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On The Road

Set 3, 3 down ? to go

The start of treatment cycle is invariably when I get the worse end of side effects, but unbeknown to me, cycle 3 was going to throw a curve-ball at me. Admittedly there was a slight SNAFU, in that I didn't actually have an appointment for any future pre-assessments or treatments, but I got bloodwork done as normal on the Monday, and then dropped the hospital a line. I ended up calling the next day and left it in the hands of the admin team. By the end of Tuesday the matter had been resolved. Simple matter of no-one thinking to book me in for a new set of treatment cycles. Not to worry, it's not like it's anything important like chemotherapy. To be honest, the person I dealt with could not have been more helpful. These things happen. One positive thing from this, was my treatment was rearranged for Thursdays, not Fridays, giving me slightly more of the weekend to enjoy.


The pre-assessment call went OK, bloods were good, slight rise in CEA, but the oncologist was not overly concerned, so gave me the nod for treatment the next day. Treatment itself was unremarkable, familiar faces on both the nursing and patient sides, and my assigned nurse giving me the usual high standard of care and compassion. When I got home I crashed as I tend to do, but didn't have the nausea of last time around, so happy days (ish).


Saturday, my new disconnection day, came around, and I took myself back to the hospital, and encountered a familiar problem: no-one had told the ward that heparin was needed to flush my chemoport. The nurse was extremely apologetic about the issue, and during the 1 hour wait, kept popping in to check on me, and apologise again. Ultimately, they found some heparin somewhere, of a different strength to what was needed and as the nurse said to me "we're going to have to Blue Peter it, and dilute it down so you don't pass out and bleed out of your ears." Certainly it sounded a sensible approach to dilute it down. When she administered the dose she said, with some element of humour "I haven't filled out the paperwork for this, so if anyone asks, I didn't give you anything." This is the sort of thing that only makes me love the NHS, and its staff, more. It might not be everyone's cup of tea, but lightening up crap situations works for me.


On the Sunday we had visitors: my brother-in-law and family came for the night. Due to obvious shielding and social distancing measures, they didn't stay in the house, rather they camped in the garden. Our house has an outside loo, and a shower and sink in the very back, so they weren't having to deal with overly harsh conditions. The camping experiment went well. Good weather meant we spent time outside, ate meals on the deck, and took a walk with the dogs through the fields.


On the Tuesday, my sister and her partner popped over for lunch. Whilst she didn't say anything at the time, she did comment that I didn't look too good that day. If only she had said something. On Wednesday I woke up late (I am not one to sleep in, so that in itself was odd), had my pre-assessment call (everything was fine, CEA had fallen again, treatment signed off for the next day, happy days). I had breakfast and then dealt with a few messages from work. A colleague was following up with me on something, I replied that I wasn't fully with it so give me a bit of time, was feeling tired rather than ill. This proved to be a totally wrong call. After dealing with work stuff I then crashed out for the rest of the morning, until an old university friend came over to see us for lunch. We sat out, but then I passed on going for a walk, leaving my wife and her to take the dogs, and went and crashed again. By about 6pm I was still feeling rotten, and my wife then noted that I was somewhat hot. I checked my temperature and found it was over 39C.


As part of the chemotherapy process, you are given a card that advises to call the helpline if your temperature goes above 38C due to the risk of sepsis, and authorises you to receive a dose of top-shelf antibiotics. As such, I gave them a call. From this point on, the NHS were amazing. I spoke to the nurse on the cancer ward, she took my details, and advised she would call back with details of what I needed to do. After a short wait she called back, I was told to report to a ward and they would take it from there. So, we drove in. I must say at this point I was genuinely worried as to what might be the problem. Given the current situation, covid-19 was on my mind, and I knew that that could be a catastrophic outcome. We had distanced from all our visitors in recent weeks, but you just never know.


We arrived at the hospital, and I had to call the ward, and then someone came out to collect me. I was taken into the ward, and then watched as they invoked their sepsis protocols. A full set of bloodwork was taken, a canula was put in, and then I was hooked up to a bag of Tazocin, the super magic antibiotic. By this time my temperature was up to 39.6C, and my blood pressure had dropped to 90/50. Neither particularly good news. I also had the joy of being swabbed for covid and MRSA tests. The covid swab is particularly invasive, but not overly painful. Later on I had an ECG, a chest X-ray and gave urine samples. Basically the doctors were trying to nail down what was actually wrong with me. My comments of "I just don't feel 100%" were possibly not helping their job. Ultimately they narrowed it down to "not coronavirus" which 1) was good news but 2) didn't really solve the problem. My bloods came back OK, my ECG showed my heart was working in a totally un-Tin Man way. In all this, I was still not sure whether I would be staying in overnight. This was resolved at about 9pm, when I got put on an IV fluid bag for 4 hours. At this point I called my wife (who was at her brother's close by) and told her to stand down.


The next thought on my mind was the fact my chemotherapy was scheduled for 10am: At about 2am I got put on another IV bag, this one due to last 8 hours. Which resolved the treatment question: I certainly wasn't going to make it. Through the night my vitals were being checked: my blood pressure was slow climbing back to normal, and my temperature was dropping, though was a bit volatile. Aside from the fact I was being woken up every few hours I actually had a decent night's sleep, and by the morning I was starting to feel better. Later morning a nurse from the oncology team came in to discuss my situation. Clearly treatment was going to be postponed, but the plan was to see me over this hump and then get back for a pre-assessment as soon as possible. Various doctors were in and out through the night trying to work out was the cause of the problem, but to no avail.


By lunchtime I was bored out of my mind, but feeling OK. The last set of vitals were taken, blood pressure was near normal, as was my temperature. A doctor came in to check on me, and asked if I was feeling well enough to go home. I said I was (and not just because I was bored), so got given a discharge letter and was given the nod to call my wife to collect me. And with that I was done.


For the duration of the 20 hours or so I was in the hospital, the doctors, nurses and HCAs were nothing short of stellar. I know I have banged on before about this, but seeing the machinery of the NHS operate in critical situations is something to behold. The level of care, the humanity it is delivered in, and the general professionalism of the staff is incredible. Sure, the NHS has problems, any organisation of that size is always going to have them, but when the situation requires it, they are amazing. Not a day will pass that I am not grateful for all they do to keep me alive. Nor will I ever stop defending them. Anybody who criticises the NHS should consider a world where we don't have it.

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