I spent 12 hours at Hospital Marie Curie yesterday, not including travel time. From 6:50 in the morning to 6:50 at night. Not sure how I stayed up to a reasonable bedtime hour but I did. Didn’t want to wake up wide-eyed at 4 AM.
Intravenous chemotherapy was scheduled to start yesterday but as I wrote a couple days ago, the public drug bank, or dispensary, was out of Oaxliplatin. My doctors had become aware of the problem by the time I saw them yesterday and said that instead of waiting for a turno in the day hospital, as I normally would, they would admit me to the hospital, give me a bed and administer the chemo there.
“We want to start you right away,” Lucas said. Lucas is the cute, hairy, hunky doctor I might have mentioned a while back.
But being admitted required multiple signatures on three different floors and then revisiting admissions twice. It really is absurd. But several people were making the same rounds for the same reason, including a model-handsome young guy I’d never seen before and what I can only call a gigantic woman who always tries to push herself to the head of the line no matter where she’s at. Yes, there are people in this world who think their cancer is more important than yours.
Then I waited in the basement café, as told — “Don’t leave the hospital!” — from 11 to 12:30, catching up on my sent-to-Kindle Web pages. Lucas came and got me, asked “Listo?” and off we went.
Up in my room, which was better than Rivadavia’s, near medieval, and, with its heavy, 50s mint-green curtains, more private than Penna’s. I settled down for yet more reading. I dozed off.
Two young folks came in and dropped off the equipment — a bag of saline, the bag of Oxaliplatin, a couple syringes, some drip tubes, plus the everywhere-present bucket o’ cottonballs. Then the nurses came in 10 minutes later, dug around for a vein — I have small veins — started the drip, and left me alone to get fed with poison.
I feel asleep for a while but woke back up an hour later to find the bag was only half-empty. Going way too slow for a treatment that’s only supposed to last an hour and a half. Still, one reason they go slow is that if you overwhelm the vein, the drug can leak out and damage surrounding tissue. Also, faster dripping hurts.
Lucas came in and increased the drip-speed and it ran out half-an-hour later. But I still had to go searching for nurses to get me out of there, dragging the drip-stand with me. It had wheels, unlike the 20 lb ones at Rivadavia, but they didn’t really work.
But before I left, I got a visit from an old comrade, Doctor Paz. He was wearing dark blue scrubs unlike the white lab coat I usually saw him wearing, and it seemed like he had a tan and maintained a big smile the whole time he talked to me. Normally, when I saw him in the hospital, he was ultra-placid, and rarely showed any emotion — unlike in that photo linked above in which he seemed very pleased to be getting his picture taken.
He told me he was working in two different clinics and another public hospital. He said it all in halting English, mostly without verbs. It was a funny conversation because he tried to speak English, and I tried to speak Spanish. But, I finally said to him, in Spanish, “My castellano is still better than your English, Viktor!” It was the first time I’d addressed by his first name. Everyone in the ward just called him, Paz. Anyway, that made him laugh.
It was good to see him and I was touched that he came to see me since he didn’t have to, no longer being in charge of my treatment. We shook hands and he left.
I located the uncharacteristically laconic, for an Argentine, nurse, to take out my IV, and 15 minutes later I was out of there and already feeling side effects.
Oral chemo is relatively easy to handle. Fatigue and diarrhea are the worst of it. Oxaliplatin is another thing entirely. The most irritating side effect is a high sensitivity to cold which produces peripheral neuropathy and numbness in my hands, fingers and feet and toes. I need to wear gloves indoors in my unheated room — even cool door handles hurt — and I can’t drink cold or cool water. If I do, and I did try it a couple times before I knew better, it feels like swallowing a mouthful of tiny sharp rocks. Cold or very cool air breathed in outdoors feels similar and my lips become minty-fresh. Imagine your hands nearing frostbite and the pain you feel when they warm up, combined with the weird jangling discomfort of hitting your funny bone. That’s what it’s like.
There’s also some jaw-lockup and pain when I first start eating but that goes away the longer I chew. Sometimes my fingers don’t work and the joints lock up, as well. I can type, for some reason, at the same speed and accuracy but signing my signature makes me look demented — the hands of an old crone.
I’m supposed to have 3 cycles in total. One day of intravenous followed by two weeks of oral capecitabina, 5 pills a day, then a week off. Start over with the same regimen for another week and then another. I was wrecked the first time I did this but maybe I’ve built up some resistance after all this time.
Reading that Wikipedia link about Oxaliplatin, I discovered that at my stage of cancer, treatment like this does not affect overall survival rate significantly, but rather improves progression-free survival rate. That seems counter-intuitive. If the disease arrests and doesn’t progress, doesn’t that improve survival rate? If not, that’s a sobering thought, and it’s why some patients in consultation with doctors elect not to take the chemo at all, because of its high toxicity and side effects.
Really, I’ve just let the docs make that decision for me. Side effects seem so much a part of my life right now that I can’t even remember what it’s like to feel normal.