Tuesday 25 December 2012

Happy Christmas!

When I thought about Christmas this year I didn't know how I would be feeling, and whether I would have any appetite. I am very happy to report that I had a wonderful Christmas evening, absolutely stuffed myself with Yasmin's incredible cooking and got nicely tipsy on her cordon bleu mulled wine. Eggplant slices rolled round chopped walnuts, roast chicken with chestnut stuffing, beef hotpot, onion stuffed with burgul, home baked buns, mushrooms topped with something so tasty I couldn't resist them.... and a cheese platter with Camembert, strawberries dipped in chocolate and mousse filled wafers which Eli, Hilah's husband did. Wow, what a meal!
 I am now one week into treatment and still feel fine, am still working 4 hours a day except Tuesdays. Today I am being really lazy, but have to get up soon and go shopping. The bad cold I had seems to have gone, thank goodness!
Today is nurse, doctor and blood test day at the center so it will take longer than usual, but we are getting used to the trip and honing down the time it takes to get there. We are down to going out at 4.20 in order to arrive before 6.00pm, which is not bad seeing as it is over 50km to Beilinson. On usual days it takes exactly 5 minutes to do the treatment, of which four minutes is just getting my gown on and getting into the right position. I already know exactly how the machine will do it, 10 seconds from above, 15 seconds from the right side and 15 seconds from the left side. It amazes me that something so quick and completely painless can be so important.
Happy Christmas to everyone, cheers!

Thursday 20 December 2012

Day Three (what already?)

Not much to say, getting into a routine. Yesterday I went on the bus, it was ok except that I was too hot almost all the way, then finally realized I hadn't opened the air conditioning duct over my head! Today the weather is suddenly really cold and pouring with rain, so I decided to spoil myself, cancelled work and stayed in bed, yaaaay! I'm really hoping Oren will be back from work in time to take me today, because he has taken the umbrella. (See, this is one of those countries where people have one umbrella, just for emergencies.)
The only side effect I can say definitely that I am experiencing so far is a change in the taste of food. Ketchup tastes really acidic, and pecans taste really really good, I mean world class. Vodka tastes really good too, but this morning I have a bit of a hang over, so maybe I shouldn't really be drinking it with chemotherapy, well daaaah. Chocolate is still ok but a bit tasteless. This list gives away too much about my eating habits, doesn't it? Although I must say that Oren made a really good healthy Thai stir fry yesterday and it was great. I also have a bit of a craving for mashed potato with butter.

Tuesday 18 December 2012

The First Day

On the first day of Christmas my true love gave to me; two doses of chemo and a big dose of radiotherapy! (Well, I know it's not the first day of Christmas but it does nearly rhyme, give me a break.)
So... It feels a bit of an anticlimax. I've been waiting for so long to start treatment; I thought I would feel some change in my body immediately. All I feel is a certain amount of release from tension, no nausea or anything. I know this is usual, but I thought I would feel something, maybe just a tingling or something.
The radiotherapy unit is becoming more familiar to me, and I now have my own gown which I will use for all the treatments. I wait in the waiting area until my number is called, go into the changing room and find my gown, get changed and go to my 'accelerator'. The technicians there help me to get into position, I lie there for a few minutes and the machine does its job. Then I go out, get dressed and go either to the nurse, doctor or straight home, depending on what is written on my appointment card for that day. Today was nurse day, I got blood taken and got weighed; I have gained 1.7 kilos in the last month (told you I was stuffing my face, didn't I).
 I think evening is a good time to do the radiotherapy, it means I don't waste the best part of the day- being winter it is dark by 4.30 or so anyway. Also the mall across from the hospital is open when I come out, ah ha!
I started the chemotherapy this morning, also a big let down. No immediate projectile vomiting, reams of hair strewn about or anything. I hope this stuff is strong enough. Lucky they don't let you mix your own, I'd make it super strength and poison myself to death probably.

Saturday 15 December 2012

T - 3 days and counting....

So.... just a bit of background really, since nothing is new. Oh, except that I have received the chemotherapy drug I will be taking. The drug is called Xeloda, and converts in the body to 5FU. It doesn't look at all special, just medium sized pink oval pills. I'll be taking a lot; 1500mg in the morning and 1000mg in the evening, every day I have radiation. It has a synergistic effect, which means it makes the radiotherapy much more efficient at killing that nasty thing stuck up my nether regions. I will be doing 28 treatments broken up into 5 day blocks, with Friday and Saturday off, so about five and a half weeks. The main side effect both of the chemo and radiotherapy is probably going to be diarrhea, with fatigue a close second, and loss of appetite in there too. These are things I can deal with, the worst scenario is that I stop working for a while, and only eat chocolate, hahahahaha.
One issue that bothers me is the cognitive side effects of this treatment. First of all, I will probably have a rather wooly brain during treatment, this is called chemobrain and is caused by  neurotoxicity. Short term memory loss, confusion, even dementia like symptoms can appear, and may last for quite a while afterwards. So if I stop blogging you can make an educated guess I've forgotten how, ha ha ha ha ha, ha ha, ahem. The second thing is that 5FU lowers serotonin levels, which usually causes depression. So, if I don't forget how to blog altogether I will probably be whingeing on, for no better reason than low serotonin. Does knowing this help? Does it help when you know you are only yelling at your husband because you have PMT? NOT REALLY.
So, to sum it up, I will be fed up and won't remember why. Or I will forget I am fed up. Hmmm....
On the positive side, it turns out I probably won't lose all my hair, it will just thin out a bit, and let's face it, I have some to spare. So I have dyed my roots, which came out too black AGAIN, grrrr! Maybe it would be better if it did all fall out and I could start again and get it the right colour.
We have finally heard news from Puerto Princesa, not from Cissy (the owner of the mooring Chasamba is on), who hasn't ever bothered to send us any emails at all even to answer ours, but from good friends who have just arrived back there to their yacht. The typhoon didn't do any damage in Puerto, Chasamba is fine, they have checked her bilges and she is dry! Also they have fixed some little holes in the sprayhood for us. We are very lucky to have such good friends. Now we just have to find a new home for Sheva, poor thing, because the person who is looking after her won't be able to do it for much longer. I wish she was here with us, but the trip would be too long and difficult for her.
Anyway, back to cancer talk; I'm strapped in, mission control is running down the check list and all systems are go.

Sunday 9 December 2012

The Simulator

Sounds like the title of an episode of Dr. Who, doesn't it?  Watch out, the simulator is coming!!! Actually...a simulator is a really big shiny white machine thing that they slid me into on a thin little bed thing. It's a non diagnostic CT, so I had to drink bitter raspberry flavoured water first, but at least no iodine injection for this one. It is preparation for radiation therapy.
The place; Davidoff Centre, Beilinson Hospital, Petach Tikva.
The time; all frigging morning.
The purpose; to map the path that the x-ray beams will take in order to try to avoid as much healthy tissue as possible.
The method;lie in cobra pose for 15 minutes without moving a muscle ( not kidding) while a jet engine whizzes round my head and body. Well, it whizzes round for 5 minutes or so, then I wait until the technician is satisfied that the position is good, then he comes and tattoos my sides and right on my tailbone. I always wanted a tattoo, but I was thinking of something more artistic. (Lucky I never did one, they might have got mixed up and irradiated my chin or something.) Then I am allowed to claw my way out of cobra pose and fall gracefully off the bed thing, semi arrange my clothing, stumble out of the Tardis and into the NASA command centre it is attached to. On one of the twenty screens I get a brief glimpse of my hip bones; rather nice hip bones when you see them from inside, without the slight blubber layer. Then I am escorted out to wait for the oncologist.
I thought the actual radiotherapy would start immediately, but the technician explained that the planning stage is the most important part of the treatment; if the area isn't exactly right I will have more side effects and the tumour will get less radiation. For this reason the scans they did today have to be checked by a team of physicists, doctors and technicians, and have to pass a final check which confirms the path the beam will take. This takes 9 days, and so the treatment will start on the 18th of December. This is ok according to the oncologist I saw today. The important thing is the response of the tumour, which meanwhile has responded by saying it wants to speak with its lawyer, and would like its one telephone call.
Today is the first day of Hannuka, Happy Hannuka everyone!

Friday 7 December 2012

Radiation Here I Come!!!

Beilinson Hospital has called, much sooner than I expected, and on Sunday we go for the first appointment. This will be to measure me, draw dots to guide the beam of x-rays and all kinds of administrative things. I am so glad not to have to wait longer and just hope this means the actual treatment will start the next day. I guess it will. I never thought I would feel happy to start radio and chemotherapy, but I am.
The technician who called gave us the option of choosing which hour we want, and I chose 6pm. This is really a good time because it means that I don't have to get up early if I don't feel good, there are less traffic jams and I can get things done in the morning, when I am likely to feel more energetic. I may even carry on working, depending on how I feel, although I am entitled to a temporary disability pension. We'll see.
So the next job is to get the clippers out, I guess. Or I could have fun pulling clumps of hair out while in line at the supermarket. I could complain loudly about the length of the line at the same time...

Wednesday 5 December 2012

Slowly Onwards....

OK, so today was the big day I have been waiting for. We got to Meir Hospital ridiculously early, hung around eating croissants ( not croissants that any French person would recognize as such, Luke) and upside down coffee ( that frothy coffee, that's what they call it in Hebrew). I was sure the Professor wasn't coming for some reason, but right on time he came in and called us into his room.
I have worked with a lot of doctors, and respect many of them, but Prof. Shpitz is honestly the best doctor I have ever had the pleasure of talking to. He is also a very nice person, and made what could have been a very difficult visit easy. We showed him all the tests I have done so far, the CT, the colonoscopy, the rectal ultrasound, the blood tests and so on, and he gave me an examination. The conclusion was as we had expected; I will have radiation therapy and chemotherapy for six weeks, then a one month rest to let the tumour shrink as much as possible, then an operation. This will be a lower anterior resection by laparotomy. Then he set up a meeting with an oncologist for us and wished us well in the meantime, leaving us his personal phone number in case of problems of any kind.
The oncologist was also ok, but couldn't compete with Prof. Shpitz in niceness. To be fair, he was much busier, and only managed to see us because Prof. Shpitz asked him to.  He explained that I will need 5000 rads of radiation split up into 33 doses, and that this will be done in Beilinson Hospital, which is in Petach Tikva. It's a long way to go every day, but at least I get traveling expenses back. Unfortunately we now have to wait AGAIN, because my file has been faxed to Beilinson but it will take them 10 days or so to get me into their schedule. This is annoying, but unavoidable ( unless you are a member of parliament, or royal or something, I expect). The oncologist says it doesn't matter, what will be important is how the tumour reacts to the treatment. The best scenario is that it could disappear altogether- although I will still need the operation. The worst one is probably that it gets it's own talk show, or brings out a cd; ,'Bummy Tumour and the Lymph Nodes play Abba's Greatest Hits'. ( For all Israeli readers, this is an example of English humour, it doesn't mean the cancer has got to my brain.)
The chemotherapy part of the treatment will be pills, so at least I don't have to be hooked up to an iv every day. The oncologist says that side effects from this regimen are fairly reasonable, mostly just diarrhea and tiredness. It's only six weeks anyway, so it should be ok. I think I lose my hair though, which is frustrating having just spent four years growing it long! Not that it is really wonderful hair anyway though, so 'capara'.  ( a totally untranslatable Hebrew term meaning that this is the chicken which is sacrificed to remove sins and save the sinners head). ( honestly.)
So, next big date is the start of radiation treatment, although I do have other things to do meanwhile. The most annoying of these is that I need another CT because my GP didn't send me for a chest CT at the same time as the pelvic one. And I TOLD her I would need one, stupid woman. So I have to go through all that again, the worst thing being the absolute waste of time spent getting there and hanging around drinking the awful radioactive water.
On the bright side the big typhoon which came really close to Puerto Princesa, where Chasamba is moored, seems to have gone just north enough to be ok. There is no word from there, but probably the electricity is down and so there is no internet. Fingers crossed all round, I suppose!