Tag Archives: st bartholomew’s hospital

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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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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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

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Bon Anniversaire

Today marks three years since Myeloma officially came into my life. It’s three years since that junior doctor cried as she sat at the foot of my bed whilst she broke the bad news to my family and me. Is it an anniversary worth celebrating? No. It is however a significant milestone in my life and one which marked for better and mostly worse, a permanent change in the life of Miss Emma Jane Jones. Put it another way, the 17 August 2012 was life changing. And it wasn’t only life changing for me.

Since that date, I have been given a whole set of new dates to remember, celebrate and dwell. My first transplant on the 17 July 2013 for example, but that failed, so it was not quite the rebirth I advocated at the time. Then there was my second auto on 1 April 2015 and then my Allo on 23 July 2015. Only time will tell if the latter dates are ones worthy of celebration or just dates of mild significance. Mind you, the date my DNA changed will always be fairly significant won’t it?

For me though, this anniversary is the Big One. It’s the one that started everything off and although I wasn’t given the formal diagnosis until three days later, the 17 August will always be the day I got myeloma. The day I got myeloma. A ridiculous notion really, because my vertebrae did not fracture on that date, and the paraprotein did not suddenly appear in my blood on the 17 August three years ago. It is the date I knew why these things were changing in my body. It is much like my birthday, except with far more adolescent longing. On this date, I can feel melancholy and I can feel slightly sorry for myself than usual. I can, if that way inclined, try and recall the best and the worst of my three years, the highs and lows of each of 1095 days, I have fought through. And it is a fight, people may be trying to soften the vocabulary, but for me, I see this as a fight, a really, really big one.

Of course, you can see and feel the date differently, which I occasionally do. For as sad as my diagnosis was and as much as I do not want to have myeloma, the 17 August is also the anniversary of me growing up. My Myeloma has forced me to do many things I have not wished to do and experience,  but it also forced me to become an adult. Not the adult I once envisaged with a mortgage, children and a shed; the sort I am jealous of now. I am an adult who is forced to sponge of the State and her parents, but I became an adult nevertheless. I look at my contemporaries and sometimes I think to myself, ‘how would you have managed it?’ It’s a question without an answer, and it is a question I would not wish upon anybody ever having to find the answer to. I do not like myself for thinking it, but even when I think about that question in relation to me, I question how I have managed it all, and I am proud of myself. Even at the moment, when I seem to question daily my strength to continue with my allo treatment, I am proud of myself for coping. I think us myeloma sufferers deserve far more kudos for merely coping. I bet you any amount of money, because I do not have any money to make any sort of meaningful bet, that three years ago, I would have thrown anybody out of my cubicle if they dared to say that the 17 August would be a date that I would eventually be proud of. 

Even though my pride only accounts for some of my feeling towards this day. My diagnosis was the making of me. 

It was indeed a Big Day. 

I could do what I have done in previous years and list all the treatment I have endured in such a short amount of time. I could go through the physical side effects I have experienced many times over and have been forced to become accustomed to. I could even talk about how long I statistically have left in this world,  but I will not be doing any of that today.  This year feels different to me. Maybe it is because I am no longer at UCH and things seem temporary at St Bart’s. Though, really My Myeloma feels more than just the facts and the figures. Since my last anniversary, I feel like so much has changed; I do not know if it is a tangible change or just a non-drug related feeling in my gut.

Perhaps, prior to this last year, when I embarked on a nine month treatment programme followed by two SCT, I believed nothing had really permanently changed. I mean, I knew things had changed, but there was a part of me that still believed that my life could at some point at an unknown time and date, just slot back until place. I know that will not happen now. My 13 months of near constant treatment shown me that.

Until this last year, I also believed that I had a well established Support Network in place. I believed that all the perceived letting down I had experienced in that first year, was the only letting down I was going to experience in My Myeloma journey. My relapse last June corrected that misunderstanding. I feel far more let down post relapse than during any other time during my illness. Make a leaflet about that Myeloma UK, some people, those without myeloma, just cannot handle the fact that myeloma is a cancer that is chronic. That it goes on forever.

It is a strange thing to say, when I feel so well supported and loved now, but I have had to grieve the fact that some people got bored of my cancer and thus they got bored of me. It felt like they had tasted and enjoyed the 11 months of freedom remission had given me, and thought that taking it all on again with another relapse was too difficult a task to take. My stock went down. There were some people who made promises of support and friendship, not always actual promises you understand, but their presence alone throughout the early days of my illness, made me naïve enough to believe there was  something special and enduring in place. A promise of friendship. All I would say of this to anybody else in the same position as me, is, be warned of the glory seeker. When I am stuck in no man’s land, where there is no guaranteed end in sight, and the cancer keeps coming back along with my unpredictable fatigue, and those around me are moving on because they can, people and their promises can disappear. I have seen many of those promises, accompanied by those friendships end up on the proverbial scrap heap. 

It’s made for a difficult year and one where I have had to learn to stand on my own two feet. Fortunately, there is a flip side to this and if my relapse had taught me anything, it was who I could trust to stand side by side with me, as my treatment and their lives continue to develop. It does not always have to be either or, even though I am still prone to bouts of paranoia on this subject. Let’s not kid ourselves, I’m only physically well rounded. 

My relapse showed me that early on in my treatment, I made mistakes. I criticised my friends’ behaviour, in some cases I did so publicly and I regret that now. They were struggling like I was and they showed their struggle differently to how how presented mine. In the last few months, I have seen so much evidence of the support I have during my transplants, that I feel confident that even on my lowest days, I’ll have at least one person willing to pull me through the darkness. We just need to work on how I let people know. 

As it currently all stands, I know that My Support Network is well founded and passionate. It is mine, it is invaluable and I know that it is built on trust, even though I do not get to see its members as much as I would like to and I am pretty certain that is a feeling that works both ways. Rather strangely, or should that be tellingly, My Support Network is made up of people I have known for years either because they are related to me (obviously) or because they have had the good fortune of being my friend long before I knew what myeloma was. It has taken a while and the occasional misunderstanding, but I know who will be there when I need them. Some people will need to be asked for help and others won’t, but that is just the way things have always been and thus, it is the way things should be. I just wish there was more I could personally do to make my friendships equal again. Homemade cards only get me so far. 

Anyway, on the subject of my Support Network, I am making myself blush and as you are not all on anti sickness pills like me, I will put an end to the subject soon, I promise.  I could have just said what I am about to say five paragraphs ago;  My Support Network is irreplaceable. It may be irreplaceable, but crucially, my personal strength and journey through My Myeloma should not be defined and determined by it, and post relapse, when the droppings happened liked flies, I had to accept this the hard way and quickly.

My ability to cope with myeloma, is a much broader achievement than my Support Network. I personally, will always feel isolated by my illness and I have spent three years learning how to cope with this. I do not have all the answers, but I have more than I did last year, so who knows what I will be saying next year? And the year after that? And the year after that? 

Last night, as I was trying to drift off to sleep, I began to worry that with three years of near-constant treatment, there was a possibility  that soon, I might not have the strength to continue fighting should my current treatment fail. My current treatment, which I am nearly halfway though, is not exactly a walk in the park and trust me when I say, I have many a down day. I am fully aware that I will have more down days over the next x days. I will fail to get out of bed a few more times, find myself physically unrecognisable and cry over missing events with my  friends. I worried so much about my occasional thoughts of giving up, that I envisaged quite a different blog to the one you are currently reading. 

I haven’t only experienced treatment, relapse and drugs in my third year of myeloma. In the last year, somebody dear to me lost his fight against myeloma. He became dearer to me, selfishly, with my own diagnosis three years ago. He was somebody who I never saw being remotely negative about the bastard that is myeloma apart from rebranding Velcade, “Cillit Bang”.  I fear negativity is my default position the minute the going gets remotely tough. His eldest daughter also gave me an invaluable crash course in myeloma and continues to offer me considerable patience. Her Dad did not have a sibling donor and thus could not have an Allo SCT, instead  he had two auto SCTs and several other treatments such is the norm for current myeloma treatment on the NHS. He was given velcade and among many of the things, he suffered from steroid insomnia. He did not know it, but he was My Myeloma rock, and the only other person with myeloma I needed to know. My current treatment is the first treatment I have had that he did not have in some incarnation or another. I remind myself that I  feel poorly because I am lucky enough to have a sibling donor, and last week when I couldn’t get out of bed, I thought about him and his family, (and not because I had just watched The Man With The Golden Gun remembering a holiday we had) and I got out of bed. That’s all I really want to say about that. 

Three years after my diagnosis, in the middle of a transplant where I had to sign to say I was aware of all the risks that could happen during it, I am ever aware of my life and the chance of my death. I am also ever aware of the chance of my death being further away than the statistics that I will not talk about, and current literature would suggest. 

It’s been three years of changing and developing treatments and a changing and developing me. I don’t know how to end my acknowledgement of my anniversary, so I am just going to say goodbye and thank you for reading my blogs. I promise they will continue.

EJB x 

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Admission

By the time Wednesday morning   came, when I walked onto daycare ward 7A late at 11:15hrs with my suitcase and rucksack , I had spent my morning psyching myself up for my inevitable admittance to the hospital. I  snuggled my goodbyes with Bruce  and then immediately coated myself in antiseptic before doing it again because I still wasn’t quite prepared to not see his face for a few weeks. I even forced myself to watch some daytime TV tripe whilst reading the news on my phone as Bruce breathed into the back of my neck,  because I evidentially have a borderline unhealthy relationship with a dog. “What do you miss most from home Emma, your…?” “Bruce”, in a heartbeat. It was a shame that conversation was with a nursing assistant who took ‘Bruce’ to mean my “handsome husband.” 

 So, yes, it was 11:15hrs and I knew I was ready to go into hospital.

I was ready to go in, but I was not happy about it. I had to employ a fair amount of common sense to the scenario to be ready and argue against myself. Lest not forget that I had been told I was having an outpatient procedure with the chances of admittance being 50-70%. Almost as soon as I stepped into Daycare, seven days earlier, I was told that my admittance was an inevitability.  “As soon as your neutrophils reach 0.5 or below; it’s our policy”, one Medically Trained Person would say or “you have to be in the hostel!”. One Doctor simply said that I was down to do it as an outpatient, so we should try to do it as an outpatient.  No more, no less. He made sense to me. Sort of. So, when he said to me on Wednesday that despite having no fever, cold or flu type symptoms, he was recommending for me to be admitted to the hospital, I did not have the energy to reason back why I should have stayed out.

I can reason about it now of course. My admittance on Wednesday was partly based on a Medically Trained Person’s assessment from the previous day that I was “struggling”, with the then current arrangements. A struggle that could quickly become  a ‘routine’ but for a few simple changes made to the outpatient programme. For example, said patients could see the doctors at roughly the same time they have their bloods taken each day. Maybe they do not need to see a doctor everyday? The blood tests could be taken at the same time everyday to avoid the the need to wait and fill a collection box worth of the stuff before it is deemed financially viable for the lab to run the requested tests.  The biggest adjustment would allow for the patient, once they gave been seen and they require no other treatment that day, to go home. Having to be seen by a nursing assistant, a nurse (usually a sister) and a doctor, daily,  one could theoretically go home before the daily blood results come back in, on the agreement that you would come back if the bloods dictated a need to do so.  In the week I was there, nothing changed in the four hours it took to get my bloods back other than my ability to speak and my need for my bed. On some of the days, especially at the weekend, the SeniorMedically  Trained people were working to day old blood results anyway. 

Shaving off that few hours a day, could have potentially kept me out for a few days longer. The same person who said I was struggling on Tuesday, on Wednesday told me that I seemed like I had much more energy. I think getting home by 12:30hrs the previous day, in my own space had a lot to do with it, and I believe me, I said as much.

Looking tired was not the only reason for my admittance. The staff here are serious scientists and I should not go forgetting it. Some of them, I believe are caring ones at that. The move into a bed that somebody in all probabability, have probably soiled themselves on at least once,  was precautionary measure, I might not have any bugs yet, but my bloods were on a downward pattern with my neutrophils by Wednesday falling to a level of  0.1 for two consequative days. It’s Friday today and despite asking, nobody has given me my blood results since Wednesday. 

Since my arrival at 17:30hrs on Wednesday Night, all I have wanted to do was to sleep and  poop. Sleep and poop. It’s not too much information, it is the painstaking truth, of wanting to not pass out when you stand up sort of pain. Fortunately after six long days, my Movicol kicked in this morning and I sang my Hallelujahs. 

Sleep is harder to quantify. Yesterday I persistently wanted to vomit, which prevented me from an interrupted sleep but it was an abuse that could only be cured by sleep.  I could have easily of slept all day and  I slept all night AND done the same today. I am probably not long off it today. 

I fear that  my admittance, my admittance, to my very own side room no less, is a fraud. Is there a reality show where the winner gets their own room if they are the sickest? I know I am neutropenic, but I knew that it was okay on Tuesday night when I was fine in my own home. My bloods have  flatlined before, in April and I did not get a bug then, I was fine. History could repeat itself. Accept, I wasn’t really fine on Tuesday. I could stay out because I had other people to look after me. No amount of planning ahead made it any easier for me to heat up a frozen baked potato. Big Sister had driven down earlier that day to feed me and repack my hospital bag. Over the weekend, Mamma Jones did pretty much everything for me. I could have stayed at home if I had 24 hour care for an unknown amount of time, but that just is not practical. By Wednesday morning, the short walk from the Little Britain hospital entrance to the day care ward had me gasping.

My worries about being a fraud in my own side room, with a window without curtains and a television where the channel can only changed by turning it up, were proved preposterous this morning when the simple act of getting up to brush my teeth required an hour nap afterwards. After my shower and stool, it was a two hour nap. It would appear among the many things going on inside my body, outwardly, it needs days made of sweet dreams.*

Plus, yesterday, a magical pump was put into my arm that I have to carry everywhere I go (bed and toilet), which automatically dismisses anti sickness medicine. It’s a revelation. I woke up this morning and gulped down a cup of water and I did not want to immediately vomit it back up. I wouldn’t have got that home. 

The truth is, the communication may  only be marginally better than on Daycare, but this place is still the best place for me as much as I could sit here and pick apart all the errors in their systems. What errors you ask? Well, despite my need for twice daily morphine  being one of the first things I mentioned to the ward nurse on Wednesday, who by the way told me off for saying that my back problems were myeloma related and scolded me for not informing her that I was Day+6 post mini allo. On the latter point I just looked dumbfounded and said that I thought that information was a given . I’ll let you into secret,  MST is  a medication I care about a lot, so much so in fact that in the two days I have been here I have  also mentioned it to the pharmacist, the chief ward nurse, every doctor I have seen and any nurse who has given me any drug, and yet they are still claiming I have never been prescribed MST by this hospital. Thank goodness for my secret stash and my own toilet. A communal bathroom just would not be fair on anybody else.

EJB x
* if sweet dreams can be achieved with a minimum of one interruption every four hours, but we all know it is more. I have seen one friend today, five nurses, three nursing assistants, a doctor, two cleaners and one tea lady. At least I think I have.

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Drooping

I have literally spent months, maybe even a year willing for something to change in my treatment, so that I had something interesting to blog about. I have a lot that keeps me awake at nights, but I still managed to squeeze in the worry that the monotony of daily cancer care would drive people away. Fast forward to my allograft and I have something new to say almost on the hour. Everything seems like it is new and I am in a state of flux. The problem? Nothing is keeping me awake at night. Very little is keeping me awake in the daytime. My treatment and this experience seems to be moving at such a rate that I do no have the time and I definitely do not have the energy to tell you about it all.

The headline is simple, I have had my transplant. Unlike the original plan, I had not one but two Day Zeros because Big Sister did not produce enough stem cells on the first day. I am far too tired to have body issues at present, which is for the best, because more than one Medically Trained Person told me that the reason for the two day transplant was my sister’s significantly smaller body size.

I just asked Mamma Jones to confirm how many cells I should have had over how many cells I actually had, and I felt like her answer lacked conviction. All you need to know is that I was only marginally short on Day Zero The First, and by close of play on Day Zero The Second, I had had more stem cells than originally intended. 

I now very much want to be a watched pot. I am being monitored so intently, that hopefully, my body will never have the chance to boil… I keep imagining that one day I will wake up and have enough energy to reply to my messages and blog about my experience to do date. If that day doesn’t come, let me tell you that this watching schedule is intense, with absolutely no room for respite. 

Going into this transplant, I was told that it was easy when compared to what I have already experienced over the last three years. I think the word ‘easy’, was a white lie. What I am doing, what I am having to do everyday without a day off is exhausting. Two years ago, I was stuck on a ward on UCH with green coming out every orifice; that was hard. Today, I do not have green coming out every orifice, but it is my 10th day of travelling into Bart’s for blood tests, forgoing rest and questioning the real purpose of showering. On Thursday, utterly dejected, I sat at the foot of Big Sister’s Harvest Bed and declared that I had never felt as ill as I did in that moment. 

If I could, I would sleep all day long. I just paused to see if I could have a few waking hours and truly the answer is no, I could sleep all day long. Yesterday, my neutrophils dropped to 0.6, so we are anticipating being told that I have to go into the hospital today. Exhaustion doesn’t cover what I feel. I am drained and I am fairly certain were it not for people putting food and drink in front of me, I would consume neither.

As for St Bart’s itself, I cannot be kind. There has been mistake after mistake, some I think are potentially serious. On average, I have been sitting in the patient bays for 5-8 hours a day and the fact that it is not only me feeling let down by the service is of some comfort. Individually, some of the Medically Trained People are lovely and I’d like to see Jeremy Hunt work the 10 day week plus on call one of my doctors just worked, but collectively, it’s disjointed. 

I keep reminding myself that I am a pragmatist and the only new age things I believe in are my Mindfulness Colouring In Books, for if I believed in more, I know I would get bogged down on how the ward has made me feel and to what detriment that has had to my overall treatment. It’s a blog in it’s own right, but when I questioned whether I would still be standing if St Bart’s had been my hospital from the start of my treatment, I think that really says something about my perception of their care. 

Now, Mamma Jones has to read this to see if it makes any sense and I am going to close my eyes to see if I can shake off this headache I have had for the last 48 hours. I am not allowed paracetamol anymore. Or suppositories, but that is another medical issue entirely. Bloody neutropenia.

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Rallying

Yesterday marked the end of five days of pre transplant conditioning. That would be, five whole days of travelling to and from St Bart’s for chemotherapy. Since the fist clenching, swear word swallowing experience of Day One’ (Day-6), I have endeavoured to be on my best behaviour when on the ward, experiencing the medical equivalent of seeing Wagner’s longest work without subtitles with an innate hatred of opera. 

I concluded that if I cannot always  service with a smile, I should be the one delivering said smile. It is something that is much easily willed than done, especially as the chemotherapy is having a negative, cumulative impact on every aspect of my body. My brain, my muscles, my bowel and my bladder feels like they have been assaulted by a BB gun and multiple sacks of potatoes. Thus, finding the energy to smile, let alone speak, does not come as easily to me as it usually, all so naturally does.

I have been attempting to rally myself into a state of positivity, but for me, this last five days at least, it is not something I have been able to do all on my lonesome. I have needed assistance. Poor Mamma Jones has been on the other end of the phone wishing she was in London. I even admitted to my friends that I was in need of assistance. Assistance being in the form company to make the hours in the clinic more bearable. Assistance to remind me that this is only a temporary measure, that won’t go on forever. Special kudos has to go out to Housemate who fought through what I can only imagine was a horrific hangover on Saturday to be at the hospital for 9am, returning home at 5pm. Yesterday, he even did my dishes, which is unheard of. 

In all honesty, this cannot be done alone. Yesterday, I forgot to brush my teeth, which I am sure was a pleasure for the Medically Trained People who had to get remotely close to my face. Even with a support network, the treatment is isolating.  If I feel like this now, who the heck knows how I will feel in a few months time?

In terms of the immediate side effects,   the hiccups have been plaguing me since yesterday, and when one looks like this post chemo, imagine what I look like mid multiple jerk:

 
Today, I have a ‘day off’, but this still involves heading into the hospital for blood tests. Big Sister also arrives in the Big Smoke for her part of the process today, so it seems only fair that I meet her to express some of the inexpressable gratifitude. 

Prior to last Thursday, I was told that I would find the conditioning relatively easy in comparison to my previous treatments. I wouldn’t go out and out and call this a white lie, I just think it’s difficult to be comparative to my past experiences when my current experience is so foul.  I might have fouled myself twice in 2013, but that is no consolation when I cannot take my morning medication without vomiting or distinguish whether ‘consolation’ is the correct word to use here over ‘consolidation’. 

We all know how much I love to talk about my toilet issues, so imagine the complex situation I found myself in on Monday night, four days without passing a number 2 whilst experiencing a cystitis-like pain from the cyclophosphamide. Every effort to unleash the stool, angered the other thing. It was a pain that could only be muted by taking two diazepam to permit a long sleep. It was a temporary reprieve, for it was still an issue present upon waking, but, hey, at least I got some sleep. Last night on the other hand, my sleep was interrupted five times to pass water because of the cyclophosphamide. 

The last five days have been relentless. With an auto, it’s one day of treatment than the transplant. The horrible side effects hit you later. I will probably be thankful when what experienced in 2013 doesn’t hit me, but right now, I just really, really want a week in my bed to recover. I know I am a good few weeks away from this luxury. 

So, in the meantime, I just have to rally. Rally and remember the key words that ‘This Soon Time Pass’.

  
EJB x

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