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Wednesday, March 23, 2011

Avastin junkie

I guess I know now what it feels like to be a full-on junkie. You know the ones, those who must have their next hit just to feel normal, not to experience a high. I am vaguely disappointed that I have reached a similar stage without having that first glorious series of rushes that the injectors of heroin do. That feeling so wonderful that it seems worth whatever it takes to experience it again – and yet again – until the brain and body cry out for it in a fever that there is no escaping.

   No high for the junkie then. No rush. Just relief, I am sure, when the drug starts coursing through the veins.

   That’s the point where they know it’s all they have; or at least, to be told by those receptors in the brain that if they don’t have it, the body will be wracked by spasms and physical pain until the demon in the brain is satisfied, for the moment at least.

   Of course, it’s the opposite for me, in a sense. My brain is demanding its hit of Avastin, which will come if all goes to the usual plan at 11.30 this morning. It’s telling me that it has to have this infusion to combat the rising power of the tumour; power that’s become so obvious to me in the past couple of days.

   Don’t get me wrong. It’s not that I have had a lot of negative reactions in that time. On the contrary, in most ways, if there’s a copybook cycle for an Avastin junkie, this probably is it. I have had two, maybe four Panadol in the past three weeks, no more – the only extra-curricular medications, as it were, in the whole period, and I think those were times when I stayed up too late reading and writing, as is my wont.

   I have had no seizures, no pains worthy of complaining about, and my bodily strength has improved, as I’ve mentioned before and won’t repeat again. I have been as lucid as I have ever been, barring periods of lapses of memory that everyone claims they are just as guilty of.

   Perhaps. Maybe they say that to make me feel better. But in any case, it’s been good.

   Yet I can now see the pattern starting to develop, coming up to my ninth dose of the drug. $52,200 worth, in small packages that look like saline solution, if we put it in the terms the manufacturers would be interested in.

   The pattern. All feels well until the last few days of the cycle. With surprising suddenness, my limbs feel leaden, almost like that feeling after a seizure. I struggle to get out of the armchair. My balance is not good. Walking is a huge effort.

   I can’t hold that knife in the right hand with enough power to cut, or without a tremor in the hand too strong to hold the knife in place. The angle of the wrist suddenly is back where it shouldn’t be, and the knife is almost parallel to the table. My speech is slightly slurred, as if my tongue has swollen. It hasn’t, but it seems so. Bleeding from skin areas, though slight, is hard to stop.

   I feel irritable and dispirited. I know that Brian, my unwelcome stranger, is taking these few days to rebound with all the fury he can muster. He is putting out his tentacles again, reaching down, seeking blood that has been denied him for weeks until now. Foggy head syndrome is back with a vengeance, as sleep patterns are disrupted.

   So at 11.30 am I will go to the ONCOLOGY section of the hospital. Oncology. I always hated the sound of that word, long before I ever thought how much intimacy we would share. It sounded as alien as it looked on a sign – a place where other people, very sick people are forced to go. Never I, who might find myself seeking treatment. But we are on very familiar terms these days.

   I’ll probably feel the need for Tracey’s arm this time as we walk up the ramp. My body will feel the weight of a neutron star. The staff will be cheery and friendly as ever. They must have their bad days but it never shows. We’ll find something to joke about and I’ll stand on the scales, and complain that I have put on yet another kilo in spite of my best efforts. (That won’t be true -  'better efforts' is more accurate.)

   I’ll go to the toilet, provide a specimen, and find a chair alongside everyone else. I’ll see who I know. They come and go, always some one or two new; others, I never see again. The ones who recognise me will smile, probably, unless they feel utterly miserable, which sometimes happens.

   We are members of an exclusive club. What was it Groucho Marx famously said? I wouldn’t want to belong to any club who’d have me as a member.

   I don’t want to belong to this club, but we are members nevertheless, so we make the best of it.

   Then will come the worst part of the whole proceedings – finding a suitable vein. I have the feeling that this time it will be no problem, but I’ve been wrong before. I’ll try to pump up the arms a bit before we leave home, to make the veins sit up. In theory they should be better this time than when my arms were so weak the right one couldn’t support its own weight and I needed a sling.

   I haven’t used that sling for many months. Cop that, Brian....

   And then, all going well, there’ll be a short infusion of saline solution to ready things for the Avastin, and they’ll bring it in a little bag that they’ll cover with a black plastic hood, like it’s so special no-one’s allowed to look at it. Well, that’s sort of true, it’s nearly $6000 worth of pale liquid. That’s got to be special, I suppose.

   It will take only half an hour to infuse, another saline burst to flush the system, and I’ll be allowed to go. We’ll make another appointment, round about 13 April I suppose. See you next time, she says.

   Next time. Hmmm. The whole thing, all going smoothly, will take about an hour.

   And again, all going smoothly, I will feel normal tomorrow, and the energy will flow back to me over the days. But I am pretty sure that the effect will run out just that bit sooner at the end of this coming cycle than the last, and in the final days before the next hit, Brian will probably take the opportunity to strengthen as much as possible, to be stronger for the next time than he is now. Little by little, he’ll try to gain power.

   Let’s stop there and not try to predict too far. It’s pointless, and some wildcard event could intervene, as it has so often done before.

   I’ll let you know how it goes.

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