Sunday, February 24, 2013

Nobody expects the Spanish Inquisition

This round is proving to be even harder work than the last one. Given the escalation of side effects, and the knowledge that the poisons are building up in my body over time, shouldn't I have expected that?

Nobody expects the Spanish Inquisition.

I mean, for heaven's sake. The first type of antibiotic didn't get rid of my chest infection. Neither did the second. The third made me instantly nauseous, being one of those rotten things that has to be taken on an empty stomach, and by the end of the first course I hadn't seen much of an improvement in my cough. I even rang Dr Mellow to suggest that this regime wasn't doing the trick; you'll probably be unsurprised to hear that the message was faithfully passed on and he rang me back this time, promising to shoot me full of intravenous antibiotics at Round 5 if I wasn't 100%.

Thanks, Vi.

That was reassuring, in a way, but it didn't do much for my current predicament. I really hadn't had any respite for weeks and weeks from feeling as flat as a steamrolled cat. My exercise regime had gone to hell in a handcart, and of course that had made me mentally miserable on top of the sheer numbing lethargy in my bones. I lay completely inert in bed for so long my body was starting to ache from the inactivity. Only the thought of bed sores- bed sores? That's for grandmothers!- spurred me into momentary movement.

Getting up for any reason other than to drag myself to the bathroom? Nah. Shoulder exercises? Meh. Lymph massages? Hrmph. Now and then, half-heartedly.

And then we got flooded in, AGAIN. Another cyclonic weather system moved in from the east, dumping inches more rain and blowing down yet another huge tree near the house. Miraculously, the falling giant again missed all the buildings.

Thank the stars, it also came nowhere near the Bear this time, who watched it fall standing by my side on the veranda (yep, that got me up) instead of being engrossed in his usual caper of running around in the elements trying to do heroics.

Crazy yachtsman. But once bitten, twice wise.

And then, as the jewel in the crown, as the weekend arrived I managed to pick up a 24-hour gastric bug. Oh joy. Bring out the Iron Maiden. Seriously, there were some moments where death felt like a desirable option.

*****************

At first I was blaming the new antibiotic for how lousy I was feeling. The first chilling symptom was that on Friday night I could only get halfway through my bowl of cousin Nancy's soup. I'm telling you, nobody who starts a bowl of her soup eats half of it. 

Bloody antibiotics, I cursed, pushing the plate away.

By Saturday morning, I truly wanted to die. My stomach was in knots and I was doing laps to the dunny. In a rare moment of calm I looked up the side effects leaflet for Roxithromycin on the internet, and sure enough, there it was: vomiting and diarrhoea.

Wonderful.

And then came the moment I'd been dreading. What the chemo couldn't achieve, the antibiotic had managed- Ferdinand lost his lunch.

Violently, and immediately.

I wouldn't have believed, by the end of the day, that I had anything left in my body to deliver to the Caroma. Lord knows I hadn't eaten a thing since ignoring Ferdi's NO! and swallowing a few cautious mouthfuls of custard to grease his drying scales.

Note to self: when Ferdi says NO!, he means NO!.

But apparently inserting food is not a prerequisite. Off I staggered, over and over again, falling over dogs and stumbling on steps as I negotiated the well-worn track to the porcelain throne.

I remember thinking, at one particularly dire moment when my stomach was gripped with outrageous cramps, how fortunate I had been through all this chemo to have been completely spared the nausea. Nausea is the one thing that undoes me completely. Yes, yes, I can put on the Superwoman cloak and bluff my merry way through all sorts of side effects and symptoms with a smile on my dial- even joke about them- but attack my stomach and I lose everything. No pun intended. The sense of humour leaves first, hand in hand with my will to live. I just want it to stop.

Yep, this would be a very different blog if I didn't have a cast iron gut.

***************

The next day, when I'd at least stopped hurling and could get myself out of the throne room for long enough to do a Google search, I started looking for answers. I talked to medically-astute friends. I decided to stop the antibiotic.

Changed my mind.

Changed my mind again.

And again.

Realised I was being irrational.

Realised I needed proper medical advice- but here I was, totally stranded, on a weekend, and possibly dehydrating at a rate of knots. I realised I had no clear idea of who I should be calling for help.

Of course, in the end I called Jools, who was soon telling me persuasively that this wasn't the usual course of an intolerance reaction to an antibiotic- it was much more likely to be another infection. With my protective earth-mother friend shaking her finger down the phone at me and talking severely about rescue helicopters again, I finally found the energy to call Dr Rosie's practice. Surely there would be a weekend locum's number?

I got a recorded message telling me the opening hours and advising me to ring 000 in case of emergency.

Oh. Sorry, but it's not exactly an emergency... and anyway, ambulances can't swim.

So I tried calling the Base Hospital. Three full explanations of my plight later, I got transferred to an A & E nurse who had taken bright-and-breezy to a new level.

"Do you have a temperature?" she sparkled, after I'd explained absolutely everything for the fourth time.

"No."

"Well you're okay then. If you get a temperature, call the rescue helicopter and come in."

I could almost see the chaos that must be raging around her in the ward, inspiring her to minimise the workload if humanly possible. I got it. But it didn't help.

Mind you, I was starting to feel better, millimetre by millimetre. I'd given up my 24-hour lease on Caromaville. I'd made up some rehydration liquid to the World Health Organisation recipe, and was sipping at it alternately with watered-down pink grapefruit juice. It stayed down.

Perhaps I was on the way up again. Perhaps the nurse was right not to be alarmed.

With the rug of righteousness comprehensively removed from under my feet, I talked to Jools again, who was becoming increasingly incandescent at the other end of the line.

"You're going round and round inside your own head," she spluttered, when I volunteered that I really didn't feel as bad any more. "For fuck's sake, you've had a chest infection, a gastric infection on top of it and you're right at the bottom of your cycle for immunosuppression. You need IV antibiotics and rehydration. I think you should call the helicopter and get the fuck out of there."

I had trouble with that. I didn't feel like an emergency- not any more. I did the previous day, sure... but now my body was telling me it was coming up for air.

Jools was less than convinced. Poor woman. There she is, all the way down in Mexico (the Bear's term for anywhere 'south of the border'), trying to give informed advice to me, her dearest and oldest friend, without even being able to see me with her own eyes to make an assessment. Worrying her arse off that I'll be blase about how sick I am until I'm actually beyond help.

I can be frustrating like that. I know it. It's hard to tell when I'm 'minimising', as my other doctor-friend Frances would say, and when I'm assessing my own need accurately. That's the downside of being able to see the funny side of one's plight; it can be tricky moving back to being 100% authentic when things start to go pear-shaped.

"You need a second opinion you can trust," continued Jools, clearly frustrated by being unable to check me out in person. "Go down and see Christine and Jarvis and see what they say."

I couldn't get my mind around that. I figured that they would say they had no medical knowledge to back up any opinion they might have, because that's the sort of careful, honest people they are. But a switch finally tripped in my head.

"I'll ask Jimmy," I offered. "He's a paramedic."

Yep, all this time living across the road from Jimmy, knowing full well he'd been a paramedic back in the States, and it hadn't occurred to me in my hour of need that his experience might be relevant.

Blame it on chemo brain. If the damned TAC's going to give me this hard a time, it can pay me back a little by taking the rap for everything I do that's a bit daft.

***********************

He's a man of many talents, our Jimmy. But I'd never seen him with this particular hat on before. His professionalism- excuse me- shat all over the nurse at the Base Hospital.

Within fifteen minutes he'd assessed all the relevant vital signs and declared that I wasn't an emergency. My pulse was regular and normal, my colour was good, I was showing no signs of dehydration, the blood was returning very quickly to my extremities when pinched and released. And so on. He went down his checklist with total focus, telling me at each step what he was doing and why.

Give that man a banana. Off he went to fetch me some nasturtium leaves from his garden, as a natural antibiotic; the chronic cough he still considered a problem. Just not an emergency.

I felt like I'd been given a get-out-of-jail card.

*********************

See, I was feeling like a fraud, trying to push people to put me on a chopper and fly me out. Once I stopped feeling nauseated and wanting to die, my body started telling me very clearly that everything was going to be fine- even if it wasn't quite fine yet. With all the total crap that this poor body has had to go through since last September, the least I can do is listen when it speaks to me.

It's partly about fully owning my body, too, and being responsible for my decisions about that body. I've had to make so many hard, crucial decisions, and there are plenty more to come. How much of my left boob will I have chopped off? Will I submit to being poisoned, when it makes me terribly ill and only increases my survival chances a relatively small amount? Will I allow x-rays to flow through my body and burn me, in the hope that it'll knock off any stragglers? Hormone therapy? Genetic investigation? Rip out the ovaries? Reconstruction?

They're not easy decisions. They take it out of me. They bring me face to face with so many unpleasant realities that there's absolutely no way to hide behind half-heartedness, or to slough the decision onto someone else's shoulders. It's me who has to live with it, so it's me who has to decide.

And they're just the big questions- there are millions of little ones, too. Which tablets will I agree to take, to combat the side effects? How many is too many? Which ones do I need today? Am I ready to lift my arm higher above my head? Can I exercise today or do I need to rest more?

It goes on and on, every single day; and to answer all those questions well and safely for me, I've had to learn a deep respect for and awareness of the way my body feels.

And so when anyone, no matter how well-intentioned, tries to lean me in a direction that doesn't feel quite right today when I ask my body about it, I push back. I resist. I didn't realise that till yesterday. I have this whole new confident relationship with my body that is giving me more strength to say no sometimes, and to say yes sometimes.

I think that's a good thing.

Naturally it's not that clean-cut. Nothing ever is. Lurking behind that, there's the creeping horror I have of hypochondria. My father, heaven help him, spoke about his ailments endlessly; I can see why, given that he'd been shot through the leg in the war and was in chronic pain for decades until he discovered the miracle of acupuncture. But over time, and as dementia set in, his single issue spread and spread until every conversation was laced with horrendously over-detailed descriptions of minor symptoms that he was sure would kill him.

It drove me nuts. It defied logic. His parents had lived well into their eighties, and given that he had the constitution of a lump of granite, there was no reason to believe he wouldn't too.

In the end he died in a nursing home of a completely understandable heart attack, aged 87. The only surprise, to the nurses, was that he was found upright in the chair by his bed. Nobody had seen him relocate himself for months, and he was considered bedridden.

But they didn't know my family. Stubbornness runs deep, and we don't take death lying down.

But still, he spoke about his ailments to the day he stopped talking at all. I don't want to be like that, ever. I don't want to treat every little thing that happens to me as life-threatening, unless I actually believe it is. The cold fingers on my heart are a pretty good guide for that. I believe the cold fingers. I believe I know when I'm in danger.

But how confusing it must be for my friends. I'm all chirpiness and good humour, making wisecracks about the most dire events- and then suddenly my hand shoots up like a signal from a Bondi surfer, because I feel for a moment that I'm in danger, or I've lost my sense of direction.

They paddle out to rescue me, bless them, and the moment I'm on their board- I can breathe. I'm fine again. They're primed with adrenaline, ready to pump the water out of my lungs. They anticipate that I'll be passive, accepting, compliant- and I damn well turn around and resist treatment on the shore. I get up and walk away.

It's a wonder nobody's slapped me, really. I must be completely maddening.

But you see, I'm still learning how to ask for help, too. I'm probably not even gracious about it. It's hard- no, it's well-nigh impossible- for me to lie back and enjoy being helped unless I believe I really need it. It makes me more than twitchy; it strikes deeply at my conscience.

If my body says I'm fine now, I don't need a stretcher to casualty. I just need a ride back to shore.

***********************

Last night I mulched up Jimmy's nasturtium leaves in the blender and sprinkled them through my jacket potato; what the hell, every little bit helps. This morning my cough was much improved- barely there in fact- so who knows? Maybe the antibiotic finally kicked in. Or maybe the nasturtium was the kick in the arse I needed. I had the rest sprinkled in my soup for lunch, and I've hardly coughed at all this afternoon.

Who knows?

At any rate, it feel like the spikes of the Iron Maiden have gradually being withdrawn from my innards. The gastric symptoms are gone. Perhaps I'll get a little bit of a break this cycle after all.

And next cycle?

Perhaps I just have to expect the Spanish Inquisition, and then deal with it.

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