Anna Donald: Confessions of a chemo-veteran

I’ve spent the last week reading. I haven’t done much else, because my cough has reached the point where it’s slowing down my movements: constant coughing fits are tiring. On Friday night, I declined an invitation to a cocktail party and on Saturday, to a dinner party, for fear of coughing all over the guests and hosts and having to take cough drops with the vichyssoise. I’m having more scans today (I’ll soon be glowing in the dark) to see what’s going on. To see if it’s time for more chemotherapy.

I must emphasise as something of a chemo-veteran that chemotherapy is not the horror treatment it was even fifteen years ago. Anti-nausea drugs have completely transformed chemotherapy. They mean that while you still feel pretty unwell, you rarely face the kind of over-the-toilet wretchedness that gave chemotherapy such a bad name. I think the newer anti-emetics are close to being what anaesthesia is for the general population in their impact upon quality of life for people with cancer.

That said, I am not thrilled about the idea of more chemo. I’ve got lots of metaphors for it: a small elephant that sits on you, then trundles off, only to absent-mindedly turn around and sit on you again. As the days pass, the elephant becomes a donkey, and finally a small dog. Then you feel a bit better. Other times, chemo is like being immersed in loud white noise. You just have to wait until it’s over.

I had my first round of chemotherapy (epirubicin) five years ago. It was an alarming red and hit you like a train. Nothing’s ever made me as sick. I spent the first night in Accident and Emergency being rehydrated, having been given insufficient anti-nausea drugs to take home and no instruction about how to take them (for example, that you can just take another one if you need to).

Subsequently, I often found myself advising first-time fellow patients in the chemo suite to get better cover, when their doctor had only given them medium-grade anti-emetics (and to one poor lady on epirubicin, only paracetemol; I had a good mind to report her doctor).  I have no idea why so many oncologists seem to under-treat nausea in first-time chemo patients. Sadism? Incompetence? Probably a lack of understanding of what an enormous shock to the system your first chemo dose is, causing your body to buckle and heave, requiring heavy anti-nausea cover even if later cycles do not when your body knows what to expect. Combined, probably, with some degree of denial. It hurts to cause suffering. 

I found an alarming moralistic attitude among some oncologists that medium-grade or low-grade anti-emetics “should” cover the nausea – as if patients are somehow just being weak if they allow themselves to feel nausea and need to be taught how to handle themselves. So send them home with paracetemol to give them a bit of backbone (that particular example was, thankfully, an outlier).

Oh the joys of chemo. Well, I’m not there yet. I’ve got an appointment with my oncologist on Thursday, when the results of scans and blood tests should have arrived. Fingers crossed for no chemotherapy, but then again, I’d rather have chemotherapy than increasing debilitation and exhaustion from a cough that just won’t heal.

On the bright side, the bad weather that was supposed to show up in Sydney this weekend never materialised. We’ve had gloriously blue and sunny skies. Our flat looks out over the harbour which is especially glittery in the winter sunshine. Mango season is over, but there are plenty of amazing things to eat in this big blessed island. Can’t complain too much.

Again, my sincere thanks to people’s lovely comments and offers of assistance and resources. They are a huge support to me. I am very behind in my correspondence and apologise for my lack of reply to people whose comment begged one. I hope to remedy this over the coming weeks.