Tuesday, September 08, 2009

You give me fever

By Friday I had withdrawal. Wednesday had been Herceptin in the MDU, Thursday the Portacath in DOSA and Friday was proving to be just another boring day. Trying on wigs, lunch with friends and bits and pieces of work in between. By the time I'd picked T up from school, done the groceries and prepared for tea I was feeling a little hollow. No injections, no monitoring machines, no-one fussing over me. If you're ever in the same boat and need to induce a fever that is sure to see you rushed into hospital and kept in protective isolation for the next four nights, follow this simple checklist.

1. Reflect on all your failures. My top five are: a) failed a ballet exam when I was 13. Mum, my beloved sister K and I were all in bed together when we opened the mail. We all cried. And cried. b) I wasn't the Head Girl or Dux of my high school. c) I left my run a bit late and didn't make it in the Honours program for Law. d) I've never saved more than about $500 in a savings account. e) I was the keynote speaker at a conference in Sweden. Perhaps 1/5 of the audience listened to me while the rest just chatted amongst themselves. In Swedish. Flurgen klurgen murgen skul.

Reflecting on our failures usually always induces a physiological response. My heart rate goes up. I get a sick feeling of dread in my tummy. When you're trying to manufacture a fever this is all good stuff.

2. Reflect on your most embarrassing moments. My top three are a) singing Tracy Chapman's 'Baby Can I Hold you Tonight?" at my 6th form talent quest wearing an ankle length full circle skirt. b) introducing two of my friends to each other by highlighting that they both enjoyed marijuana and waiting for the conversation to take off from there. c) running a training session for Les Mills Auckland personal trainers that started badly and got worse with ever word I spoke.

Even as I type these I get flushed, the hairs of my arms stand up and I would give anything to be able to relive those moments and make different choices. Temperature rising nicely.

3. Reflect on your biggest regrets. My top 3 are: a) I can think of 2 specific instances in my childhood when I knew I was about to be unkind and I kept on going with my hurtful words. b) I wasted way too much time in relationships with guys who just weren't that into me c) I have spent too much time talking and not enough time listening

As you think about your regrets you should really start to churn. A few tears perhaps. Shooting pains and aching joints should begin to manifest. Right about now would be a good time to take your blood pressure and temperature and visit your GP.

For chemo quaffers like me, a temperature of 38 or above means a trip to A & E, so on Friday night to stave off my CDHB withdrawal pains C rushed me in.

What fascinates me though is that if all that negativity and cataloguing of woes can influence the way we feel, and our physiology, then the converse must be true. The NLP crowd and the Tony Robbins disciples are onto something.

Brave, courageous, positive - all words that people have kindly used to describe me in the last few weeks and months. But the first two aren't true. Being brave and courageous is about acting despite fear, and of course I'm not afraid so no valour required. Positive I'll live with but I prefer optimism.

Positivists say 'don't worry, everything will be fine.' Optimists say 'everything will not necessarily be fine. But if I apply all I know and believe about my ability to overcome and tackle each new challenge with a mindset of hope, then I will give myself the best possible chance of success.' I choose everyday to adopt a mindset of hope but the last few days have tested this to its limit.

Of course I didn't induce my fever. It came courtesy of the asymptomatic pneumonia that was lurking undetected in my chest which either came from the aforementioned (w.o.t.w) old geezer, or Ish and Ian and the coughing crowds in the cafe where we had lunch. When your white blood cells get really low (as they do between day 7-10 of any chemo cycle) your body no longer fights disease and so doesn't produce any symptoms of illness to let you know you're unwell. I didn't have a cough, or runny nose, or breathlessness - nada. Just a slight spike in temperature. Normally a person has a neutraphil (white blood cell) count of around 2.0. Being neutrapenic means your count is below 0.5. With chemo this indicates that you've reached your lowest point for immunity, are at your most vulnerable but can look forward to increases every day as your white blood count improves.

When I arrived at A & E they immediately started intravenous antibiotics, took a chest xray and blood tests to check my neutraphils. The results were rushed back - 0.0. Yip, no white blood cells - at all. And so Saturday, Sunday, Monday and half of today were spent in Ward 27 in protective isolation to keep everyone else's potential nasties away from me. I was allowed out of my room to shower in a special bathroom and had to wear a mask to make this 15 metre trip down the corridor. I was on top shelf IV antibiotics. After each dose I had a blood test taken to make sure they hadn't given me too much - these drugs are toxic in high volumes. The area around my portacath, which if you remember has been in less than a week, was swollen and very bruised, the nurses woke me several times through each night to check my vitals, and by this morning I had been injected with needles 17 times since Wednesday.

I don't share this to garner sympathy but so you know that I understand that the hope mindset is sometimes hard to access. On Saturday morning when C brought the children in to see me I wept when they left. "Take me home," I pleaded. "I just want to come home." I couldn't imagine ever having the energy for the things that bring me the greatest joy. My children, singing cheesy songs badly in inappropriate clothes, watching too much golf on TV with C. It all felt too hard. The only thing that enabled me to go beyond the claustrophobic intensity of that little room was a mindset of gratitude. All around me on the ward were people far worse off than me.

Hope, gratitude - whatever it takes. And of course, the heaviness passed. It always does. And now I have another thing to add to my long, long, long list of great achievements. This is my checklist for summoning a fever of self-belief and optimism:

1. Reflect on your achievements. I have far too many to list here now :), but I'm adding 'surviving 4 nights in protective isolation'.

Notice your physiology change. Feel good hormones are released, tension decreases in your pressure zones and you start to smile.

2. Reflect on your most embarrassing moments. Stop taking yourself so seriously and laugh about the ridiculous person you were when those cringe making moments took place. Make a mental note of whether you are still alive. If you are, then these sorry sagas didn't kill you did they?

You should be standing just that little bit taller, shoulders back and ready to roll.

3. Reflect on how lucky you are compared to me. Have you ever been mistaken for Ruth Dyson?

Just after lunch today, Dr Indian Spunkyfeatures from The Far Pavilions gave me the all clear to come home. Mum drove black beauty at the breakneck speed of 50km per hour and whilst looking at the sign that says Sumner, drove me into the curb as we made a left turn. That's 2/2 for rough trips home!

You needn't worry about my hospital withdrawal though. I'm back at MDU at 9am in the morning for my third dose of weekly Herceptin. We'll try the Portacath for the first time and I'll be modelling appropriate infusion fashion. I do hope Santa takes note.


Kyla said...

I am full. Not so full that I can't get up from the table but that wonderful, satisfied full; like after we have Japanese for lunch :)

While you were in hospital I knew your mind would be racing, perhaps even crafting a sentence or two. The thought of your next chapter kept me optimisitc.

You, your words and your heart are delicious.

Kelly said...

Sach I can't imagine you in forced isolation!

I recall running (we'll call it that) a 10km race around the gardens and feeling that I could not possibly make the end.... that I would never feel worse than I did right then - and then watched in admiration at the young man I lapped with cerebal palsy that was taking a lifetime to shuffle along.

While there are always others that will be worse off.... allow yourself to wallow a little every now and then - you have earned that right!

Scott said...

I wondered when the Dyson comparison would come out! Apologies for lack of chat...how come I haven't seen the 'Demi Moore'? You're just b____y copying mine anyway. That was so last year.

BeJolly said...

Ahhhh - the power of positive thought and imagery. If only you had been a PhEd'er and done Hodgies course in PST (Psychological Skills Training) then you would have known the science behind all of this for over half your life!! However you would have had to let the science do the talking (bit hard for you I expect - tee hee!) rather than just create a well crafted argument. Yet - however good PhEd'ers are at PST I'm not aware of any known for their eloquence (apologies to any of you reading this who think you are).... Sacha we'd all be poorer for not being able to be tickled with your wonderful words.