#14 Happiness Is A Tablet Called Aprepitant – Nov 4, 2007

Number of days since last chemo: 9
Number of days until next chemo: 19
Number of chemo treatments left: 3
Mood: jubliant!

Yes that’s right, it’s my first entry after a chemo treatment and I’m using words like ‘happiness’ and ‘jubilant’ rather than ‘nightmare’ and ‘horrendous’ – I can hardly believe it myself, but it’s true! And all because the promised wonder anti-sickness tablet really lived up to its reputation.

The day of the chemo started well when Justin phoned the hospital and they confirmed there was a bed available for me, and that I should be at the ward by 10:30am ready to be admitted. Of course that never actually means that your bed is freshly made and empty ready for you to climb into, it just means that it’s going to be empty at some point during the day for you to have. So, after a 4 hour wait my bed finally became free and I got admitted onto the ward. Then came the greatly anticipated part – I was given a single tablet to take orally, the magic, and apparently quite expensive to the NHS, aprepitant. Once you have taken it, you wait for a hour and then have your chemo as nomal. It was quite a good job I did have to wait for an hour too, because it took them most of that time to find a vein and get a cannula in. My veins are not always very cooperative, which I guess I can’t blame them for really considering how much they have been used and abused over the last couple of years. According to almost every doctor or nurse who looks at them, they are very small and narrow, so I always have to wrap my arm in a heat pad for about 1/2 hour to dilate them and make it easier to find a viable one to use. Unfortunately this time they just weren’t having any of it, and a doctor made 2 very painful attempts at getting a cannula in (wikipedia ‘cannula’ to see just how torturous they are!), puncturing the side of one vein in the process, before I virtually screamed at him to stop! He then went to get a nurse to do it, who also got the cannula needle part way into a vein in my right wrist, before pushing it straight through the vein wall. By that stage I’d been at hospital for 5 hours, I was tense and nervous about how ill the chemo was going to make me, and had extremely painful and bleeding wrists and hands, along with the fear that they wouldn’t ever be able to find a vein, so I did something I have never done at a hospital before, I sat and cried. Fortunately they went off and found a specialist phlebotomy nurse who was really lovely, and spent about 20 minutes trying to find a vein before even attempting to cannulate. She also found a smaller needle kit and, because all the larger blue veins in my wrists and hands had been brutalised, managed to find and successfully cannulate a smaller vein halfway up my arm. It was a huge relief!

By that point I was starting to think that maybe things weren’t boding quite so well for the chemo after all. But, at 4:00pm I finally started having the chemo and there was no going back. 6 & 1/2 hours later, and a full 12 hours after getting to the hospital, the chemo was over and all I could do was to try and sleep and just keep my fingers crossed that the sickness didn’t start. At about 2:00am I started to feel a bit worse for wear, so the doctor gave me a sleeping tablet to try and knock me out, which under any normal circumstances it might have done, but this was a hospital and therefore not an environment conducive to peaceful sleep! Not only are there lights on in the corridors, but patients ring their call bells so nurses are constantly moving around, there’s the noise of other people snoring/moaning/being sick, and worst of all, because on this ward there was some very ill people, there were cardiac arrest sirens with an accompanying automated voice alerting all the doctors and nurses to the cardiac arrest and telling them which bed it’s in. I think it is honestly one of the worst sounds I have ever heard because you know that not far from you someone is losing their battle with cancer. So, even with a sleeping tablet it’s pretty hard to actually nod off. But, I did manage to a bit, and at 8:00am when they come around with the drugs trolley I got another aprepitant tablet, along with a couple of the regular anti-sickness drugs I take after chemo, and by 11:00am I was feeling fine enough to actually start wondering what was for lunch. Yes that’s right, the day after chemo and I was eating and drinking! I’m not exactly talking 3 course meal, but considering after my last treatment I didn’t eat for 4 days, I was practically bouncing off the walls with excitement! I was still a bit anxious that the tablet was just delaying the sickness, but by Saturday night the nurses took my drip down, and on Sunday, after my third and final aprepitant tablet, I felt confident enough to discharge myself.

Once I was back home the district nurses came in to check on me, and couldn’t believe their eyes. I was out of bed, dressed, and managing to eat and drink, it really was like I was a different person! However, with this silver lining there was a small cloud, in the form of an infection that I picked up while in hospital. So, just as I thought I was doing really well, on Wednesday Justin had to call out a doctor because my throat had swollen up – blasted hospital germs! To go along with that one of the side effects of Taxol, aching and painful joints, really kicked in and meant I could barely hobble, and Justin had to practically carry me around the house. Yesterday I finally managed the stairs on my own – it’s amazing how the smallest thing can suddenly seem like a huge achievement! My knees and ankles still feel like those of an 80 year old, and I’m still on antibiotics for my gammy throat, but I have managed a whole chemo treatment without being sick, and that brings a huge grin to my face. Not only that, but hopefully it means that for my remaining treatments I’ll be able to bring the tablet home and won’t have to stay in hospital. It may have taken 9 doses to get the right drug for me, but I’ve found it, and no matter how much it costs the NHS, I’m not letting it go!

xxx