Well here we are. The night before the morning after. My chemo kicks off in about 12 hours time. After a couple of false starts, and a lot of sitting around waiting, I’m finally about to embark on my treatment. I’d be lying, and barely human if I didn’t confess to feeling a little apprehension, after all the cure is renowned for being worse than the illness, but mostly I’m just feeling relief, and even a little perverse excitement.
Jo and I went up to the Oncology Unit this morning for my final assessment prior to starting my first chemotherapy cycle first thing in the morning. This consultation seems to revolve mostly around me signing more consent forms and making sure that I completely, absolutely, and definitely-without-a-shaddow-of-doubt understand what I’m letting myself in for. Like I have a choice. We all run over the drug regime in detail again, and I’m weighed and measured (again), after which Aemon our rosy cheeked Jewish/Irish oncologist de jour performs lengthy and complicated calculations on an improbably large desktop calculator – something to do with my Body Mass Index and aerodynamic drag-coefficient – then writes me out an even lengthier prescription in that dense and inscrutable handwriting reserved exclusively for physicians and the profoundly handicapped.
We head down to the hospital pharmacy and I hand over the script. The girl behind the counter wants to weigh and measure me yet again, but by this time I’m able to rattle off the salient information from memory. (180 cm / 80.5 Kgs / Aquarius / Golf handicap 126). After the obligatory half hour wait, my name is called and I step up to the counter to be presented with a small plastic shopping basket brimming with boxes and jars of tablets and capsules. Surly some mistake I protest. these can’t possibly all be for me. There are enough drugs here to render Keith Richards temporarily unconscious. I’m assured that yes, these are all for me. And this is just for the first three weeks. I run over the complicated doses and timings again with the head pharmacist, and I’m presented with a little green spiral bound book with more blood-curdling information about Xeloda, it’s correct use, and it’s veritable cavalcade of alarming side-effects. It’s printed in bright colours and jaunty typefaces in an entirely unconvincing attempt to render the contents more palatable. A little like those creepy and patronizing bank ads in “Teenager” and “Girlfriend” designed to separate young adults from their first pay-packet. In the back is a diary section where I am to record my daily dosage, along with my temperature, weight and a code letter for any symptoms or side-effects.
D = Diarrhea
V = Vomiting
S = Stomatitis
N = Nausea
H = Hand-Foot Syndrome
F = Fever
O = Other Side-Effects
R = Rest
FG = Feel Good
DGASA = Don’t Give a Shit Anymore
ICSA = I Can See Angels!
OKIMTLTU = OK, I made those last two up
When I get home, I empty the bulging brown paper bag of pharmaceuticals out onto the table for an inventory. Two boxes of Xeloda (Capecitabine) one enormous, the other merely large. 500 mg tablets and 150 mg tablets respectively. Baby Pink. I wonder if that’s a function of the ingredients, or some marketing psychologists lame attempt to make them look slightly less sinister – like painting the inside of a panic-room pastel green.I’m gratified to note that boxes are marked Made in Mexico where all the very best narcotics come from. I wonder if Roche leave severed heads on the roadside to warn off the other local drug barons.
Oh yes. One other thing. You know you’re operating at the pointy end of the Pharmo-chemical spectrum when your box of tablets come with its own training DVD. Incidentally, according to the till receipt, my three week supply of Xeloda cost you the taxpayer just under eight hundred bucks. Cost to me $10. Thanks guys.
This then, is the X component of my ECX regime, the E for Epirubicin and C for Cisplatin will be administered intravenously at the hospital in the morning. There is also a plastic bottle of a steroid called Dexamethasone, a powerful anti-nausea agent, and two further boxes of something called Damperidone, which is also for sickness and vomiting. Hmm. I think there’s a message here somewhere. I cast my mind back to an innocent question I asked Aemon this morning. “Any particular dietary advice?” He gave me a wry smile and said “Anything you can keep down will be just fine.”