Pre-assessment

It's Wednesday and it is back to hospital to see the Macmillan nurse. She has a large pile of booklets on her desk, including my hospital record which is a centimetre thick.

Today's appointment is actually not clinical - the only clinical activity is taking my height and weight so that my dosage can be calculated. Rather there is a lot of talking, explaining exactly what will happen and going over the side effects and what I should do about them. She is very focused on how much of last week's consultation I have understood, and gives me the opportunity to ask questions. She is also very helpful on management of side effects, offering strong suggestions such as using a mouthwash to prevent ulcers and bringing a scarf to sessions because the cold air can make you feel like your throat is closing up. The main potential side effects seem to be: neuropathy - pins and needles - in the hands and feet, hair thinning (she suggests I cut my shoulder length hair to lessen the weight so it breaks less), constipation (from the anti-sickness drugs), diahorrea (from the chemo drugs), mouth ulcers, increased sensitivity to cold, dry hands and feet, brittle nails and fatigue. I'm sure there's a couple in there that I have forgotten. There's a booklet, a bit like the maternity notes you get given here to carry around with you, that comes with a grid listing the side effects and grading their severity from white, which means call us to discuss managing it, then green, amber and red. If you're in the amber or red zone you're in trouble. Side effects apart there is help for everything if we need it - financial advice, emotional support, day-to-day practicalities. We're very lucky we don't need it right now, but it's comforting to know it's there if we do.

What I had assumed was that as week 3 is rest week, this would be my best week for going out and doing stuff. Apparently not - 7 to 10 days post chemo is when the body is at its lowest so the immune system is most compromised and the fatigue is worst. However, as I've already decided to get on with things, make arrangements and then break them if it's all too much, this won't really make a difference.

DH and I leave feeling a lot better informed. He has asked once or twice if I'm scared. Actually, I'm not. This needs doing, so let's just get on with it shall we?

Wednesday night DH and I go out for pre-chemo dinner. This involves rare steak, seafood, soft boiled eggs and a sampling of DH's cheese course so I can have my last taste of blue cheese. Looking at that list it doesn't sound very appetising but it really was! We talk about nice things to do post chemo and all sorts of non-cancer related things, and I leave the restaurant feeling almost normal. I just hope they don't check my alcohol levels in the morning bloods!