Wednesday 26 March 2008

24. visit to the oncologist

Tuesday 25th March:

this is the outcome of the afternoon's little jaunt. So!! The only bad news was I am definitely going to lose my hair. That's it as far as bad news goes. That is because I am going to be having 70 – 80% Carboplatin, and between 20 – 30% Paclitaxel [known commonly as Taxol]. They work out the dosage dependant on what your kidneys are like – e.g.: if you have the kidneys of a buffalo, they give you more Carboplatin, as the kidneys pass it too quickly for it to do you any good, but if your kidneys are weaker, they give you less, or the kidneys are likely to be abused by too much. But the Taxol is the stuff that really drives it home, and it’s supposed to be worth the side effects for the result. The Carboplatin does most of the work though.

Re: the hair. He said I will definitely lose it. I did get a bit tearful at that point, even though I expected that, and to be fair, I was going to ask if I could have the combination of the Carboplatin and the Taxol if they didn’t talk about that, as I would rather have no hair for a few months than have to go through this twice. The more aggressive the initial treatment the more likely I am to come out the other side free of this stupid disease, so I am happier to have both. But this is merely my personal opinion.

Right, bad news over. Now I just need to think about HOW I would prefer to lose the hair – I actually don’t think it will be a good idea to cut it off myself, as I think it would be too traumatic for me – you’ve seen the pics of me, and my hair is part of my ‘personality’ and losing it is going to be a bit weird [same for everyone I would think]. So I think I might have it done at the hairdressers. BUT, I’ll wait and discuss it with my friends – a team decision! Why not? Also think I’ll have the wig from the NHS just in case I need it etc. Some days I am sure I won’t care, but others I might, so better to have the choice.

The hair falls by the 2nd session – between week 2 and week 4 I’ll lose the lot. Thank goodness I didn’t bother going to the hairdressers and spending a fortune on colouring it. Can now spend that money on hats. ;o] But, hair apart [oops – forgot one thing, it takes about 6 months for the hair to grow back to the point of being able to get a brush through it apparently] – so, enough about hair, to all the factoids.

I had Serous ovarian cancer - the commonest type. It was a Grade 3, and a stage 3b. Grade is how aggressive the cancer was, and Stage is how ‘big’ it was – for instance, mine was big, but visible and has been removed to the best of the surgeons ability, 3c is when there are bits they can’t remove but they see them and know they are there. Those bits have to be chemo-ed or gotten rid of with radio-therapy. Apparently my prognosis is good, as he managed to remove everything in sight, and the remainder is invisible [IF it’s there at all] – it was ‘Maximal Debulking Surgery’ – good grief... debulking??

The chemo will go in through a cannula in the back of my hand [phew – didn’t fancy that thing through the main artery in the neck – yuck!]. It takes about 5 hours, as they can only start preparing the chemo when you arrive for your appointment, as it can’t stand around waiting for you. Obviously chemo is impatient stuff heh heh.

This is the best bit! It made me laugh - I can drink wine! It’s recommended! Apparently the people who have the most nausea are tea-totallers. Unreal. Seriously though, apparently it’s a fact that a glass or two of wine at night can really help with nausea. RED wine. So there ARE a few good points about this. Can race home after chemo, put my feet up in front of the fire and have a nice glass of Chianti! Ooookay! [obviously this doesn’t mean one can race out and party until dawn – all in moderation]

I will be given steroids and anti-sickness shots before the chemo each time. Anti-sickness tablets for 3 days afterward, and a few extra ones, but a bit milder for ‘in case’ it lasts longer than that. He said the nausea is not as prevalent as one hears, and that a lot of people don’t have it at all. As I felt sick most of the time before having the Great Debulking [!] I am sure I can cope with that. Plus there's the Ginger, which I will try if I need to.

Temperature has to be watched, as the immune system is being battered all the time – apparently you get cold and shivery if your temperature is too high, so at least it’s distinguishable from the hot flushes! Above 38° you call the hospital. Side effects are mostly; hair loss, nausea [but not always], aches and pains, bruising, bleeding [like a blood nose – again, call the hospital] and pins and needles [the latter three are all rare – but one has to call the hospital or at least tell them, as they have to deal with that] – but it’s not USUAL.

BEST thing – the ‘2 year’ statistic is rubbish – he said ovarian cancer is a VERY treatable type of cancer, it responds very well to the chemo, and that I have a very favourable outlook. He was amazed when I told him about the statistics we saw on the Ovacomb site. He said that’s not true. Personally, I believe the doctor over the site. And he said I had the best surgeon, and the best possible outcome of the surgery. I came home feeling 2 kilos lighter, as all that was such a relief. Common belief is that this kills you – well, as usual – lots of supposed ‘facts’ are not quite what they seem. And not quite right.

I came back shattered – I think it was the relief of knowing that those statistics are not correct [perhaps it’s out of date? who knows...], and that I know where I am with the hair scenario. My first chemo is Tuesday 8th April, after an assessment on the 4th. After that, off to the GP for a blood count 3 days before each session. 6 sessions in total, one every 3 weeks as long as my blood count remains ok.
Travelling during chemo isn't advised, as the risk of infection is high, especially from the 7th to the 14th day after the chemo when the immune system is at it's lowest. So, avoid the Great Unwashed at all costs it seems!

When you read this, please remember that all this is MY personal opinion, and the things I have been told relate personally to me. So!! Just to get through the next 4 months, and back to normal life as we know it. I really think it’ll speed by, as I'll be waiting as per usual - waiting for the blood count, then the chemo, then the blood count etc etc. A fast forward button would be handy!

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