Stent and Chemo 6 update

Sean Callagy Live Blood Image 2013-11-21
My blood ten days after Chemo 6

A lot… an awful lot… has happened since my last post. And, yes, a lot of what has happened has been awful. Not physically awful like my reaction to that anti-biotic, but emotionally and mentally awful. Because, while November and December were replete with signs that I was getting steadily better and better (including a nicer Live Blood Analysis profile – see photo), I was finally beginning to feel it all.

Very deeply.

I guess it’s the reality of how we humans deal with trauma. While in the thick of something we do all we can to get through. Including dampening our emotions. Then, when it’s all over, we collapse in our own individual ways… and then find our individual ways of recovering in our own time. That’s why I’ve been so quiet these last few months.

Because, despite having so much to tell you about – and despite the fact that most of it is thankfully positive – I just couldn’t bring myself to share it. Because recounting meant recalling; and recalling meant reliving… and there was no way I could do that while simultaneously trying to admit and process huge post-traumatic emotions while also researching and informing myself about my survival chances and prognosis if I declined the suggested post-chemo, two-year maintenance treatment.

Let me summarise the roller-coaster for you…

Reading the stats on your own chances with a cancer that medics say is incurable is horrible beyond words. Add to that the upset of the last six months finally kicking in. Then compund that yet again with new fear that grips when you notice a lump is slightly bigger than it was yesterday. Then a Great Northern Diver eats a crab in the ocean just yards from you and the wonder of Life triggers joy… and then you remember that since having your stent fitted in November, three men you shared a ward with have died with cancer and… oh, and you have it too.

So with all that emotional see-sawing going on, sometimes dozens of times a day, putting energy into blogging would have been unwise.

However, mid-January I started Art Therapy in the Sligo Cancer Support Centre and am now feeling more at home with my new reality and the plethora of emotions it’s triggering. Yes, there are times when the horror of it all still comes crashing through… but those times are growing less and less frequent now. Which means there is more room for joy and there is a very welcome (but still fragile) confidence growing as my new epigenetic-focused lifestyle seems to be taking hold nicely.* Time will tell just how well-placed that confidence is. But if Robert Miller was diagnosed at 45 and is still going strong at 70+ now – and his oncologist works with two members of the team who identified the 109 genes involved in Follicular Lymphoma – there’s every chance he’s on the mark with his suggestions how I can tip the eipgenetic balance back in my favour.

So, I finally have the energy to update you to the end of November…

Stent almost unnoticeable

Thankfully. Apart from two, fairly non-intrusive phenomena.

The first is an occasional sensation of pressure inside. Somewhere around where my right kidney is. Only occasional, and not painful. Just mildly annoying. As it would be if you felt someone’s finger pressing into your back and they didn’t ease off when you objected. But shifting a bit in my chair or standing and moving generally releases it. It only happens once every two or three days so, as it’s preserving what’s left of my right kidney function, I can live with it. The other experience is also tolerable; and in fact is, at times, somewhat entertaining.

Prior to the stent I would always get plenty of warning about when my bladder might need emptying. So much warning that I could often go several hours from first hint to a desperate need to empty. Which gave me plenty of time to plan where I’d eventually go (very useful on a long drive or when stuck in traffic!). But those ‘plenty-of-warning’ days are no more.

Because now, I can be sitting watching TV, on the computer or driving and get no hint at all of anything building up. Then I stand and… whoosh!… it’s like a bucket of water has been suddenly poured into my bladder and there are barely minutes before my trousers are in danger of a soaking. The entertaining bit? Well it’s sometimes frankly ludicrous just how much the signals can be at odds with the results. In some cases a mild urge produces what must surely be a pint or more. Other times an extremely urgent and dangerously full feeling barely yields a whiskey glass worth.

But thankfully, other than in those two ways, the stent in my right ureter is unnoticeable. I hope this continues to be the case when it’s replaced in the coming weeks… unless… unless… dare I dream?… my abdominal nodes have shrunk sufficiently since the last renogram that they no longer encase my urter. Which would mean my kidney would no longer need the help of this artificial drain pipe. My January 9th renogram will have revealed the inner story – and they will tell me when they bring me in for the operation in the coming weeks (apparently the procedure is so light, I could be released that same day or, at worst, kept overnight).

Chemo 6 – sheer exhaustion

November 11th brought the sixth of six sessions of R-CHOP. As usual the day passed quickly – no doubt helped by sleeping through considerable chunks of it. But there were several notable experiences. The first of which was seeing myself in a mirror halfway through.

As usual, by lunch, my bum was sore from sitting for hours and my bladder was dropping some hints. So, seizing the opportunity between drips, I took my usual corridor stroll with my friend, and surprised myself by walking way further than on any previous day. So I found myself using an unknown toilet – a toilet with a mirror. From which a drained, haggard and ghostly white face stared back. A face so different from the one my mirror at home had shown me that morning that I was jolted into almost the same depths of shock as when I’d had “My Auschwitz Moment” some months before.**

But I took a breath, dug deep… very deep… and reminded myself that things were going pretty well. I was now regularly walking 2-4km daily – further than I’d been able to walk for years (yip, this cancer had been tiring me for years). Bloods the day before had revealed a new LDH low of 332 suggesting those abdominal nodes were continuing to shrink. Also, there had been previous chemo days on which I’d been far, far weaker. So weak in fact that I needed a wheelchair to get and from the treatment room. Yet here I was… having just walked yonks further than on any previous break… able to stand freely and stare at myself in a mirror knowing full well I could walk all the way back with barely an effort. So no matter what impression the mirror gave, I was doing okay.

Of course, logic doesn’t always trump feelings. But nonetheless, somewhat reassured, I walked back and feel asleep shortly after the next drip began.

Next thing I knew they were waking me for the final three injections. Three huge syringes, the contents of which had to be injected manually through a cannula – because these are the ones most likely to cause your veins to collapse and so might need to be stopped promptly. Dripping them in, unobserved, is considered too dangerous.

All was going well until… along with the normal chilly cold feeling (one of them came from the fridge)… I sensed a change in my arm. Something different. Something like what I felt just before that anti-biotic shock. The nurse paused and asked very seriously if I wanted her to continue. I said yes but to proceed with caution. She asked again. This was chemo and she needed to be sure I wanted to go on. More nervously now, I still affirmed. That strange sensation continued for a few more seconds… but then faded. So I made it to the end of the injections.

The other incident of note that day was an internal one: the sudden realisation that a whole new emotional vista was opening in front of me. A new, dreadfully unknown, landscape had to be entered. Unlike other landscapes, ones which might open because I had chosen a new career for instance, this was one I couldn’t turn and walk away from. This one was going to be my landscape for the rest of my life. No matter which way I turned. Of course I knew this moment had been coming all along… but still, I wasn’t ready for just how powerfully it would hit me when, while syringing, the nurse said something along the lines of “Great day for you today Sean! The last day of chemo!”.

Of course she thought I’d be happy to see the end of treatment. No more hospital visits. No more chemical-laden injections. But my reaction was “oh fuck, oh holy fuck, I’ve reached the end of chemo… the end of the stuff that has just saved my life… what happens now… what if the cancer comes back… what if the epignetic and anti-angiogenesis stuff stuff doesn’t work for me… what if this is the beginning of my end… ?”

It was a tough few minutes. Far tougher than the toilet mirror. But, nonetheless, I couldn’t help falling asleep after the final injection… and remaining so until 4:30 when they woke me so they could close the ward. I’d somehow slept through the hubbub of six other patients leaving their own chemo chairs and going home. I found this worrying. Because 3pm was my usual departure time… and as that strange sensation in my arm had happened during the red injection (the one known to be toxic to the heart muscle) I worried if I’d pushed things too far when saying “yes, please continue”.

But thankfully I was able to walk to the car… and then (amazingly) walked nearly 1.5km when back in Rosses Point. Then I quickly settled into the same pattern I’d adopted for each of the previous three-week cycles. The fruit, nut and yoghurt breakfast followed by some weights and as long a walk as I could manage. Then some meat and veg for lunch while testing my brain with Countdown before dozing / napping until ready to eat more veg and meat, fish or eggs in the evening. Or pudding rice with Simon’s Buns, almonds and maybe some Carrageen.

Then in week three, as had been happening ever since Chemo 3 onward, the nausea got worse and more frequent. An experience the nurses had quaintly and reassuringly dubbed “delayed nausea”. Seems it happens that some folk get the nausea some time after the chemo chemicals have faded (fading which takes about 5-6 days after treatment). But, helped by walking-to-distract-from-it, that fortnight too passed.

Suddenly it was December… and there were several big, very big, things looming on the horizon.

I needed dental work done. Then there was a CAT Scan ahead that would show the size of whatever remained of abdominal nodes. After that there was a PET Scan to see just how much active cancer still remained (because they can’t kill Follicular Lymphoma with chemo; at best they can knock it back for a while). And, biggest of all, I needed to make a decision about maintenance treatment – scheduled to start January 7th.

So, while glad to be alive to enjoy another one, it was going to be a fateful and busy run up to, and through, Solstice. But thankfully I was finally beginning to feel the energy to engage with it all… 😀


* Epigenetics refers to how lifestyle and life experiences determine to what extent certain genetic potentials are expressed or not. For instance, identical twins with matching genetic profiles in their early years, develop completely different epigenome profiles as they age – and so can have vastly different health experiences as a result. This video gives a good intro to the subject:

** This is not a glib remark. My Auschwitz Moment is the most succinct way I can convey the horror of what I saw one day in a hospital mirror. Prior to and after my first chemo I was so weak that I was collapsing exhausted into bed after every 3m round trip from bed to toilet and back. Yes, a 3m, leaning-on-wall shuffle left me exhausted every time. But gradually, as I grew accustomed to the interweaving patterns of nausea and heartburn, I managed to increase food intake and began to gain strength. Until one day I felt ready for the challenge of planning and executing a shower. While undressing I saw myself in the mirror and was rooted with shock. Finally tears of horror, shock and the most awful fear impulsed me away from the sight of my own emaciation. Which was all the more shocking because, until that moment, my steroid-swollen legs and cancer-bloated abdomen were all I’d seen of my body. So I’d had no hint of just how dreadfully thin I’d become. The fluid retention in particular had been hiding it. But now there was no escaping the sight of my rib cage, the absence of pectoral muscles and horribly bone-thin upper arms… the like of which I’d only ever seen before in those horrific concentration camp photos. Hence my dubbing this My Auschwitz Moment.