Of Dexamethasone, the Internet describes it as a medicine this time and as ‘a synthetic drug of corticosteroids type, used especially as an anti-inflammatory agent’. I’m not going to begin to understand what that means, all I would say, is that for the moral of our current story, remember it’s use as an ‘anti-inflammatory agent’. 

Whilst we are on the subject of uses, I do not know, as this blog should clearly indicate, why I take this drug so routinely. I think I understand why I am talking it now, but why Dexamethasone supports pretty much all the myeloma treatment I have ever been on, well, that reason is anybody’s time to research. In light of my ignorance, I thought the least I could do was to investigate the list of known side effects, for it is those where I feel I know the drug as well as I need to. 

According to Wikipedia the side effects of taking this dreamboat can include acne, insnomnia, vertigo, increased appetite, weight gain, impaired skin healing, depression, euphoria, hypertension, increased risk of infection, raised intraocular pressure, vomiting, dsyspepsia, confusion, amnesia, irritability, nausea, malaise, headaches and cataract. These are the common side effects.  If you are bored, research further but I think I have copied enough to get my point across. They do a lot and they are unpleasant. 

Steroids are hard on the body. They have always been hard on my body. In fact, such has been my response to steroids that for the last two treatments I have had, I have been allowed to take a lower than the recommended dose so that I could have something that resembles a normal human’s week at the end of it. I would rather take any other of my routine medications, even the one that gave me nightmares. 

Wikipedia’s list failed to list my biggest problem with the stuff and that’s the fatigue. The inevitable crash after the fall. And it was inevitable. I used to prefer taking my month’s steroids over four back to back days as opposed to weekly, just so I did not have to deal with them as much. I didn’t always succeed, but that was my goal. Get them out of the way as soon as humanly possible, whilst still adhering to the will of the Medically Trained People.

Why on earth are you telling us all of this, Emma? 

Patience. Something I lack in abundance, but bear with me. There is relevant, I assure you. 

Scooped up all the shock that happened 10 days ago now, I was prescribed what is medically known as a ‘pulse of steroids’; with the particular steroid being, yes you guessed it, Dexamethasone. At the time, I thought I had been on a similar pulse of steroids before,  but I soon discovered that the only thing I had to compare this pulse to from previous treatments was like walking up Parliament Hill and comparing it to Mount Snowdon.

The course started with taking 20 tablets (40mgs of Dex) for four days, reducing to 10 tablets (20mgs of Dex) on days 5 and 6. By Day 7 and 8 I was down to just five tablets ( 10mgs Dex) and for the final two days, I was prescribed a piddly two tablets per day. Just in case you were wondering, this was to be taken on top of my usual-keep-things-at-bay and not-so-usual-pile-of-pain-medication. So, I have been taking a lot of medication. The prescription for the first four days was for more steroids than I had taken in the last four complete monthly cycles of treatment. It was a LOT of steroids.

When I first heard of this mammoth dose, I thought that it was the sour cherry on top of a pretty ropey, dry cake. It didn’t take long, even in the mental state I was in that day, to be apprehensive about this course of treatment. Eyes were rolled.

How big is the inevitable crash going to be? When am I going to crash? How am I going to go to the toilet over the next week? Am I even going to be able to go to the toilet? What’s my mouth going to taste like? Will I be able to drink water? 

Sometimes, I should spend less time worry about the answers to unknown questions and just let Myeloma take me for a ride. I mean, that sounds all very nice and tranquil and a creator of less worry knots. To be clear however, I would never complain about worry knots. If worry knots exist and you were to mention your own worry knots to me, especially after 10 days on steroids, there might be problems. Or at least some solitarily mocking.

I am digressing. I am constantly digressing and that’s because I am here to tell you what it actually feels like to take 238mg of Dexamethasone.  It makes your brain feel like fuzz. My mental recall, unless it is about episodes of the West Wing, is… well… what was I saying? At this rate, I am going to wish I had different friends. They are too learned for me right now.

Digressing again… I was right to be apprehensive about it. Prior to starting, I had already discovered that the Dex offered some pain relief in the 24 hours after taking it, but this was the only benefit I saw and I did not know for certain that it was the Dex that had made it easier to get around on that particular day. My immediate thought was that I was not going to be able to move for at least 10 days. At a push, I thought I would get through the first few days and then I would be a bedbound mess for weeks after, unable to get out of bed for a drink. Thankfully, so far at least, that has not happened.

Instead, the steroids ploughed me into a period of emotional instability supported by mass uncontrollable, US reality TV level of food cravings. It’s probably best to break it down. Wikipedia needs to update it’s ‘common side effects’ information because nowhere on that list did I see fatigue, constipation, tin mouth, facial hair growing  at the speed of light and tears, lots and lots of tears.

My first few days can be easily categorised as ‘the crying days’. Without the Dex, I dare say that I had some very valid excuses to cry, but on the Dex it was uncontrollable. My usual stoicism forbids this sort of behaviour and I have managed to install a usual system where my crying is done in the privacy of my fortnightly counsellor’s sessions or alone at the darkness of night.

I returned to the safety of Mamma Jones’s nest after the latest of my Bad News Day, and it was there, where I am surround by my immediate family, where I found a lot of things to get emotional about. I could feel that a full outburst was never far away and it wasn’t far away. Somedays, I cried just because the pain was overwhelming me. Other days, and these are the ones that surprised me, I cried in gratitude and in sadness and all of it was completely out of my hands. 
Something as simple as Mamma Jones bringing me my dinner. She cooked it, carried it upstairs to my room and served it to me every day. Almost every delivery resulted in tears, whether she saw them or not. The steroids made my insides come out. 

The worst part of my behaviour was around my nieces. Aged 5 and 10 years old, I do not know if they have an idea why they  Auntie Emma constantly breaking into silent tears mid conversation over the course of a weekend. It’s not something I chose to do, it was completely out of my hands and that is a testament to the power of steroids.

For the first few days, as I acclimatised and things sunk in, I just had to look at them and I immediately began to miss them. My brain would fast forward to that point in time where I once again won’t be there and I’d worry they wouldn’t remember me. Thoughts like that could come in an instance. Would I always be their favourite auntie (if I am indeed their favourite auntie) if they cannot remember me at all?  I asked the eldest if she would miss me, I know I shouldn’t have done, but my steroids took away the filter. Her answer was a ‘maybe’. So, bathed in love and not feeling remotely vulnerable, I cried again. The eldest was supposed to spend two days with me in London, and even the guilt at having to let her down had me blubbing. 

At my most confusing, at least what I imagine was the most confusing for them anyway, was a very innocent conversation about breasts or in our case ‘boobies’, that may well be ranked in my non-existent list of worst conversations ever. At the age of 10, my eldest niece is going through the changes girls go through. Her little sister enjoys this and proceeding to tell us that ‘Lara has little boobs, Auntie Emma has BIG boobs and I have no boobies’. That was it. That’s all she said. Even recounting said story makes my ears water. I immediately started to cry, not loadly, it was more of a silent, please do not see this, sort of cry. It was so innocent, but it highlighted how much there is for me to lose and I have absolutely no control over it. I think they rallied together, but I am pretty sure they had a few days of thinking that Auntie Emma was a total wing bat.

I expected the mood altering side of steroids to manifest itself into rage. Sorry, I meant RAGE! It did not. Even when two women complained bitchily to me that I had put my luggage in the wrong place on a train carriage resulting in them dismantling my disabled friendly bag set up lovingly done by Big Sister, so they did not need to lift up their own suitcases,  even then, the rage was nowhere to be seen. Instead, I apologised, returned to me seat and cried. I should have told them why I couldn’t move my luggage, or why they had just seen my sister escort me onto the train, or why one of the bags was full of prescription medication and another contained two empty specimen bottles awaiting 24hrs worth of my urine, or why I was free to travel in the middle of a week day. I should have done all or any of these things, but I didn’t. The steroids just made me cry and I am wholeheartedly ashamed of myself. 

Maybe that will come, but if it is anywhere near as strong as the tears, stay away from me. Actually, don’t stay away from me, the steroids make me paranoid and I do not want to feel like that either. Anyway, I cannot do up my bra at the moment, so I doubt I’ll be getting into any physical fights any time some.

I suppose the tears the could be neatly boxed under Wikipedia’s ‘depression’ section. I do not think I have been able to portray the weight of the feelings I felt. Just do me a favour and trust me when I say it was ‘bad’. Thankfully, as my dose has lowered, there have been less tears. I have been feeling far more aligned with my usual self and that involves burying my true feelings until I am alone or with my counselling. A healthy approach if ever there was one. 

All other side effects, possibly with the acceception constantly thinking I have glandular fever and excess facial hair, are concentrated around bodily holes. That is how powerful steroids are. 

If there is one thing that a pulse of steroids did to me that I was expecting, was to increase my appetite. A bodily hole. I dare not total up how much I have eaten in the last ten days nor how many calories have been consumed on pretty much zero physical activity. It’s a lot. Like, a bloody lot.  As I soon discovered, the Dex did not have me searching for all foods, just the bad ones. I know asparagus is good for you and I like asparagus, but a tin of mushy peas made a far better plate fellow with a pie.  Like I really had to explain that? 

Dexamethasone when taken in isolation and mixed with my body loves nothing more than carbohydrates. If said carbohydrates happen to be served fried, with butter or with a sprinkling of cheese,served with a massive piece of chicken, comes in a packet disguised as a crisp,  or as a cake then that was Nirvana. Fulfilling each craving felt medicinal.

Thinking about food beats thinking about death, but I have never known my desire to eat to be so all consuming. I’ll be honest, and this does make me weak, no ifs or buts, I gave in to every single craving. I’m sure a nutritionist might have a view on this, or just an opinionated person who eats a lot of greens, but I do not want to hear it. I know that it was bad having a bowl of frozen mash potato as a snack one hour before dinner, but I needed the instance gratification despite the fact I had only just finished half a tub of hummus and had porridge for breakfast. The four slices of Soreen that followed that dinner were also completely necessary and, unavoidable. It was treatment.

I know that I have had steroid cravings before, but this last week has been a whole new realm. I arranged a supermarket delivery on Saturday and on top of including foods that would keep me semi-independent, I ordered Skips, Wootsits, Squares (salt and vinegar), toffee popcorn, mini popodoms, boxes of cereal and a packet of bagels.
 The shame!

On Friday, I sent my friend on a quest to my favourite bakery in London to buy slices of my two favourite cakes in our fair land. It was all to satisfy a craving that started 24 hours before. On Thursday, I found myself on Tottenham Court Road with 90 minutes to kill between appointments. In theory, the cakes could have been mine then, but in practice, they could not be. Do you know why? Because I could not walk the 0.8 miles round trip to get them. I had to settle for a Krispy Kreme instead and I do not really like a Krispy Kreme. Oh, just to maintain some level of continuity with this blog, do you know what happened when I realised I was unable of walking to Konditor and Cook for my slices of Lemon Chiffon cake and a Curly Whirly? I cried.

As with anything that goes in, it must come out. Wikipedia definitely neglected to tell us about this. The only thing I will say on this matter, is sodium docusate. Sodium docusate and lots of it. My long experience in large doses of steroids does not support any argument towards diarrhoea. Steroids mixed with the pain medication I am on, causes the opposite issue. I prepared for this eventuality and so far, so every four days. Yesterday, my experience can only be classed as sublime.

Being on so many steroids also had me searching my brain for the techniques of years gone by. Again, this relates to holes. Linseed is a lifesaver, just don’t accidentally let a puppy eat it. 

Finally, no story of mountains of steroids would be complete if I did not mention the effect it has on my mouth. I used to call it Tin Mouth. I still call it Tin Mouth. I think I have listed enough life altering side effects already, but do not underestimate the impact of having everything in your mouth, including your salvia tastes like mental. Thank goodness nobody but my dentist gets near my mouth. Every flavour is distorted. No amount of ice lollies will get rid of it. My tastebuds are tainted. The weather this weekend was lovely, but I could not quench my thirst with an ice cold glass of water because such a thing would taste of week old unbrushed teeth mixed with pond. Thankfully, though probably not for my kidneys, steroids make me less thirsty than usual, but unfortunately one still needs fluids to function. People like me need fluids to take their 20-40 pills per day. The trusty brew is strictly off the menu. The only thing that tastes remotely like something I would want in my mouth is lemon squash. That was another thing I had to think about and prepare for. Squash had to be purchased.

👅🐽😭👅🐽😭👅🐽😭

I think you get it now. A course of steroids is no walk in the park. I mean, I cannot walk around a park at the moment, but it’s hard. The Dex, even though it is there to help, above all the other medications I take it seems, mostly to hinder. Nothing seems safe from it.  I would even go as far as saying I hate them.  I hate that I have to make sure I take it by 11am, even if I am too tired to make sure my stomach is full, so I can get a good night’s sleep. I hate that even though I have taken it early everyday, there have still been nights where the power of the Dex have overpowered the strength of my sedatives.

Most of all, I hate the unknown. I finish said course of steroids today and I have no idea if I am about to have one of those, all too familiar steroid crashes.  I have been preparing myself for this for 10 days, and it looks like it may not come.  Do I let my guard down?  It’s not worth the punt.

I will never live a life completely free of steroids. I may get to be free of them for the next week, but they’ll be back. They’ll always come back.  Dexamethosone goes with Myeloma like salt in porridge. They should always be served together. It’s an acquired taste. 

In conclusion, despite everything I have written, I am a liar. Despite previously willing this pulse to end as quickly as possible and for the steroids to depart my body,  I do not want to stop taking them in the short term. In fact, first thing this morning I called the  Medically Trained People ready to beg  them to allow me to  take more.  

I do not want to prolong the mouth, waist and emotional altering torment just to give me something to talk about. I just want my pain to improve. And at the beginning of last week, for 12 hour periods at a time, my pain improved. The Dex really did act as an ‘anti-inflammatory agent’. Last week, when I was taking 20 or 40mg a day of steroids, I may have been eating non-stop and crying at the sight of the dog, but I could walk normally. I did not walk like Quasimodo. The ‘pulse’ of steroids, designed to control my pain, actually did control my pain. I’ve weighed it up in my head. I will get more from the steroids right now, crash or no crash, than I would by not taking them. The radiotherapy is going to work, it’s just not going to work right away and I need some independence. I need to be able to clean the mushy peas I dropped on the kitchen floor on Saturday.

I never thought I would say it, but I don’t think I can do it without them. 

EJBx

P.S. I cannot think of steroids without thinking of the sign my friend made for me all the way back in 2012, that states ‘It’ Only Da ‘Roids’. She’s literate by the way, I think the use of ‘da’ was designed to make me smile.  It’s a thought I hold close. Through tears, shout, late night shopping and whatever else it throws at me; steroids are not my controller. 

Myeloma is.

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The Fear – Part II

You have stopped responding fast enough to traditional Myeloma treatments’.

Fuck. 

Few things warrant the use of such foul language, especially in the written form, but a ‘fuck’ or a ‘bugger’ is definitely suitable in the situation I found myself in last Thursday afternoon. I didn’t say it out loud; I was still able to maintain some level of decorum.

I think I know what that statement means. It’s not the worse news I could have received, but it is not far from it. It wasn’t what I was expecting. It is a polite way of saying that my treatment isn’t working. Not working. Stupidlyhow could I have thought my treatment was working when I was in so much pain? In fact, after my first full cycle on the recently licensed drug I was on, I told a Medically Trained Person that I did not think it was working. I wish, with every weakened bone in my body that I was wrong. I wasn’t. 

 Am I dying? 

I don’t think I thought all of this or processed it when I was in the Medically Trained Person’s office.  I was in shock and I was trying to hold myself together. I didn’t hold myself together. I couldn’t speak, not initially anyway.  The first words I uttered, did not sound like fully formed words. It was an explosion of emotion. I tried to say that I wanted my hip fixed but that became a sob about how overwhelmed I was with the news. That’s right people, in this circumstance, I simply chose to yelp ‘I am so overwhelmed!’. Then I sobbed. It was not a cry, it was a snot-producing, face-pulling sob that was softened when I saw the tears in the eyes of the Medically Trained Person.  

I haven’t had long enough.

Thank goodness for my Big Sister. I had no doubt that she would step up in this kind of  situation and step up she did. I think I had become deaf to what was happening around me. To me, everything that happened in that room was a blur, but she wrapped me up in metaphorical love and got on with what needed to be discussed. It could not have been easy for her. It is one thing to be afraid of something, but facing that fear head on, whilst holding somebody else up, is on another plain entirely. I know that it was not just my fear either. What is happening to me, what was said in that room, is a fear held by everyone I know (and happens to like me). I will readily admit that I lost control. For the rest of that afternoon I repeatedly tried to compose myself, but failed miserably. I didn’t know that tears could flow so uncontrollably. Nor did I know that I was capable of talking such complete and utter drivel. But, for the rest of that afternoon and evening, I had my sister sitting next to me, looking after me and discovering the many benefits of a banana milkshake.

Am I a failure?

Anyway, let’s move on from this emotional mumbo jumbo; we have some real business to get to. In a nutshell, despite three stem cell transplants and many, many rounds of treatment my disease is currently active and my paraprotein is on a rampage. It is so active that I have to have radiotherapy on the distruction it has created in my body. Whilst the drugs I have been taking including the one I changed to in January are doing something, the cruel circumstance is that they have not been doing enough. This leaves the question I asked just a few months ago, what else is there?

Is this the end of the line? It now seems an almost rhetorical question. 

I do not wish to bore you with the history of Myeloma treatments, largely because I’ll reveal how little I have chosen to know about it. I’ve been deceiving, most of you will know far more than I do on the subject. For where we are in my story, all you need to know is that new myeloma drugs tend to be derivatives of older drugs. They are related.  This means, in a shake-your-head, we’re-out-of-ideas sort of way, the Medically Trained People do not think that such medications will work on me for much longer. It’s hard to process that, I almost have to sound it out in slow motion. And then repeat it. And repeat it again.

There are too many things to say about all of this and I don’t have the distance or the benefit of an adequate pain and drug feee sleep to eloquently describe how I feel. I know I am angry. Since I was diagnosed, I did everything I was asked to do. Almost anyway, I haven’t lived in a complete sin free bubble, but I have lived and I have done what I have been told to do. I took my various treatments, I coped with the disappointment after disappointment and still, I get out of bed almost every day and take the pills I have been prescribed. Yet it has still gone wrong. I used to joke that given my age and the flocks of people trying to help me, that I was a medical marvel. I willed myself to be, terrified that I wasn’t. It now transpires that the only thing marvellous about my treatment history is in how powerful my Myeloma has been. Perhaps I should have gone gluten free as one nosy Parker once offered as superior soundbite.

I do not believe in any kind of divinity. I have nobody to prey to and nobody to blame. A stranger once told me that my lack of faith was the reason I had cancer, but let’s face it, there are a lot of knobs in this world.  When I add it all together, I just think something bloody awful has happened to me and no matter how much I have fought it and continue to fight it, it’s stronger than I am. Long gone is my bereavement for my lost children, old age and a picket fence. My fears now seem so much more urgent.

I don’t know why this happened to me, but for the last week, I have felt ashamed. I know that I did not bring this on to myself, even if I do love white bread too much. I do not believe that somebody’s willed for this to happen to me. And yet, I feel like I should have told my body to do more. Fight harder. Forget about being polite and smiling at everyone, I should have been a total bitch, constantly in attack mode like the scary army captain I met once in the cancer centre who made me cry when she announced it was her sheer willpower that caused her continued remission. I have willpower. I have multiple reasons to live, and yet I currently live in a world where I cannot do up my shoes.  

I should have reacted better to my medication and treatment plans. All those odds, all those odds and I was always on the wrong side. I’m angry that all of this is making me think about what this world will look like without me in it. I didn’t realise I have so much to lose. I watched my mum run around after me at the weekend, making me food and making sure my neck was adequately supported by my pillows, I listened as my nieces nervously tried to make me laugh as I tried to rewind my tears, as their Mum tried to keep us strong, and with every vibration, I could feel my friends trying to cheer me up or express their anger. I feel like I have let all of them  down. 

I made so many half promises about my treatment. This one will work. We will go on that trip. I can make it to that pub. Seeing the waves of broken promises scatter around me is my new definition of fear.

But what the hell is all of this? I cannot stop yet. I must not stop yet.

The Medically Trained People aren’t quite ready to stop and nor should I be. Last Thursday, when Big Sister’s concentration powers really kicked in, I was told of a clinical drug trial at St Bart’s involving antibodies. I could give you the medical blurb, but I think I should save that for a rainy day. All you need to know is that it is completely separate to all other treatments I have had. It might work, it might not, but the space on the trial could be mine. It took a few days, but I can now firmly say that I take back everything negative I have said against that hospital. 

A lifeline. 

It may sound foolish, given my very limited options, but the thought of leaving the comfort of UCLH once more added to my devastation. That hospital, in both my successes and failures have held me up. I have no other point to make on this subject, but it’s important. Ever the pragmatist however,  as I said last week, I think I said it anyway, if it is not clear to you yet my memory is a haze; ‘it is what it is’. I have to get on with it. 

On top of all that has come before this,  we had to discuss my need for radiotherapy. The practicalities. You can imagine how long this one clinic appointment felt. So much to take it in, so much to fathom. Ahead of last week, when I was suffering from worry filled sleepless nights, I thought the good and bad news hinged on the what was found in my MRI.  Clearly they did not, and now it seems easy to forget that I need some fairly urgent treatment. I have something in my neck that shouldn’t be there for crying out loud. And yet, the radiotherapy feels like it has become secondary to the ‘big news’ despite how quickly I have once again found myself increasingly immobile. 

I do not know if it is in the form of lesions or tumours or the generic term of bone disease, but I require treatment in my neck and my hip. The area in my neck has caused the majority of my recent problems in my upper back and my arms. Again, this may sound minor, but wondering why and how I have lost the sensation in half my hand for the last month, is a blood-curling. To even consider how the knee bone really is connected to the leg bone is mind blowing. If anybody has seen me move in the last month, you would have witnessed how much this pain has made me squirm. The pain and this is something that has not happened in a long time has been at a cry inducing level. I have cried not because I feel sorry for myself, I mean I have done that too, but because the physical discomfort has been so great.

It’s a juggling act though. As I am now due to start a new treatment at a different hospital, my doctor was reluctant to also zap (a term I have used a lot over the last week when discussing my radiotherapy, mostly because I can use an emoji) my pelvis. It may lower my blood counts and it will make me feel groggy, but even in the whatever state I was in last Thursday, I knew I needed my hip fixing. To get through my next, I have to be as fit as I can be.

I think it goes without saying, but the last week has been a whirlwind. It doesn’t feel like a week. In whatever timeframe I am now working in, and I guess it is a new timeframe now, I feel like my world has been turned upside down. I have so many things coming from so many directions, that I laugh at the meagre everyday complaints I have been able to read on social media. I used to think I was a great multi-tasker, but when it comes to affairs of my life, and the time that is left in that life; I do not have the foggiest.

I have to give myself a few passes. Firstly, I have been put on a ‘pulse’ of steroids, that is controlling my pain and will hopefully hold the myeloma whilst the Medically Trained People are doing their juggling. It is a ten day course of as much steroids as I can take. That’s right, ten days, decreasing by half every other day. It’s a well known fact that I cannot take a lot of steroids, but to put it into perspective, the first day’s dose was more steroids than I usually take during a full cycle on my old treatment and each weekly dose of that put me in bed for two or three days. I am awaiting for the inevitable crash increasing alarm and dread.

Secondly, I am currently on a lot of pain medication including sedatives. I basically rattle. 

Thirdly, I am once again struggling to look after myself more than I usually struggle to look after myself. I cannot bare weight in my left arm, my right arm is starting to go the same way and every activity, whether it is washing, eating or cooking seems impossible. In this mindset and the physical prison, I have to arrange my forthcoming radiotherapy sessions and attend the necessary testing for the clinical trial. And don’t think for one second, I have done any of that without my lipstick on. On Monday, which again is a story for another day, Mamma Jones and I spent 12 hours in London waiting, meeting new people and satisfying my steroid induced hunger. Today, I have seen a doctor, looked at some scan results, been measured and had two radiotherapy tattoos. 

Lastly, I just ask you to add everything up, consider everything I have said in this here blog and attempt to fathom where on earth I can begin. I have to begin somewhere after all. Welcome, to another volume in my possibly soon to be ended story of my life. 

To clear my head, Mamma Jones took me on an epic adventure to a National Trust property last Friday. I thought you might appreciate the evidence that I am still here. Getting out of bed.

So, there it is my current story. It’s not cohesive, it’s all over the place because I am all over the place. It’s new. It’s daunting. And my goodness, it is fucking scary. 

EJB x

P.S. Kudos, and I mean bucket loads of the stuff must go to my Medically Trained People and the NHS in general. In just seven days, they have seen me transferred to St Bart’s for (hopefully) the start of a clinical trial. UCLH somehow got my name into the mix of said clinical trial and St Bart’s seem to be moving whatever needs to be moved to accommodate me (no jinx yet though). They have also liasied with the radiotherapy department, resulting in an appointment today which included all my pre treatment measurements, ensuring that all areas requiring treatment are attended to. The treatment for which is starting tomorrow and will conclude next Thursday.  I have no more words in me to describe my gratitude.

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