Part 1 - 30.06.26
The visit to the doctor gave me no breaking news. This time around, the doctors in the room were a young doctor with Indian heritage, who has probably been the one I've seen the most, my main doctor, and a young doctor in training.
My main doctor said that there were more faces today because of the doctor in training - this is a university hospital, after all; in the women's clinic there is always a student doctor on site. To which I replied that at least I was getting some familiar faces. The Indian heritage doctor was among those who responded when I had the reaction in my first chemo treatment round. She has been in at least two pre-round consultation sessions. She was one of the doctors helping assess the risk of my increased blood pressure during one of my last rounds; one time, when I had a mild reaction to the treatment again, even after getting the antihistamines beforehand.
And my main doctor, well, she was the one who gave me the diagnosis. She has been present in every consultation after an MRI. And I have spoken with her on the phone a couple of times too. She is the only doctor whose name I remember. Because it was explicitly said to me, as one of the things I should remember. Like all the medicine that I get. But even the medicine, I only remember the names of a few by heart. With all the roster of doctors and nurses, it's difficult to remember names. But faces, that is a whole other story.
What I was told this time is that, while the treatment has fragmented the tumour, the area it occupies is still large. If I were to be operated on, it would be a very invasive operation. The word the doctor used was omfattende, which translates better as "comprehensive." My main doctor wants the tumour to shrink further. Ideally, to nothing, she keeps saying.
I know. I have also wondered: if it shrinks to nothing, is it still necessary to operate? My brain keeps responding yes: to take away dead cells. But I haven't asked directly.
I did ask after the results of my blood panel. My immunity is reduced, but still not to concerning levels. My haemoglobin has recovered. I am not losing weight. Quite the opposite. I keep telling myself that it is water. My doctors support that belief. I trust with my brain and doubt slightly with my heart. Because water in the body has always only meant: well, you're just getting fat.
But getting fat when one has cancer makes people think that one is looking healthy. So, silver linings?!
My hope that the operation would happen sooner was not confirmed. So, my reading of the radiologists' reaction to what they saw in the MRI results and their surprised faces at an operation only in October must have been my brain fantasising.
What will likely happen now is that I will have two rounds (instead of 3), before a new MRI. With a new combination of chemo drugs, Epirubicin and Cyclophosphamide. The combination is called EC90. A new set of side effects (some are the same), with emphasis on nausea and forstoppelse (constipation). I am likely to urinate red a few days after the treatment, because of the Epirubicin, which is red. Hair loss and mouth sores are also on the list. It may also affect my heart muscles.
This EC90 combination apparently has a lower likelihood of reactions. No need for antihistamines. And neuropathy is not among the side effects. In preparation for the treatment round, I also had to take dexamethasone once (instead of over 3 days). This was one of the drugs that was thought to be causing the increase in blood pressure. Together with the dexamethasone, I had to take one new drug, Akynzeo, for preventing nausea.
After two rounds of this combination, they will decide whether to change to a third combination of drugs. Then comes likely the operation. Then radiotherapy, for three weeks every weekday.
When I told the main doctor that I had heard that radiotherapy was worse than chemo, she almost burst out laughing and assured me that it wasn't. Again, my brain trusts her. My heart tells me that personal experiences are true as well.
After the radiotherapy, I go back to Phesgo. It cannot be taken together with this new treatment combination. I asked if that didn't reduce the effects of the treatment, given that this drug attacks this cancer specifically. She assured me that the new combination attacks the cancer cells (and everything else) just as efficiently.
My brain is suspicious because we seem to be reducing from the atomic solution to something softer. A milder missile attack. I wonder if the new combination, after the EC90 will be something like a drone attack. This "demotion" on the strength of the onslaught reminds me of Uma Truman in Kill Bill, when she finally confronts Bill and asks him why he tried to kill her, and he responds that he overreacted.
Part 2
The treatment was scheduled for the morning. Coincidentally, in the same room where I had the very first round of treatment. Now I walk confidently in this space. It is still being renovated. The nurse, a new face, apologised for the noise, which I hadn't registered until she mentioned it. She assured me that they were in the last section of the floor.
She introduced herself, saying that she didn't think that we had met before. The literal term in Norwegian is hilst før (greeted before). There is an important distinction here, because during the session she said that she had been one of the nurses responding to my latest reaction to the chemo. But since she hadn't introduced herself then, we hadn't properly met/greeted.
The nurse checked my name and ID number while looking at her papers. The number is a unique number that is used for everything across multiple state agencies and banking. The number makes you uniquely you within the Norwegian system. They call it fødselsnummer (birth number). It is the number assigned at birth or when you are "born" (registered) for the first time in the system, like in my case. The first 6 numbers are our birth day, month and year. Followed by a sequence of five unique numbers.
This ensures that blood samples are not mixed, the wrong medicine is not given, etc. Of course, care that mixups don't happen in samples and medicine is not unique to Norway. Most systems have a way of trying to ensure this type of care. I still find it fascinating how nurses ask obsessively for our number to check. Even when they know. We, the patients, have to be the ones giving the number. Over and over again. Even during the same appointment, every time they are to give a new medicine. It sounds tedious, but I am sure that it saves lives.
The nurse explained that I was going to have a new combination of drugs. She didn't expect me to have a reaction, but with my history, she prepared a syringe with antihistamines. Just in case.
I warmed my hands under the standard warm pillow. I commented that my veins tended to hide. She said that she wouldn't stick the needle until she saw a vein. After examining both arms, she found one in an awkward position.
She listed all the scary parts of the treatment. The content in the first IV bag, containing Epirubicin, could burn if it came into contact with the skin rather than entering the bloodstream. It is red. I would pee red for a while. I had to sit still. She would be there the whole time and ensure that I didn't move the arm, so the solution didn't drip outside and burn me. But it would be quick. About 15 minutes.
Combination EC90
She would be strict (about enforcing my sitting still), she said. I believed her. She carried a no-nonsense authority demeanour, mixed with confident care and kindness.
At some point, the nurse explained that the combination now is usually a first line of treatment. Honestly, if this one has fewer side effects, I am happy that I started with the worst and am moving to something milder.
After the first IV was finished, I could move, while the second dripped. Between one and the other, a saline solution washed clean the tubes and into my system. Saline solutions always feel clean and fresh.
They did not monitor my blood pressure this time. The whole session lasted exactly one hour. No drama, no fuss. I did feel a little woozy immediately after the session. I went to the library, sat, and took a couple of calls until I felt myself again. Now I just have to wait and see how the body will react to this combination.
No comments:
Post a Comment