The Annual Challenge

Once upon a 2013, I explained on this very site that every year I stay up to watch the annual Academy Awards https://ejbones.wordpress.com/2013/02/25/oscar-night/. 2017 was going to be no different. Myeloma or no myeloma, I would be fulfilling my annual challenge, maintaining a 19 year tradition. I do not wish to keep you in suspense, thus I can confirm that 2017 was no different to the 18 years before it and I did fulfil my annual challenge. 

And the Oscar goes to me!

That said, with each passing year with myeloma, I am realise that it is getting more and more difficult to complete my challenge. Last year, I had been released from hospital three days prior to the ceremony after a nasty bout of Influenza B. This year, as my previous blog covered in too much detail, I was exhausted after an uncharacteristically busy February. My Myeloma is a massive hurdle in this challenge, that only my sheer determination can overcome. I hope the day never comes where my determination is not enough.

You might wonder who am I actually challenging each February and why does it even matter? I used to think I was just challenging myself as a film fan, I don’t even know how or why it started. I don’t think I even considered it a challenge then, I was probably just happy Mamma Jones allowed me to stay up on a school night. It has now become so much more than that. It’s a tradition and if there is one thing I love, it’s a personal tradition. Just ask Big Sister whenever she proposes a change to our family Christmas meals. 

Not only are the Oscars now a passport to my former life, I now use them to challenge myself to rise above the limitations of My Myeloma. I have not dared to imagine how I would feel were I unable to stay up all night and watch a ceremony that in the grand scheme of things means very little and where I find the a number of the films lacking in both personal enjoyment and originality (cough, Hacksaw Ridge). Thinking about it now, without any hint of exaggeration, I would be devastated. I would feel like I had lost something. I would mourn.

Since my relapse last year, I am usually in bed by 21:00hrs every night, asleep by 22:00hrs unless I am experiencing drug induced insomnia or just the bog standard insomnia. Last New Year’s Eve I stayed out until 04:00hrs, but prior to that, the last time I had voluntarily kept myself awake past midnight (bar a handful of social occasions if I am being 100 percent truthful) was for the 88th Academy Awards on the 28 February 2016. Physically, the act of staying up all night is a feat of major endurance. Add to that actually following and retaining what is being said until 05:20hrs and you have what is now my equivalent of a marathon, albeit on my mother’s sofa with all the snacks my stomach can handle.

Back in my youth, which I now patronisingly see as my pre myeloma years, it would take me a single day to recover from staying up all night. Since my first ceremony with myeloma, I think I could add a day’s recovery time to each year that has past. I know that physically, staying up all night is to my own detriment, but mentally, well mentally, it makes me feel like I can sing for a year.

I cannot pinpoint when I started to try and watch as many of the nominated films as possible prior to the ceremony, that has not been going on for 19 years, but it certainly predates myeloma. It seems to have grown Year on Year too, with me watching more of the nominated pictures and completing more of the categories. You cannot understand the satisfaction I glean from completing a category, even if that meant having to watch Hacksaw Ridge and pay for the um, privilege. 

I completed 21 categories by the way. There are 24.

This year, just as staying awake proved to be more difficult, so too did finding the time, energy and finances to watch the films. Some people might think I have an abundance of free time, but I wager they have not tried to watch a three hour subtitled film whilst under the influence of chemotherapy and morphine. In addition to loom knitting 23 hats, going on a mini break to Amsterdam, attending a wedding, catching the flu and having two additional weeks of treatment on top of my usual treatment, having the ability to sit down, focus and follow the plot of a movie was hard. There were many days where I was incapable of doing it, resulting in a film heavy four days last week. To put this into perspective, over the last two months (as with every month) there have been many days when I have struggled to get up and cook a ready meal or even get myself a glass of water. I think this warrants calling what I do for the first two months of each year a challenge. This year, I am fortunate enough that I chose wisely at my other annual film related Challenge at last year’s London Film Festival.

I used to jokingly refer to Oscar Season, and it deserves to be capitalised, as an annual challenge. It doesn’t feel like a joke now. It is My Annual Challenge. I may laugh or look embarrassed when I tell people about it in case they think I do not realise it is just a meaningless and unfair system where a bunch of rich people reward and celebrate other rich people. I know the ceremony itself is not world changing, groundbreaking or profound; I do not watch other award shows. For me however, and I cannot explain why it is, it is important. It’s important to me. I don’t need to pontificate over the politics of it, the worthiness of the recipients or get into social media spats about any or all of the above. I personally celebrate my ability to watch the films in the lead up and then the ceremony itself acts as the conclusion of months of effort. Trust me when I say, it is most certainly an effort, especially in a year when something Clint Eastwood has directed is nominated.

When the credits roll as the sun comes up, my Challenge is complete and I do not want to talk about it any further. In fact, I find analysing it and any press coverage after the fact irritating. This year, I made a slight concession because of the slight ‘mishap’ at the end, but generally, I’m done. The Challenge is over. This blog seems outdated, note how I am not mentioning any of the winners.

Watching the ceremony feels like something I have always done, and I believe, I will always do. I genuinely fear a day when I cannot do it. The difficulties I faced this year, does give me some cause for concern. So far, the closest I have come to not watching the ceremony was last year, and I was prepared to discharge myself from hospital in order to do it. Like most things that create excitement in my life, this year, I had to peter my pre show enthusiasm in case I did have an uncontrollable need to sleep or unexpected health issue. My previous bravado saying it is something I’ll always do is wishful thinking. The truth is, I just do not know if I will always be able to do it. 

For now, knowing I have completed My Annual Challenge, I feel a certain level of contentment that I do not want to lose. In the last week, I have congratulated myself on more than one occasion. Naturally, I did not do it alone and I owe a great deal of gratitude to the two fine gentlemen who helped me along the way. 

Until next year then, I wish you all well in the cinema. 

EJB x

P.S. I may have completed the challenge at my parents’ house, but I was forced to deviate from my other Annual Challenge tradition when I discovered that Marks and Spencer’s had discontinued my Hickory Steak Oscar Night Pizza. I was outraged. I’m still outraged. Sure, I purchased a different oven pizza, but it was not the same. Not the same at all. 

An Almost Quarterly Update

You may be wondering, ‘what the hell has Emma been up to?’ I wouldn’t blame you if you are, my life is an unpredictable rollercoaster of super fun times that many people would wish to emulate. It is for that reason that I don’t keep my blogs up to date and not because I am too tired, stuck in my bed and unable to follow the plot of Pretty Woman… Sure, I can always dream. The closest my life could come to a rollercoaster would be the teacups, where one goes safely round and around  finding the occasional thrill within the monotony, let’s say, like waving to somebody you know each time you pass them as the teacup swirls.

I’m being  a little harsh. I had a jam packed February, one that has left me feeling exhausted, sick, frustrated, happy and satisfied in equal measure. It was jam packed for me, jam packed for somebody who spends at least two full days a week in bed and has 4 good hours a day on a good day. Looking forward to it, way back when in January, I thought my plans impossible. 

Before I explain my month of (relative) excess, I should tell you what is happening with my body. Spending so much time in bed, measuring time by cycles, I struggle to fathom actual time now, but for the sake of this story, let’s go back to November. I realised that my paraprotein level was no longer falling as quickly as I would have liked. The dastardly thing had started to plateau, which by January meant the Medically Trained People took as a sign that I should be on a different treatment regime. It had stopped working after all. It was a decision that made sense to me, but worried me at the same time. It may have plateaued but on the other hand, it was not going up, could a new treatment offer more?  

In all of this, I am unable to forget that myeloma treatments are not infinite. There are only so many treatments that exist and if I work through all the possibilities available at a 6 monthly pace, what does that mean for my longevity? 

I’ll let you think about that for a while, because I have been thinking about it for a long old while. Three failed transplants and another failed treatment; I do not think it is pessimistic to put two and two together and work out the obvious. Though, I imagine my nearest and dearest do find my arithmetic something gloomy.

On the other hand, I do not think it is healthy to dwell, so let’s move on. 

My new treatment was introduced at the beginning of January. Unfortunately, I caught Influenza A, which is a bog standard flu to the masses, but in me, it meant everything had to stop. It meant isolation and face masks. Points must be awarded to my CNS who decided to swab me after I fell asleep in the waiting area, despite my protestation that it was only a slight cough and I was fine. Catching it early meant that the anti flu medication worked, meaning it only took me a fortnight to get over the flu instead of the six weeks it took last year. I was also able to suffer from my own bed instead of a hospital bed, for which I am most grateful. 
As an aside, following this experience, I will inform the Medically Trained People of any new ailment as soon as I experience it. Well, within 24 hours later. Maybe 48 hours. What I am trying to say is that I will not try and manage it alone now, the consequences of a slight bug are not the same as they once were. I must use my common sense and being a martyr does not equal common sense as much as I think it makes me look like a badass.

So, I got over the flu and once my throat and nose had been swabbed once more, I commenced my new treatment. I am sure scientifically there is a difference, but practically there is not a great deal to distinguish between a regimen of Revlimid, Dexamethasone and Ixazomib and a regimen of Pomalidomide and Dexamethasone. I still take one of the drugs nightly for three weeks, with one week off. I still have to take steroids weekly and I still feel rotten as a result. On the plus side, I do not have to deal with the sickness caused by the Ixazomib. The downside is that I have not had a paraprotein result from the new treatment yet and thus, I do not know if it is working. 

The last month has made me pause to consider whether said drugs are working and that is not just because I am plagued by pragmatic pessimism. I am in more pain than I was in December. I hope this is a result of over exertion in February. The jury is out on that one.

I am not the sort of cancer patient who reads up on new treatments and overly questions the Medically Trained People. I have chosen to trust them, rather than invest my energy trying to find a better solution. Some may disagree with this approach, but that is how I manage. I only mention this because Pomalidomide has only recently been made available as a regular treatment in the UK and I did not know this. It makes me hope that there will be new drugs and combinations of drugs, that will broaden that scary finite list that I (and so many others) am a hostage to.

Prior to last week, I had been on constant treatment for five weeks instead of the usual three weeks and I could certainly feel the difference. It felt like everything about me from my brain to my toes had slowed down. I don’t think my recent fatigue was helped by starting my new treatment straight after the flu either. Just trust me when I say, it has been exhausting. 

Despite the dense fog of exhaustion where I found myself for almost the entire month, I have had an exceptionally time of it. My compromised body handled February pretty much the way I expected it to handle it. With difficulty.

I was honoured to be invited on a Stag Do, taking place in Amsterdam. Yes, a Stag Do. That’s positively normal behaviour for humans of my age. I thought long and hard about all the issues I would have to face, weighed up the pros and cons. Limited walking, early nights and limited energy compared with the 21 able bodied thirty somethings also going we’re definitely high on the ‘con’ list. All of it pointed to not attending, but where’s the fun in that? Giving in to it, no way Jose!

Inevitably I scrimped, scraped, borrowed and I went. That act alone felt rebellious. I also travelled without medical insurance cover for the simple reason that I could not afford  a £260 minimum spend for a three night trip. That wasn’t rebellious, it was reckless and it won’t be something I would dare repeat, especially to a location covered in snow and ice. I usually live in a world where I would not step out of my front door if there is a mild frost. It meant as great a release as my trip was, I could never fully relax because I feared something would go wrong. I had even planned a contingency of Mamma Jones driving over to Amsterdam to rescue you me, were something to have happened to me.

Prior to the trip, I decided that I would loom knit a hat for each attendee. If you were still wondering what I did for January and the first 10 days of February; the answer is hats, lots and lots of hats. Sitting on my sofa making hats. Dreaming about hats.  I think it was a project that whilst garnering a great deal of personal satisfaction for being able to complete such a task, it put me on the back foot energy wise before my busy February even began. I gave myself no time to relax because I was proving a point that did not need to be made. 

I won’t go through everything I did in Amsterdam. Just know that it was a tonic. A very large tonic. I never once had to lift my suitcase and whenever I left our accommodation I felt protected by a group of bodies who were almost as worried about me slipping on the ice and breaking a bone as I was. It is quite different going away with a group of friends then going away with one’s mother. If there was a secret test, my friends certainly passed it. In a nutshell, the only person to make me feel like there was something wrong with me, was me.

This computer in Amsterdam said I was Happy. It was correct.

Leaving Amsterdam, walking through the airport, I realised that my body had done all it could. I feel for the person walking with me to the gate as he was met with a constant whiny chorus of ‘I can’t walk anymore, I can’t walk anymore’. On returning to London on a Tuesday evening, I got straight into bed, took my nightly dose of chemo and my weekly dose of steroids and stayed in bed until the Friday. I had to leave temporarily on the Thursday to go to a meeting, but that required Marvel Studio-like strength and resulted in the most horrible feeling of weakness that had me yearning for my bed.

On that Friday, the one where it took me until 15.30hrs to have the energy to get out of bed despite my cleaner trying to change it, I was due to travel out of London for a wedding. For somebody that has four hours of energy a day, on a good day, this was a mammoth task. Gargantuan. I was not going to miss the wedding however, it was too important and I too stubborn for that to have been a possibility. Somehow, and I really do mean somehow, because I have no idea how I achieved this, I managed to pack, shave my legs and meet my friends at our car rental for 17.30hrs.

Once again, like in Amsterdam, I felt fully protected by the people I was travelling with. They were so considerate of my limitations, I felt like I was getting my energy through them. They drove me to my hotel, financed said hotel and just made the whole thing possible. It made it possible for me to watch a dear friend get married, with my body only giving up two hours before the wedding was due to end. Give up it did. With all the excitement, drugs and post Amsterdam fatigue, by 22:00hrs, talking was proving to be impossible. Walking, from an afternoon of standing and not putting my feet up, had slowed to a shuffle accompanied by constant pain from my pelvis to my neck. Unavoidably, having lost my ability to speak and most of my leg function, I had to leave.
This is me posing next to, I do not know what, at said wedding. 

Leaving early made me so angry. There are times when I tolerate my body, but crawling onto my hotel bed trying to make a nest of pillows large enough to ease my pain, I hated my body. I was embarrassed by it. I was annoyed that I could not speak to the friends who where there as much as I would have liked because my body had automatically switched to battery saving mode. Whilst in that mood, I also became irritated that the same rules applied in Amsterdam. I may well have got the most I was capable to get from it, but I did not get to experience everything on offer. Myeloma always makes me feel, even temporarily, that no matter how much I participate, that I am on the outside looking in. 

Fortunately in this instance, I took 10mg of Amitriptaline and I was able to have some resemblance of a reasonable night’s sleep. Waking not to a feeling of melancholy, but to a hangover mixed with pleasure that I was invited and able to attend the wedding, I forgave my body. It has not been forgiven yet. 

All my common sense tells me that when one is as deep into the myeloma journey as I am, I have to see these trips and experiences as a bonus. In February, I had two big fat bonuses. 

I’m paying for all of this now. On the Sunday I returned home, I got into bed, took my steroids and stayed there until the Wednesday. I then travelled back to my parents’ house and spent some more quality time in bed, feeling the burn.

Ignoring the puppy draped round my neck, I think this photograph sums up ‘the burn’ pretty well.

It is now almost two weeks later and I am still tired. I am always tired, but sometimes, just sometimes, I can pull a rabbit out of a hat and experience something different. 
Running throughout this whole period, in addition to my pill popping ways, I also completed my annual Oscar challenge. To quote an Oscar winning movie, I will ask myself when frustration kicks in, how do you like them apples? 

EJB x

Last Christmas

The following was written some time ago, but unfortunately, I live in a world full of germs and I caught Influenza A and subsequently forgot that I had written this blog, let alone that I needed to post it. It seems a shame to waste my ramblings; so close your eyes (then open them again so you can read) and take yourself all the way back to December 2016:

  🎄 🎅🏻 🎄 🎅🏻 🎄 🎅🏻 🎄 🎅🏻 🎄 🎅🏻  🎄 

You may think that Christmas was so last year, but as today is the 10th Day of Christmas, I think I can just about sneak a blog post about Christmas under the radar.  Plus, ordinarily I love Christmas, so it would be remiss of me after a year of blogging very little, to not recognise Christmas as it is a pivotal part of my annual calendar.

This year, things were different. I found it incredibly diffficult to get into the Christmas spirit. The Christmas spirit usually comes so easy to me. The drugs seemed to have sucked all the energy out of me, preventing me from participating in some of my favourite Christmas activities. Thus, going through December, I was not seeing combinations of red and gold and getting goosebumps, I wasn’t singing O Come All Ye Faithful in the shower. I felt nothing. I know what the main cause for my humbug was, and it opens one up to saying a crude but well timed joke about George Michael; was this, 2016, going to be my last Christmas? I’m not plucking this negativity from the air by the way, there’s a genuine (outside) chance that it was. With that seed planted, what Hope was there to have an innocent, Myeloma free Christmas? 

So, when it came to making my beloved Christmas cards, cards that I had designed and invested time and money into, and had been thinking about since September: I just couldn’t do it. For at least three days, I slept next to all of my craft paraphernalia convinced it would help me complete them. It’s a similar strategy I employed at university walking round with the biography of Menachem Begin for six weeks, hoping that it would go in via osmosis. It didn’t work then either. Comparing the feeling I had to university stress is apt. The enjoyment I was gained from this activity, had passed. All I felt was undue stress. 

I argued with myself for three weeks. You enjoy it, Emma! Pull your finger out, Emma ! Everybody is expecting them! You are a failure! That was one side, the other side just rolled over and fell asleep. It seems like such a mundane thing to get so upset over, but upset I was. Every year since I was diagnosed, I have made my own Christmas cards. Last year, I made and sent over 50. Was the fact I could not do them a sign that medically, I am detiorating or had the Grinch simply stolen my Christmas?   

I cannot answer those questions, but on top of not making and sending Christmas cards, I also failed to do any Christmas themed baking or make the additional decorations for my tree I had been planning for months. The weight of each of incomplete activity, was unfathomable. Is it really possible for me to have an enjoyable Christmas without all the planned activities I once deemed to be fun? 

I refused to give in. I sought any excuse for my humbug that did not involve Myeloma and the makings of a bad TV movie. It must have been somewhere. The search felt endless. Could my lack of festive feeling be due to my age?  That’s never been an issue before, so Veto. 

Due to financial restraints brought on by  not working and being on benefits , I was unable to buy many Christmas presents. Thinking about what gifts I can buy my loved ones and wrapping them up in a style to suit the recipients personality, has always been a Christmas highlight. But alas, that was no longer open to me. I found that I did not even have the energy to think about presents. 

What about work? I thought. My experience of working in an office is that during the month of December (and the back end of November) there would be at least one discussion a day about Christmas. Work drinks, family drinks, Christmas presents, wrapping; the talk was endless. Despite forcing myself to watch endless Christmas movies, perhaps my failure to socialise with colleagues, buoying each other’s festive spirits up day in day and day out was the cause of my sadness. 2016 also marked the first Christmas I had not been invited to a work Christmas Do since I was 14. 

Could that really be it? Had being forgotten by my work colleagues ruined Christmas? In short, no. Veto. I was invited to the Christmas party last year and chose not to go because I could not afford it, and I did not feel any the worse off. Like last year, my free time has to be used and planned carefully. I do not have seven days and seven nights to play with anymore.

It would also be wrong not to mention the level of pain I was in during December. I was in a lot of increasing pain, which on many a day, prevented me from moving. I don’t know how responsible it is, but my chronic pain was definitely guilty of ruining some of December. Upon return to my mother’s I discovered that I could no longer climb stairs without using both banisters. Yet another sign of deterioration perhaps?

Somewhere around the middle of December, coincidently, the day Rogue One was released, something strange happened. I uttered the words out loud that I was not going to be able to complete the cards, Mamma Jones told me it did not matter, and I began to relax. I really relaxed. My dear sweet Mamma lifted the weight off my shoulders at a most crucial time.  Socialising time. 

The 16 December launched four days of back to back socialising, which believe me, is now something very hard for me to do. I was suddenly busy and somewhere in that busy-ness, and laughs with my friends, I stopped dwelling. I stopped yearning for what once was and I began to enjoy myself. I smelt satsumas, mince pies and sang along to the Muppets. Finding my way out my slump gave me goosebumps.

And then, there was home. Home. Aware, at least I think they were aware, that I had been on a long Myeloma Downer, my family pulled out all the stops (at least I think that it was intentional). Christmas itself was marvellous. For the nine days I was home, Big Sister and her offspring were around for eight of them. I felt loved. The time went so quickly, that when it came to New Year’s Eve, I did not want to leave my family. For leaving meant that Christmas would be over and we might not know another one like it. 

Before I move on, anybody advising positivity, believe me when I say that I do not want my fears to become a self fulfilling prophecy. My fears are real and I cope with them by voicing them, much to the chagrin of my loved ones. I see things more clearly this way.

I did not intend to enjoy Christmas. I had been so worried that it was going to be my Last Christmas, that I was convinced I would find every tradition, every action, melancholy. Melancholy doesn’t cover it, I thought that every tradition, every action would rip my heart out through my throat and lay it bare for all the world to see. Thankfully, that did not happen. 

This photo clearly shows me unwillingly embarking on my journey back to London Town.

For me, our Jones Family Christmas worked so well because everybody, well all eight of us, was home. At no point was I stuck in the middle of nowhere with nothing to do. Between Mamma Jones, Big Sister and my neices, I had plenty to do. We did things together as a family and had family fun; I wanted to bottle the feeling up and savour it. 

I do wonder, with the benefit of a few days of hindsight, if it is possible to have a Christmas without the feeling that it will be my Last. Should I have just saved this blog for next Christmas? It’s the unknown. Everything from here is unknown.  I do know that things are changing, I can feel it in my aching bones. I was aware as of the 22 December that my treatment is going to change at some point in the near future, meaning my current treatment is failing. We are running out of options. Another daily thought that added weight to this theory of doom. 

I spent my New Year’s Eve with some friends, doing things that adults do like watching Jools Holland, eating nibbles off paper plates and playing board games. Somehow, I managed to stay out until 4am. I don’t think I did that for all of 2016. To fast forward, I did not have a hangover on New Year’s Day. A success by no stretch of the imagination. 

For the evening in question, I had managed to surround myself with good people and there were a few times during the evening that I could feel that hand approaching my heart again, ready to detach it from my body. I really am full of emotions these days. I don’t want to repeat earlier paragraphs, but essentially high from my visit home, now surrounded by friends I love, I wished that this was not my last New Year’s Eve. 

Despite being asked the question, I did not make any resolutions for 2017. I do not see the point, not for me anyway. Every time I was asked about resolutions or plans for 2017, my answer was the same. I do not want to make noticeable  changes. I want to keep on living. I want to be able to do what I am doing, maintain my freedom.  I want to enjoy my friends and my family. Most of all, I want to be able to make the most of my good days and get through the bad. 

Perhaps these are resolutions after all. 

And this is where the writing stopped and the flu took over. It took over for a whole fortnight, marking a great start to 2017. I know what caused the flu (New Year’s Eve) and who the culprit was (Nameless). I still would not trade NYE’s, despite the vomit and general foulness of the flu. I was ‘living’, right?

EJB x

Thumbs Down 👎

WARNING!

The following blog does not contain any references to feelings or death (bar a brief discussion about my hatred of something). Therefore, to break out of my current cycle, this blog is not depressing. My usual content will resume at some point, so in the meantime, sit back and enjoy reading something mundane. 

👍👍🏻👍🏼👍🏽👍🏾👍🏿

After living with Myeloma for 1589 days, I thought I had experienced every possible side effect, bowel issue, general irritant and injury possible that relates to this wretched disease. Yesterday, I discovered that I was wrong. Things can still happen as a direct result of having Myeloma that I can not foresee. Yesterday, my unforeseen injury was paper cuts. Those small things. That’s right, for nearly 48 hours, in spite of my current inability to walk up or down any stairs without clutching on to both banisters and leaving the sound of what some would consider to be very odd sex noises in the air, whenever and wherever I do something remotely ‘strenuous’; I have been moaning about paper cuts. * For the past 48 hours, all of the above pales in insignificance to the paper cuts, the bleeding paper cuts I received all in the name of Myeloma.

👎👎🏻👎🏼👎🏽👎🏾👎🏿

How could this possibly happen I hear you cry? How could I, Emma Jane Bones make such a Living-with-Cancer -rookie-error, that resulted in the breakage of two thumb nails and cuts to the skin between the nail and thumb, on both thumbs at the same time? 

The answer lies with tablets. Lots and lots of tablets, technique and a dash of poor post application of gel polish nail care.

👎👎🏻👎🏼👎🏽👎🏾👎🏿

I dread to think how many tablets I have taken over the 1589 days, I wouldn’t even know how to calculate it. As a rule of thumb, I work on a fortnightly basis instead because sorting my medication is the most depressing thing I have to do on the regular. I do not want to be reminded of my shackles on any basis, but having to do it twice a month beats having that feeling it evokes four times a month. On a far more practical level, sorting my drugs in bulk creates space. Yesterday was Drug Delivery Day, so I was in desperate need to make the packaging of two bags full of drugs, disappear. I live in a room in a two bedroom flat in London;  the space is too limited to include cancer medication and the unnecessary packaging that comes with it. I ” have two dossette boxes, should I live the dream and get four?

I currently take at least 33 pills a day. My weekly pill total has 245 pills destined for my gullet, which takes into account the extras medication requires for Mondays. That’s 492 pills per fortnight; that is 492 individual pills removed from a box and then pushed out of its packaging into the relevant divided section in my waiting dosette boxes. 492. 492 times I pushed one of my thumbs against the slab a pill willing it to come out of it’s packaging before the top of my thumb hit the empty casing of the plastic. I probably failed 491 times. With each push, I  added further injury to my already injured thumbnails. I should have known better. 

Yesterday, I also receieved over 300 of my prescribed laxatives spread across at least six different boxes. It’s been a while since I mentioned it, but know that this is medication js still extremely cruicial to my wellbeing. Being the Myeloma Pro I once was, I decided to decant these into an old empty, correctly labelled,  medicine jar I had kept for such an occasion. That’s one of my Top Myeloma Tips by the way (in modern times, it could also be referred to as a ‘hack’ but I am not modern nor am I a Buzzfeed article). Who needs boxes when you can have a clean and empty medicine bottle with a safety cap? As usual, I’m digressing, back to the story at hand; it simply meant there was approximately 300 pills on top of the 492 pills to be popped.

It becomes grey. At some point during my  hour of drug dispensing, I broke both my thumb nails. As my legendary stoicism lives on, I  too, soldiered on in spite of the pain. I kept going, despite my thumbs turning more red with every push. I endured. I thought it couldn’t break me. Then I saw the blood to accompany the stinging feeling that had been going on for a good thirty minutes and I saw my surrender. I turned to Housemate and asked him to sort out the remaining laxatives.

Quick sidebar, can you see why I hate the job in question? Obviously you can. I have developed a coping mechanism to get through it all. There is only one pleasant thing about filling my boxes and believe it or not, it’s the colour combinations of my medication.  Stick with me. At nighttime, I take a blue pill, one bright orange , two pale yellows, two bright yellow, two grey, one pale orange and several white pills of varying shape or size. Once safely tucked into their relevant sections, I look at them through cross eyes. It’s hashtag satisfying. 

EJB x
* This really just means any movement greater than holding my mobile phone with rested elbows and tap, tap, tapping away. Anything else, results in a noise and a grimace.

Election Night

Tonight, as most of the world is worrying about what the future holds at the hands of the US Presidential Election, with commentators pawing over the the poll results hypothesising whether the world is about to come to an end as we know it,  I thought it may be an opportune time to talk about me. That’s right, through no fault of my own, my priorities do not have a bigger picture. Sure, the national election in a country I do not live in is a tenuous link to a 32 year old multiple myeloma suffer, but bear with me. I’m really going to try to make this work. If worst comes to the worst, I can describe one of the candidates as a cancer. I’ll try to avoid such a cheap shot.

Anyway, why worry about global future when there is my life and my future to dissect? Both situations seem equally ridiculous. 

News channels are running constant, inescapable coverage and have been doing so for weeks ahead of the election. As I type, my TV is a sea of red and blue. I may be on a much smaller scale, but I too, am stuck with a 24 hour analysis of my situation. Similarly, my own analysis more often than not, is far from impartial. Most tellingly, I am bored of it. I think there are many people who feel the same about this election.

Since I relapsed all those months ago, my feet have not touched the ground. Not because I spend at least 60 percent of my time in my bed, but because I do not feel like I have been able to catch up to my diagnosis or my prognosis. Actually, I do not know what my prognosis is, for that, I can only forecast. For everything else, I have been led, pulled and forced in to whatever direction my drugs want to take me and it is exhausting. I am exhausted. I am exhausted of having little to no control over what is happening. Never, have I felt more that my body is not my own.

I went straight from relapse into treatment and prior to my relapse I was trying to return to work. I was tired already. Between appointments, phone calls, financial ruin and paranoia, there was no time for me to process this particular relapse. Now I am stuck in this treatment cycle. I do not have the energy to process. How could I, when there are many days when I do not have the energy to wash, get out of bed or remember to drink? I need to breathe. I need air and lots of it.

I did not expect my relapse and my triple cocktail of treatment to be difficult. I have done it before, I thought. This time round it feels different. I do not have sufficient days to refill my Good Cylinder* to get me through my dark days because the dark days are plentiful. I previously said that I do not like Mondays, but the truth is, as the cycles go on, I don’t like Tuesdays, Wednesdays or Thursdays either.  The more cycles I have (I am now coming to the end of Cycle Five), the harder it is for my body to cope.  I might have two reasonably good days, providing I remain infection free, per week during my three treatment weeks, with one weak off at the end. Entering my flat on a Monday and summoning the strength to leave on a Friday, is a common occurrence.

‘Tired’ is a word that I use far too often. It covers a multitude of sins.  I will talk about my tiredness to anybody who asks. I need a better abjective, because ‘tired’ does not do it justice. I seem to remember that I used to be quite interested in things, I used to regularly up date this blog, I listened to music and I also used to laugh. It is rare for me to muster up the energy to do any of these things. An outsider looking in may feel differently about that, but that is the overwhelming feeling I take from my last few months of apathy. 

Perhaps I do not help myself? I do not answer my phone. I make plans to write a letter or an email and three weeks later, I have done neither. I start things, but unless it is a Killer Sudoku, I do not finish it.It’s not because I do not want to, I just cannot bring myself to think. Never underestimate the power of thinking. Not being able to do it is surprisingly stressful.

The truth is, I feel so lonely. I think what I feel is loneliness. I don’t feel lonely because I don’t have anybody around me, I feel lonely because I do not think it is possible for anybody to understand just how hard I am finding this existence. I had not choice on this. How can anybody understand the level of isolation? My friends are off doing things that people my age do, I struggle to make my dinner (if I can make my dinner). A friend suggested internet dating. The idea of internet dating as some sort of cure to my lonelinesss, just reminded me that I am living with an incurable cancer, which I have had for four years and there is an invisible clock on that, I am barren, I have no money and I can comfortably leave my flat for three hours twice a week. How would that work? Have I given up? 

All of this is what I have had time to think about over recent months. I’m no fool. I use tools to try and manage these thoughts and I talk about it with loved ones and the Medically Trained People. I know what I need to do, but like I said, I am exhausted. The more tired I become, the harder it is to fight. And a fight it is (just like the Election, I hadn’t forgotten about it). I’m fighting the cancer, the medicinal side effects and my physical and mental incarceration. I am confident it is not a losing fight, but there are days when I am defeated. I never thought I would feel this way, but there have been occasions when I vocalised a wish to die that I do not have. 

I never really considered dying before, but when my Good Cylinder is depleated, my quality of life has no resemblance to my pre Myeloma life, I don’t recognise it, and I feel utterly, utterly helpless through fatigue, nausea and Chemo brain. I would not be human if I did not think of an alternative option. I feel so weak and so guilty for thinking it, let alone saying it to another human being. I am alive. I know I need to celebrate that, but sometimes, I am just too fucking tired. 

I can argue both sides of this argument all day long. Flip the coin and there is strength to be found every time I move on from those thoughts. I campaign (get it) for more positivity. My paraprotein is going down. I plan events on my good days. I was even able to attend my annual treat, the London Film Festival 15 times in nine days through sheer determination. I occasionally allow myself an acolohic beverage 🍺🍷for something I call party time. I never forget that I need to be in bed by 22:00hrs.

Unfortunately, all these things do not give me what I need. I need a break. I am at a point where I just need to step away, so I can come back strong enough to cope with my treatment. I know that sounds like I swallowed a new age guide, but despite having a eucalyptus vaposer in my bedroom, I have not. I just need to take a break from the status quo. I’m sick of my status quo. I feel trapped. I, like so many people with this election are disaffected. 

Like this election, my life is unfathomable. I sometimes imagine I am an outsider looking in or I am in a bad Hollywood movie. People will wake up tomorrow and they will have to adapt. I am trying to do just that, unfortunately, it is much easier said than done. As I am learning, a the pace of a snail carrying a tortoise,  you can’t always get what you want. 

Well, I do. I go on my first holiday in two years on Sunday providing nothing bad happens. It’s not a cure, it’s not incorrectly counted ballots, but it’s something. It’s a break and a brief taste of freedom. Maybe that is why I am awake….

EJB x

* The Good Cylinder has an opposite called The Bad Cylinder. They are constantly vying for my attention. You may have guessed that The Bad Cylinder has been winning. 

The Sweet Spot

I was tempted to entitle this blog ‘My Life Lived in Fear’, but after some reflection, I decided that some could perceive that to be melodramatic. That said, I am prone to a dash of daily sensationalism, so I couldn’t not tell you. The blog’s working title concisely and accurately summarises this current stage of my life. I am left in no doubt that if somebody were to make a mediocre biopic about my life, it would be described as a paranoid melodrama. I am constantly, metaphorically, looking over my shoulder readying myself for when the other shoe drops. Since August 2012 so many shoes have fallen out of sky, walloping me on the head during their decent that not expecting another dreaded, earth shattering wallop is impossible. Unlike the previous shoes, the next one will be the last one and most dreaded. The next one will to be steel capped. 

Wait, I am getting ahead of myself… 

March and April seem to have past me by in a post flu, get my life back on track sort of haze. March was taken up with such intense fatigue that I really did not notice the month passing. I felt things improve in April, celebrating when I realised that I had managed to spend nine consecutive hours not in my flat, and survived. Progress, I thought. 

Medically, as far as I am aware, I could not have asked for a better response to the transplant. It is difficult for me to write those words, as they are words that really ought not to be uttered.  I do not want to tempt fate. Five weeks ago, after inspecting my results and my mouth, a Medically Trained Person said that I was in a “Sweet Spot”. For those of you not in the know, this means that I have just the right about of Graft vs Host Disease and my results are good. My initial thought at his diagnosis, was panic. He’s labelled it in such positive terms that he has invited things to go wrong. 

Two days later, I pain in my left ribs suddenly appeared. A familiar pain, one that I wished I would never feel again and one that interrupted every possible human activity. I’m not ashamed to say that I panicked at this development. My active imagination was half in denial and half reconciling myself to the inevitable. Except, it was not the inevitable. It was not a broken rib caused by the return of My Myeloma; it was a suspected pulmonary embolism. Two nights in the hospital, two x-rays and a CT scan later, the Medically Trained People found that I had a chest infection. Another infection! Another week and a course of antibiotics later came with the diagnosis of pleurisy, which they say, was probably brought on my February’s bout of influenza. 

A reprieve. 

A reprieve and a lesson to me not to always think the worst. And yet, those thoughts are never really far away. It’s a daily battle. I do not want these thoughts to be so readily available to me. I do not want self pity to be my constant companion. 

I am working on it. 
In an ideal world, I would be able to enjoy the Now and not worry about a depressing future. My world is not ideal and there is another side of me that feels torn.  I do not want to be underprepared. I described it to my counsellor as a form of self preservation. Before my last relapse, I let my guard drop. I was back at work, I had planned something more than a month ahead and I did not see it coming. I was devasted. My relapse was life changing and it’s consequences went far beyond the physical. Devastated.

Like I said, I am working on it. I do not want this to become I self fulfilling prophecy. I dread the idea of somebody telling me that I brought it on myself by not thinking positively. To people who may think that or have other pearls of wisdom, I say to you, live it. Live the past four years of my life and then tell me how I should feel. Evidently, this is a touchy subject. Even these imaginary conversations make me see red.

Relapse is my main concern but it is not my only hurdle. I went for over three years only being hospitalised for diagnosis and transplants. Sure, there were a few trips to A&E in between but my overnight stays were limited. Now, I have been admitted to hospital twice in a six week period. How will this develop? Will I end up missing more birthdays and Tuesdays in my future because I have a weak immune system? You betcha. It’s an unpredictability that means that my immune system is not the only thing about me that is weak. 

In an attempt to turn my frown upside down and reduce my worry lines, I spent two weeks trying to get as comfortable as the bed of nails allows. I really did, and then there was another incident that irritated my paranoia. Enrage my paranoia more like… It was an incident that led to me vocalising my worst fears and led to my family revealing to me that my worst fears are theirs also. 

On a Wednesday, I attended my now three weekly appointment at St Bartholomew’s Hospital. At these appointments, they take my blood and my pee and chat to me about my previous results. At this specific appointment, I explained that I could now move without experiencing horrific pain and the Medically Trained Person reduced my dose of steroids; drugs I am given to keep my GVHD at bay. It was a positive 15 minutes, despite the frantic worry I experienced before it when I was told that my appointment would not be cancelled as a result of the Junior Doctor’s Strike. My pre appointment fuss went something along the lines of why didn’t they cancel this appointment when they cancelled a previous appointment when the doctors were striking.* Why? Clearly there is  something in my results that they need to discuss with me. Then cue, no constipation worries or sleep the day prior to my appointment.

I left St Bart’s  happy. The next day, a Thursday, I had my three monthly appointment at UCLH. A cause for excitement if ever there was one. Approximately an hour before my appointment, I received a phone call from a secretary at the hospital telling me that I had to go in for an appointment. In her confusion, she said I had to come in because my doctor at Bart’s had phoned to speak to my doctor at UCLH to discuss my results and those results had to be discussed with me that day. I took a deep breath and all those thoughts I had been fighting to not have, pounded out from the rock I had hidden them under and sheer, all consuming panic set in. It was a sweaty, shaky, two and a half hours of utter dread. This is it. 

When I eventually saw the Medically Trained Person, I had already explained to another how I felt. I was almost manic. I discovered that the Medically Trained Person from Bart’s had indeed phoned the head of UCLH’s Myeloma department to discuss my results. He had phoned to tell her how happy he was with my results. In short, he had phoned her to boast about my results. To boast! It took more than one exhale to get over that. In fact, nearly two weeks on and I still think I am recovering from it. 

Never in my wildest dreams did I imagine that the reason behind that phone call was to boast. I thought the worst, like I apparently always seem to do. A revelation that brought along it’s own set of neuroses. 

According to my counsellor, all my feelings are normal. I take some comfort in that. Remission does not mean that I am free, but I know that it also means that I should be able to let my hair down occasionally. It’s not long enough for that yet; I’m not a superhero. All I can do is try and my sanity needs that. My new management technique involves scheduling in time for the bad thoughts and then to banish them until the following scheduled time. I have chosen to do this on my commute. This is my commute. 

And this is my Sweet Spot. It’s a chemotherapy free, work in progress.
EJB x

Man Flu

“Post transplant, you’ll have a weakened immune system”

😷

Quick! Live in a bubble to protect the weakened immune system. The thing with a weakened immune system, even when I am told that my blood counts are misbehaving,  I cannot see or feel any evidence of supposed misbehaviour. My knee bone is connected to my thigh bone, but how is my immune system connected to the stranger who coughed as I walked past them last week? I can feel my back pain, Graft Vs Host Disease and my daily bouts of nausea. I can care about those things because I can see how it all connects in the world of My Myeloma. I take a pill and the pain reduces or if I walk too far, the pain increases. What makes one person with a sniffle the epitome of mortal danger when a person with a passing cough is a mere annoyance? 

A weakened immune system means I am more likely to catch bugs and sneezes than a healthy person. I apologise for stating the obvious, but sometimes, I need the reminder. It also means that once I catch a disease, it takes much longer than I would wish and expect for my body to fight it. An added disadvantage of getting one of these spread diseases is that my body might not even be inclined to fight it. Instead, it might just welcome a few other dirty friends into my cosy camp of a body and then I’ll be stuck spending the next few weeks being reminded that there is a reason I am prescribed two inhalers.

Regarding my immune system, I might not give it too much attention, but I do what I am told. I do not go to public swimming pools and lick the tiled surfaces and I will not eat without washing my hands. I avoid public transport during rush hour and I avoid touching people if I know they are feeling unwell. That said,  my concessions to my immunosuppression has their limits. I am sensible yes, but I refuse to walk round with a surgical mask and gloves on.   
My theory on this subject is that exposure to some germs is good for my repertoire.  Also, I want to live a reasonable life and living in constant fear of the common cold is  not normal, and seriously, how dangerous can a stranger’s cough be? 

The answer to that question is, of course is ‘quite dangerous’. I have discovered this the hard way. To my embarrassment and severe frustration, I have recently discovered that despite not being able to feel it, smell it or even notice it, my immune system can bring my life to a standstill. What started off as a cold, has brought my life to a standstill. 

Approximately 21 days ago, I developed a light sniffle and a sore throat. Two days after that, I experienced a few days of sickness and diarrhoea. The latter are not out of my ordinary, so I assumed it would pass soon enough. A fortnight ago, with my bowel seemingly back to normal, I spent my weekend suffering from lethargy, a loss of appetite and what appeared to be a throat full of knives. Every day, I would convince myself that I was improving. 

After 10 days of feeling slightly rotten and once again, spending too much time in bed,  I thought I best inform the Medically Trained People. The symptoms I had, could have been an infection or Graft vs Host Disease, so I thought it was about time I was sensible and got a second opinion. I loathed the idea of a second opinion. If I did not have myeloma and if I had not had three transplants, I could have just moaned about feeling poorly until I did not. Maybe I could have talked my friends through the varying colours of my sputum on Facebook. I would not have had to go to the hospital for tests…

The following day however, I did just that and took myself to St Bartholomew’s Hospital for tests, because I do have myeloma. Upon arrival,  I christened the building with some red tinged vomit and was informed I had a temperature of  38.5. I was poked, prodded, x-rayed and I was told that I was going to have to be admitted and given intravenous antibiotics as a precaution. I thought it was all a complete overreaction, so I bartered with them. I got the Medically Trained People to let me go home, after I had some fluids and antibiotics, and all but pinky swore that I would come back over the weekend if it got worse. I promised them that I was a very sensible person and I was most definitely capable of looking after myself…

… It turns out, I am a liar.

That Friday evening, I got home shortly after 18.00hrs, climbed into my pyjamas and then my bed and I did not get out again until Monday morning. The only times I did venture out of my pit was to run to my bathroom and produce some vomit that contained blood. I drank and ate nothing. On the Saturday, the hospital called and told me one of my tests had come back and I had Influenza B. Proper flu. As I had the ‘official’ flu, I had to come in the next day to collect some medication. Sunday morning came and I could not get out of bed. Housemate said it was pathetic. I did not need him to tell me I was being pathetic. I really could not get out of bed. Who knew the flu could completely floor me? I have had transplants, I should have been made of sterner stuff than that. 

It’s just so ordinary.

😷

By the Monday morning, I had drunk less than a litre of water since Friday. I was groaning. Literally groaning. What had started out as something small, something I did not want to make a fuss over, had somehow become something that required actual, real life, medical attention. Seeing that simply willing myself to improve was no longer working, with Housemate in tow, I made my way back to St Bart’s. I had an appointment I failed to brush my hair for, let alone source lipstick for. I did not not look my best. The lack of hydration had caused my lips to crack and the inside of my mouth to bleed.

To cut a short story even longer, we went on to see a Medically Trained Person who looked at me and simply said “oh, Emma” and promptly told me that I was going to be admitted. I had lost over a stone in a fortnight. I was transferred to a private room on a ward. And in that room I stayed for four days. I vomited more blood, I had several bags of fluids and I rediscovered the joy of Mackie’s vanilla ice cream after the anti sickness tablets had kicked in.

  
Apparently, it was necessary for me to be kept in isolation. I did not see a member of staff who was not wearing a surgical mask for the length of my stay. The flu had not only taken me down, it had heightened all my GVHD symptoms. It meant more drugs, more waiting and more lost days. Wasted time, spent alone in a hospital bed. Bar an hour a day, my only company was my laptop and the faceless staff who interrupted my sleep.

I have been out of hospital for five days now, and I am still a pathetic little weakling. I am still embarrassed and angry that I have a body that required hospital admittance for the flu. I resent the fact that even though I am out of hospital, I have been told it is going to take a few more weeks for the infection to go. 

To put my frustration into some sort of perspective, Big Sister experienced a similar illness to me at the same time. She was coughing and sleeping and generally feeling unwell. Sound familiar? Like most otherwise healthy people, she went to her GP and was prescribed a course of antibiotics and was sent on her merry way. I’m jealous that that was her experience compared to mine. In addition to my hospital stay, I required two chest x-Rays, daily blood tests, multiple bags of fluids, nasal and oral swabs, two different types of antibiotics, an inhaler, thrice daily nebulisers, steroids and ice cubes.

😷

It’s experience right? Hospitalisation for the flu will one day be a funny anecdote I can tell my friends’ kids about. When I tell it, I’ll leave out the part/s about me feeling sorry for myself that at the age of 31, I am considered a vulnerable person who cannot tend to herself. In the future, my story will also include something about being lucky that the NHS cared for me and, with acknowledgment to my stupid weakened immune system, an awareness that it could have been much worse. There are many people, far braver than I, fighting seemingly unrelated side effects of cancer as I type and you read. 

We might be lucky enough to get a remission, but, having ‘cancer’ never reallygoes away. 

😷

EJB x

Please note that real flu and a cold/other bugs are very different beasts. The memory is raw, liken  them in my presence at your own risk… My cousin said they always say the difference between real flu and a cold is whether you would get up to pick up a £50 note! Take that with you.

My Mouthful

The way I envisaged my Graft Versus Host Disease to materialise is, surprise, surprise, not the way it has actually presented itself. I imagined and hoped for weight loss inducing bowel movements and feared organ failure. Not once in all the scenarios I fretted over for I don’t know how many months, did I consider the possibility that my mouth would be the unlucky cavity awarded the honour of being infected (if that is the correct terminology) with GVHD. Not once. Nor did I realise when the first ulcer appeared, just how annoying having a painful mouth can become.

Do you know what I have learnt since my mouth turned beige? Throughout the course of a day, I use my mouth a lot. A hell of a lot. 

My cheeks are swollen, my tongue is raw and my breath is lethal. Food collects in significant lumps in the corner of my mouth, requiring a rinse or five every time I eat. Gone is my ability to swallow 10 pills in one go and going is my ability to have a gulp of water without getting half of it down my top. In, is a gentle dribble from the right hand side of my mouth and cracked lips. Delicate flavours are currently lost on me and my beloved  English Breakfast Tea now tastes like soil. I am told by the Medically Trained People that this is all very common, as is an inability to take anything hot and an extreme, almost comical aversion to chilli. 

To top all of that off, it is just plain old ugly. 

   
 
It has been over four weeks since my mouth was inspected by somebody other than myself, and I have been put on a frice daily cocktail of three mouthwashes. Yes, three mouth washes, each to be done four times a day. Even for somebody who spends as much time indoors as I, this is a difficult regimen to adhere to. The mouthwashes forming the triple cocktail are called Doxycycline (an antibiotic) Betamethasone (a steroid) and Nystan (a milky substance that tastes like a hangover). They are absolutely revolting. They taint everything. One day, I had to gobble a packet of Crispy Bacon Wheat Crunches as a palate cleanser. I suspect there are healthier options. 
For the first two weeks, I meticulously did each mouth wash making sure I swirled the Doxycycline and Betamethasone for two to three minutes each. Over the course of the day the whole thing took just under an hour. An hour! Who has an hour for oral hygiene? At my follow up  clinic appointment 18 days after I was prescribed the drugs, I was informed that it was called a ‘triple cocktail’ for a reason, meaning the drugs could be mixed together. Brilliant. A great time saver, but one that tastes rancid. Not only do they taste like something one might bring up on a morning after the night before, they also look like it. 

 Appetising 

As is clearly evident, I complain about my mouth all day every day. My intellect has led me to believe that this is because I use my mouth all day every day. It is also something new. I have experienced many a horrible thing on My Myeloma journey, but this GVHD malarkey that has manifested itself in what is essentially oral thrush, is the most irritating. It’s not a broken bone, it has not caused severe mobility issues, it’s not fatigue and it is not an incurable cancer. It’s trivial.

I know it is not actually trivial. The mechanism of GVHD with its very fine line between good and evil is a science that goes far above my head. It is also a lottery, and so far, it looks like I got the bonus ball. I wanted this necessary evil, I guess, just like everything else it is going to take some adjustment. 

👅👅👅

EJB x

Grafting

Four weeks ago, 31 days ago to be precise, I swallowed what *might* be my last ever Ciclosporin tablet. It was a noteworthy moment. It was more than that, it was a milestone that warranted me taking a badly lit photograph to commit said moment to my iCloud memory. 
 
It was a milestone that was a long time coming and one which came with something I have been yearning for. It came with a deadline. At least, it came with something that is as close to a deadline as I can get. If I learnt anything last year, definite deadlines and timescales rarely exist in the weird and wonderful world of myeloma. So, when the Medically Trained Person said that if I was going to get Graft Versus Host Disease, it would happen within six weeks of me coming off the medication, I finally had a date in my diary. Additionally, as you do need to get all the relevant information, I was told that within the six week window, I would be most likely to show symptoms at the two week mark. 

If the odds were ever in my favour, I had an unpredictable Christmas ahead of me. I had something that could almost be called a plan. I had my date. A date to look forward to and a date dread. At least, that is how I felt for the first fortnight.

Four words have been stuck in my head and followed my thoughts from the moment I knew I was going to have a donor transplant. Graft Versus Host Disease, known as GVHD to save my fingers. It might be the one medical term that is easy to pronounce, but the mechanics of it, the good and the evil of it, waiting for it, are anything but easy. 

From the moment my sister’s cells entered my body, not a day has gone by where I have not replayed conversations in my head telling me that a transplant will be (much) more successful if one gets GVHD. That a lasting remission is most likely to occur if one gets GVHD. That one only wants minor GVHD and not severe GVHD. GVHD can be worse than the cancer the transplant was intended to treat. GVHD can kill you. My post transplant world has been categorised by these thoughts and unbearable waiting to see which one applies to me the most. 

Another thing I have learnt in the most painstakingly slow way, is that the symptoms for GVHD are so broad that it has made it impossible for me to trust my body. Let’s face it, before my last transplant I already had reason enough to not trust my body. It has left no room for rational thinking. Everyday, multiple times a day, with each bowel movement, scratch, headache, bout of indigestion and shooting pain, I would wonder whether it had finally come. It did not. It was like failing my GCSEs on a daily basis. 

I woke up and continue to wake up everyday and my body does not feel right, and I do not know the cause of it. One could say I ‘do not feel right’ because I am recovering from a transplant, but I want to know more. I need to be reassured and I cannot do it myself because my body does not feel my own. Maybe I should ask Big Sister. I am 98% her now after all…This constant questioning of the unknown something, is one awful, inescapable disease. Half hypochondria, part anxiety with a sprinkle of depression and that’s before we get to the diagnostics of the physical ailment. It is a weight far beyond my actual sizeable girth and one that has often been too much to bear. Telling myself that the last 150+ days have been about recovery and not failure has been my full time job. I could not talk or write about it through fear of jinxing my snail-like progress. 

My long standing mental list of acceptable GVHD symptoms consists of oesophageal problems, diarrhoea and a rash. By December, despite developing a bottom sponsored by Andrex, the Medically Trained People told me that I had not developed anything from my list. As unpredictable and unformed as my stools had become, the fact I had not lost any weight, led the Medically Trained People to conclude it was not bad enough to warrant the GVHD label. During that conversation, the Medically Trained Person started to talk about the prospect of not getting GVHD. I left St Bart’s dejected. I felt unwell, just not the right sort of unwell.
If I thought that my days post transplant on Ciclosporin were difficult, the booming ticking clock that has been everyday post 15 December has been something all the more sinister. The first day free from the nightmare inducing horse pills, felt promising. My stomach was worse than usual and I could not stop scratching my neck. Both things soon subsided and realistically, were most likely a symptom of my nervous energy.

Over the next fortnight, I felt awful. Each 24 hours felt like double that. I was impatient. I repeated potential outcomes over and over and over again. I am embarrassed to admit that I occasionally gave in to the Bad Thoughts. The more I waited for something conclusive, for my pot to boil, the more I predicted failure. Worse than failure, a few times, I concluded that not getting GVHD which would shorten any remission, would be the easiest outcome for me. It would mean that I did not have to live with the unpredictability of waiting for a relapse and I would not have to deal with the uncertainty that awaits me when I attempt to rejoin my life. The bottom line was that at least that outcome would have a definite ending…
Then do you know what happened? 

Two weeks to the day after I took my last pill, I got a mouth ulcer. By the end of that day, I had two, and then by the following day, my mouth felt like sandpaper. It still feels like sandpaper. I hoped, and a quick Google search made me hope that little bit more that the cause of my pus filled mouth was the elusive GVHD… One week after that, I opened my mouth to a Medically Trained Person and do you know what she said? 

Read between the lines.

In that single moment I went on a metaphorical diet and I exhaled. I text members of my Support Network an update. I phoned Mamma Jones with the news, to which she responded nonchalantly, “I knew it”. Most tellingly, I left the hospital with my smile intact despite having to wait two and a half hours to rehydrate to allow for my bloods taken.

Despite allowing myself to bask in my relief for a day, I’m not buying any party poppers or downing champagne yet. The champagne would be wasted on my rotting mouth anyway. The six weeks are not up yet and although I am now on medication to treat my mild GVHD, my fears remain. No longer am I waiting to get GVHD, I am now hoping that it does not worsen. More hypochondria. My liver has not been functioning as well as it ought and although I was told not to ‘panic’ about my results, I challenge anybody in my position not to do just that. After all, I may have finally got what I wished for, but I still do not have a body I can trust. 

As I said at the start of this, there is a very fine line between good and evil. I have two more incredibly slow weeks of trying to stay on the right side of it. 

And then, what the hell is going to happen? 

Patience is not my virtue.
EJB x

Missing Milestones

Once upon an early diagnosis, I loved nothing more than recognising, in celebration or in defeat, a myeloma milestone. Back then, in what feels like a lifetime ago, everything related to my illness was new, scary and needed to be thoroughly documented or looked forward to. All my progress was marked this way; the first day of treatment, the end of a first cycle of treatment, my first birthday with myeloma, the first year with myeloma, the first stem cell transplant, the first relapse, even the second relapse and so on and so on. And so on. Three years ago, it was so easy to identify these milestones.  It was how I got through my then treatment, which I saw as something temporary, something that could be considered fleeting in the grand old scheme of life. Using the word ‘exciting’ to describe these things is a little perverse, but let us not forget that I was once a little pervert. 

I entered a world so alien to me, that the click, click clanging of an MRI scanner was exciting. Every time something changed, developed or I was sent somewhere new, I considered myself to be getting somewhere closer to the cancer nirvana. I was getting closer to remission and a life free of drugs. With each box I marked as complete, I was one step closer to the impossible something. 

I was wrong.

I was a novice and the novice in me found everything to be noteworthy. Even if I did not make an actual note of it, I would have acknowledged it to myself and marvelled in the exploration. Until my relapse, and even in the months after my relapse, I could have told anybody who asked, how many doses of chemotherapy I had had, right down to the number of Velcade injections poked into my stomach compared to the number I had stabbed into my arm. If I thought really hard, I might have even be able to have worked out how many blood tests I had had. All of it is a blur to me now. This blog acts as my record.

Time has passed. Lots of time.

Contrary to what I may have said at the time, in the early days of My Myeloma, I found it to be extraordinary. There was something fascinating to be discovered in everything it made me do and everything I planned for. Now, My Myeloma is no longer extraordinary to me, it is ordinary. It is my day and it is my night, and it has been that way for so long, that a blood test, a biopsy, a doctor’s appointment and even a stem cell transplant feels run of the mill. Fatigue, sore hands, an aching back, unformed stools, vomiting and cancelled plans are not significant. It’s my equivalent of a daily commute to work and then the 9-5 itself. 

I am not pessimistic.  I no longer track my progress as religiously as I once did, nor am I making plans for the future. I do not, not make plans because I do not think I have a future. I do not make plans because I do not know what my future will look like. If I try to envisage where I’ll be in February, for example, I have a dream of where I want to be, but the picture is fuzzy at best. That’s just February, anything beyond that is unfathomable.  Most the time, the picture is blank. Over time, I have concluded that not thinking about it and not planning for anything, preserves my sanity and reduces the size of the box entitled ‘Dashed Hopes’. 

In my post transplant world, recovery is slow. Recovery is not only slow, it is the Unknown. I could not pinpoint what I am recovering from nor for. I think and plan in terms of no more than a week. Any more than that can feel torturous.  I wake up, hope that that day is not going to be one that features vomit and I try to do as much as I can whilst factoring in the planned activity I have for the remaining seven days. Nothing more. Nothing less. That is my existence. 

I try not to think about how long I have been waiting for things to change or how much longer I have to wait for things to change. If I allowed my brain to think about it as often as it tried to, I would be stark raving mad. Given how much I already converse by song with the dog, it do not need anymore assistance in the road to madness.

In my days ruled by myeloma, but where it is the last thing I try to think about, imagine my surprise a month ago when I was told that I was now 100 days post transplant. I was not surprised it had been 100 days already; I was surprised that I had forgotten to mark such a significant milestone. 

If somebody had asked me what Day 100 would be like prior to my Day 0, I would have said I and the Medically Trained People would have a much better indication about my medical future than we do at present. I was told that at Day 100, my care would transfer back to UCH. Most importantly, when I sat down and signed all those papers, I was told that I would be taken off the Ciclosporin at Day 100, and then we would know how much, if any, Graft vs Host Disease I would get. In the last 100 days, this milestone, or the significance of this milestone has changed.

I don’t have the immediate answers I wanted. Instead, at Day 104, the Medically Trained People came up with a six week plan to slowly reduce my Ciclosporin to zero. GVHD may occur within the four weeks after that. I know this is progress, but I am pretty certain the tortoise just overtook me. Instead of being free, I have at least another six weeks of waiting (and willing) myself to become ill.

There is always the chance that I will not become ill when I come off ghastly smelling drug. If I do not break out in an unsightly rash or poop out my insides, then all of this waiting and all the treatment could be for very little. Imagine the weight of that anticipation; it’s an anti climax that hits me every day. 

On Day 105, some 27 days ago, I returned to the place where everybody knows my name for a clinic appointment. Not just any clinic appointment. It was the first appointment at UCH since treatment began at St Bart’s. That too should have been a milestone. The problem? I felt like I had nothing to tell them. There were so many questions, but no answer. Although I loved the familiarity of it all; the more comfortable seats and the smiling faces, it failed to be the milestone I wanted it to be.  It failed because we are not in the position for them to be my primary care makers again. Instead, it highlighted how slow my progress is. I get to go back again in February, by which time, I hope the  picture is in HD. 

Fifteen days ago, when I started this blog, I received a letter. A very nice letter.  The letter was a summary of the clinic  appointment at UCH on Day 105 and contained the results from a bone marrow biopsy I had on Day 103.  I could type out what the letter said, but it is 2015, I can show you instead:
 
‘Paraprotein not detected’

‘NO evidence of myeloma’

A milestone if ever there was one. Seven words that three years ago would have been my cancer nirvana.   A fortnight ago, they were words that make me smile. They were  words that made my support network squeal and cry. For a moment, I paused and felt relief.

The relief only last so long. Those seven words need to come with a footnote. A footnote that is so lengthy that I was tempted to not tell anybody about them.  I wasn’t sure if I could stand their excitement. 

Experience has taught me that it can come back, that’s one thing. My Myeloma has not shown me anything else. I have never had results as good as this before, but I have been in remission and it came back. I am still in recovery from the stem cell transplants and that means I still feel weak and my days are a struggle. My weakness is like a permananet cloud. Not having a paraprotein level or signs of myeloma, does not magically make the damage already done to my body go away.  Finally, I want GVHD. I need it. For long term success, for a better quality of life, I want GVHD. I long for it. Such is my want, I have spent the last four weeks monitoring my body to such an extent that I have become a hypochonriac. I am part excited, part suspicious of every stool, itch or back pain. 

It may surprise you, given my tone, but I know I am incredibly lucky. I do know that. I have one sibling and  against the odds, she was a perfect 10 for me. We matched when so many do not. I have almost completed my fun packed 2015, and so far, my treatment has gone as well as it could have. In fact, with just 13 days left of the Ciclosporin, I know that it could not have gone any better. My energy is increasing, not as fast as I would like, but faster than the Medically Trained People expected. Even with my energy, there are many a milestone that have occurred but gone unnoticed since I walked out of that hospital all those months ago. 

Despite this, despite all of this, despite all of these positive developments, I am tired. I am tired of my ordinary life. I want so much to be able to celebrate and acknowledge the good, but I cannot. The clarity I need could not come soon enough. I want to fast forward to a life not ruled by medical milestones. I do not know if that is even possible for me and that is terrifying.  That said, if it can happen, if it does happen, it really would be a milestone worth celebrating. 

EJB X