Lining up under the 'friendly' stormtrooper machines with their hum and whoosh
The ceiling frames remind me of a Tuscan sky
My 'go-to dreaming place', an ancient vineyard, Tuscany, Italy
May we always keep dreaming- good dreams! And acting on those dreams...
This is the third in my blog series on Head Neck Cancer, with the aim, as a participant-observer patient at Peter Mac Cancer Centre, Melbourne, to understand and raise awareness of cancer, in particular Squamous Cell Carcinoma Head and Neck Cancer (SCCHNC) of the oropharyngeal region, linked with Human Papilloma virus (HP virus; see http://www.hpv.com.au/).
I am participating in a clinical trial to compare two different chemo drugs used in combination with radiotherapy. I have just finished the first week of radiotherapy. Every day, in the lower ground floor of the stunning Peter Mac Centre, I don a dark blue hospital gown for about thirty minutes. This gown is kept in a large light blue plastic bag clearly marked with my name, and stored in a pigeon-hole locker with my name...for the seven weeks of treatment ( 35 days, Monday to Friday).
I am escorted into the treatment room and placed on a long narrow bench, already set up with my custom-made head and neck rest, and leg support. The therapists confirm that I can state my name, date of birth and address, that I know what I am being treated for, dentures are placed in the plastic box. They then fit my custom-made plastic mesh mask, ask me to wiggle to ensure the perfect fit, everything is lined up and I am clipped down for the next ten minutes. I hold a baton with bells, just in case I need urgent help. The assistants leave the room, and for the next several minutes, they slowly rotate the machines like giant benign storm-troopers, expressionless, to send their radiation to their target, a bullseye each time.
If I open my eyes, my eyelashes brush the inside of the mask. The ceiling comprises bright panels of Michelangelo blue sky, edged with leafy green tree tops; I close my eyes and drift off to my special visualisation walk in early Spring along a country lane in Impruneta, just south of Florence, and see David and me, totally relaxed, having a picnic in an ancient vineyard. ...accompanied by the music of Mozart, by request.
I don't get too far into this reverie, when the low hum of the machines stop, a therapist steps in and unclips me, packs up my mask, and sends me on my way. There is an air of unreality, a dissociation from what is happening. I change back into street clothes, packing my gown back into the plastic bag and pigeonhole. See you tomorrow. A cup of tea and sweet biscuits in the Wellbeing Centre on the first floor, brings me back to the present before we step out onto the street.
I am closely observing symptoms and side effects, and so far changes are subtle, rather than a dramatic storm surge. However, as I am also receiving chemotherapy treatment on Tuesdays via an intravenous drip, the combination sets up more noticeable side effects.
PEG feeding tube in position- not required, just yet! David flushes with warm water twice a day...
David's full-of-goodness smoothie, ready to blend
Best choc mousse in a glass
Shanghai Mouse, happy with Mr Rabbit, drawn by Mat Terrett
Dreaming with Mind Alive during Chemo treatment-2 hours
David Delight Pro from Mind Alive, David Sievers, Canada
I started chemo one week prior to commencing radiotherapy - the so called 'loading' dose of 730 mg, with reduced doses 460mg every Tuesday. The day after this first chemo treatment, I had a surgical procedure to position the PEG feeding tube in my stomach, followed by an overnight stay in the ward. The anaesthetic team mentioned 'cytotoxic' and checked if anyone was pregnant.
My ward bed was placed beside a large red bin, labelled 'CYTOTOXIC WASTE'. Every time a nurse came to do my observations, she/ he donned an oversized pale blue plastic apron and darker blue rubber gloves, before discarding them in the bin moments later. One week later, the PEG tube incision has settled; I can sit up without it hurting; David flushes the system with warm water twice daily; we use normal hygiene hand-washing procedures, no kilometres of plastic. I am eating 'normally' by mouth, but can sense changes- a drying of the mouth-and a slowing down of the time it takes to eat anything. And a desire for freshness, and moistness.
My favourite smoothie combines RAW pea-based protein powder, avocado, chocolate powder, banana, blueberries, kiwifruit, almond milk and has the consistency of a liquid chocolate mousse. However, despite the healthy diet, my face has broken out in white acne-like spots over my nose and chin, and feels as if microbes are crawling feverishly under the skin. This is a side effect of the chemo drug.
No soap, no creams, just plain, unscented sorbolene, and even that stings. I feel a bit miserable about that, but Akamin antibiotics are prescribed and the spots settle in a few days. I notice that no-one is noticing my blemished face, or they are politely ignoring it.
The chemo drug is called CETUXIMAB. The wiki says that 'Cetuximab is an epidermal growth factor receptor (EGFR) inhibitor used for the treatment of metastatic colorectal cancer, metastatic non-small cell lung cancer and head and neck cancer. Cetuximab is a chimeric monoclonal antibody given by intravenous infusion.'
In Greek mythology, a chimera is a fire-breathing female monster with a lion's head, a goat's body, and a serpent's tail.
This particular drug chimera is formed by a fusion of 'MOUSE' and human cells!
[If you know the story of Miss Mouse and Mr Rabbit in my book Shanghai Mouse, illustrated by the wonderfully talented Mat Terrett and translated by Li Fang, you will find this fact amusing! PS. Mat, you could create a new graphic book on this theme...]
Monoclonal antibodies (mAbs) are made from identical immune cells that are clones of a unique parent cell. They are used like a 'homing device' to target the cancer cells.
Pre-medication including anti-nausea, steroids and antihistamine are given prior to cetuximab.
These tend to make me sleepy. So once I am hooked up, and with the 'David' Mind Alive light-and-sound system set on 'Feeling Better 4- eXtended deep alpha alpha relaXer, I am out like a light.
Sweet dreams, on the road to recovery!
Thank you for your reading, learning, sharing and caring best wishes, And special BIG thank you and hello to the dedicated staff at Peter Mac Cancer Centre, Melbourne, Victoria, Australia. Please write firstname.lastname@example.org, leave a comment, or say hi via FB.
As a gentle provocateur of positive change, Fleur Fallon is an educator, writer, editor, consultant. From Tasmania, Australia, she has had several teaching sojourns in China since 2000.