Tag: PICC

BEP Cycle 1 Day 16

~ andrewamies ~ Leave a comment

Wednesday 19 June 2019

I woke up with quite a bit of hair on my pillow this morning. It’s getting easier to pull it out each day. A fair bit more came out while showering and drying my hair (gently), after which there remained a layer of loose detached hair on the surface of my fixed hair. Hairs from that layer were inclined to fall everywhere, making washing and drying my face an extended activity.

I had another day chemo session in the afternoon, so Pia and I took another journey to Bristol. The session went fairly swiftly. I had my PICC line redressed and some blood was taken for a full blood count. Then I had half an hour of IV saline, some hydrocortisone and then half an hour of Bleomycin. It was finished off with a bit more saline.

Second day chemo in progress

The nurse looking after me was called Susie and she had a lot to do with the Penny Brohn charity which I had learned about from Julie the day before. Susie also had a lot of knowledge on more holistic therapies and dietary practices that could help in treating cancer, so it was great to talk to her. She’s the only person in the NHS we’ve spoken to so far that has mentioned anything other than surgery and chemo. Anything else seems taboo.

My chest felt a bit funny on the way home, which it had also done after the previous week’s day chemo. I’d been slightly nervous as to how the evening would pan out after having received Bleomycin in the afternoon, but fortunately I has no fever and slept well.

BEP Cycle 1 Day 9

~ andrewamies ~ Leave a comment

Wednesday 12 June 2019

Today was my first day chemo session and my appointment was for 14:30. We arrived on time and found that due to a lack of available chairs, I was having my infusion in the Teenage and Young Adults (TYA) day chemo unit. The unit was quite pleasant, as was the nurse looking after me.

Infusing in the TYA day chemo unit

It had been a week since my PICC line had been serviced, so I first had that cleaned and redressed. Then I was started off with some saline and hydrocortisone before having Bleomycin infused for half an hour. It all went pretty smoothly and we left within two hours of arriving, which was nice.

The satnav took us home via a completely different route to normal. It was very picturesque, but I’m not sure that it was any quicker. I started feeling quite sleepy on the way home.

After dinner I started feeling shivery and decided to get into bed. It wasn’t long before I was shaking somewhat uncontrollably and my temperature was spiking again, up to 38.5 C. It felt like a repeat of two nights earlier and I was dreading having to spend another exhausting emergency night in hospital. At least it was a little earlier in the evening, a bit after nine rather than eleven.

I called my oncology team and they checked the bloods they had from my day chemo visit a few hours earlier. Neutrophils were good at 2.07. We decided that I would try to ride it out, but would come into the hospital if things got any worse during the night, or if I still had a raised temperature in the morning. Fortunately I got to sleep and the fever wore off after a couple of hours. It looked to be a typical reaction to the Bleomycin.

So no emergency on this occasion. Instead I managed to get some decent sleep which was very welcome.

BEP Cycle 1 Day 2

~ andrewamies ~ Leave a comment

Wednesday 05 June 2019

After something of a patchy sleep, I woke about 6:30 for the toilet. I lay awake for a little after that then sat up sometime soon after 7:00. The nurses did their handover about 8:00 and I had my blood pressure, pulse and temperature taken. I was offered some breakfast, but I settled for a banana which I had with me and a cup of green tea.

After that I got to meet the chap in the bed next to me called Dave. He’d had a rough day the day before, which is why I hadn’t already had the chance to speak to him. He was a really nice guy though who was very chatty when he was able. It’s nice to have someone to talk to.

I wasn’t feeling too bad in the morning, but very tired and a bit fragile.

I had an appointment for a lung function test at 10:15, so I got myself washed and dressed and headed off to another block of the hospital. The lung function test took about 20 minutes and involved breathing in and out of a monitored tube which had a snorkel-like mouthpiece. One exercise looked at overall lung capacity and strength of exhalation, and another on gas transfer time. Both tests came out with fairly normal results. I expect that I will perform these tests again at the end of my chemotherapy treatment to see if I’ve deviated from this baseline at all. Bleomycin can affect the lungs, so I imagine it’s common for patients to experience some short-term degradation.

I was feeling quite alright after that, so I headed up to the hospital restaurant on the top floor and found a table next to a sunny window to sit down at. I had a smoothie and some green tea, and I pulled out my laptop and made a start on writing this blog (at the time of writing, I’m almost three weeks behind!).

I went back to the ward after a bit. Pia came to meet me about 13:00. She’d brought food, so we ate a little. Around 14:00 the nurses gave me some Dexmethasone (steroids), Omeprazole (which helps with acid reflux whilst on steroids) and Metoclopramide (an anti-sickness drug). I also had the dressing on my PICC line changed, as it was looking a little messy from having been put in the day before. With the PICC line, I was given a PICC Passport, which is a log book that is written to each time the PICC is cleaned, dressed or altered. Cleaning and redressing needs to be done every week. This works out to be quite easy for me, as I’ll be having either inpatient or day chemo every week anyway, so no extra trips to the hospital will be necessary.

My brother, Peter, who had come to look after the children while I was in hospital and Pia was spending a lot of time with me, had decided to take them to Airhop, a trampoline park in Bristol, during the afternoon, so he and the girls dropped into the hospital on their way. Pia and I met them at reception and we went for a walk into Bristol. I don’t know Bristol very well, so it was nice to have a wander around. We had a look around an indoor market and stopped to grab a cup of tea (green for me) before heading back to the hospital and saying goodbye.

Despite being quite tired, I managed the day quite well. No pain or nausea. I got started on my chemo session around 16:00. Today’s menu was:

Etoposide – 500 ml over one hour
Etoposide – 500 ml over one hour
Saline – 1000 ml over one hour
Mannitol – 400 ml over half an hour
Cisplatin – 500 ml over one hour
Electrolyte solution – 1000 ml over two hours
Bleomycin – 250 ml over two hours

So it was basically the same as for day 1 but with the addition of Bleomycin.

The bag changes were a bit slower than the night before and the session finished after 3:00 am. I was quite knackered by the time Pia left around 20:00. I started watching a film, but didn’t get very far before I could no longer concentrate. I managed to snooze a bit during the last couple of bags, which was good. After that, I managed to sleep quite solidly for the rest of the night (between toilet trips).

BEP Cycle 1 Day 1 – Prep

~ andrewamies ~ Leave a comment

Tuesday 04 June 2019

Since deciding to pursue chemotherapy, I’ve felt confident in its ability to help me and I take full ownership in following this path. It’s none-the-less a strange feeling waking up on the first morning knowing what lies ahead. I suppose it could be a bit like setting out on a mountaineering expedition with equal measures of optimism and awe at the scale of the awaiting adventure. Having had less than six hours sleep, Pia and I left the house around 8:30 for the hour-and-a-quarter drive to the hospital.

Heading to the hospital, looking bright and cheery

My first appointment was for a PICC line placement at 10:00. PICC stands for “Peripherally Inserted Central venous Catheter”. It is essentially a narrow tube, up to around 60 cm long, which is inserted into a vein under the bicep. The line terminates in a larger vein in the chest (hence “central venous”) and allows for chemotherapy drugs and other fluids to enter the body, via a drip, and for bloods to be taken.

There are a couple of advantages to using a PICC line. The first is that some of the chemo drugs, notably Etoposide in my case, can be damaging to the veins, and there is less risk of damage to the veins in the arms if a PICC line is used rather than a cannula. The second advantage is one of convenience and comfort. Having a PICC line in for the course of the treatment (9 weeks for me), prevents the need to be continually punctured and bruised every time I make a visit to the hospital. Some hospitals do not have a PICC facility and so don’t offer lines to chemo patients, however it’s a standard part of the process for BEP chemotherapy at the Bristol Haematology and Oncology Centre (BHOC).

Having the PICC line put in involved the use of ultrasound to monitor the veins as the line is inserted

The line was put in under local anaesthetic. Having it put in was probably the only thing I’d not been looking forward to, as I’ve never been great with needles or having things inserted into veins. However, there was no discomfort whatsoever in having it placed. Even having the anaesthetic injected was barely noticeable. It took about half an hour or so complete. After the line was in, some blood was taken to be tested for tumour markers, full blood count and liver and kidney function.

PICC line in place

Following that, we headed up to the chemo ward to talk about the treatment with a nurse and go through a lengthy questionnaire. I was then sent for a chest x-ray. Pia and I then grabbed some lunch before heading to the audiology clinic to have my hearing tested. This was done to establish a baseline against which my hearing can be measured again after treatment. Chemo can cause some degradation in hearing in some cases, and tinnitus is a common short-term side effect. It can also, but rarely, be a long-term side effect.

We then headed back to the chemo ward, where there was a bed waiting for me in a room with three older gentlemen. After a bit of a wait, the last of my blood results came through (from the samples taken when I had my PICC line put in). I was weighed and had my blood pressure taken. Then I was ready to commence treatment.