By the time we left Norfolk the seroma in my armpit was once again pretty large so I was extremely relieved to be able to visit the lovely nurses in the breast care team to have it drained again. Given that It had been a whole week since last having it drained, the amount of fluid that came off wasn’t quite as much as I expected so I was hopeful that by body might be starting to get the message that the fluid it was producing wasn’t needed. I was conscious that with my chemo starting in a matter of days I could really do without additional trips to hospital to get my little friend sorted out. The nurse who saw me told me that often the chemotherapy seems to just sort the problem out. I guess that when the body is being bombarded with poison it has more important things to worry about than filling a post surgery hole with fluid.

Dan waited in the hospital car park whilst I had my seroma sorted out. Our next stop was the hospital where I would be having my chemo for a check in with the nursing team, blood tests and a COVID test. Dan was able to come in with me for this which was great after missing the oncology appointment. My mum and dad had come back from Norfolk with us so were able to look after the children. It was so nice to have their help, one less thing to worry about knowing that the kids were being entertained whilst we attended the appointments.

The hospital was about 40 mins away by car so not exactly on the doorstep but I knew as soon as we pulled into the car park that the additional journey time would be worthwhile. No multi story parking carnage to contend with. Instead a lovely leafy car park with plenty of spaces and 5 of them reserved for patients attending the cancer ward (easily pleased I know but it’s the little things!!) There was a separate entrance for the cancer ward and once we got beyond the COVID checks at reception we were straight onto the ward.

We were greeted by Vicky who took us straight into one of the treatment rooms and got us settled in. Another nurse brought us tea and biscuits and we were told that whilst in the room we could take off our masks. Result! Vicky ran us through the treatment that I would be having and the potential side effects (a useful recap for me and very useful for Dan to hear from the horses mouth) three rounds of FEC followed by three of T and a shed load of potential side effects. Nothing different to what I had been told by the oncologist. Next they took the blood they needed for the full set of tests they undertake before a chemotherapy session to ensure you are well enough to survive it. White blood cells, platelets, neutrophils and haemoglobin levels are all carefully monitored throughout the treatment. In addition to the COVID test they also wired me up for an ECG just to ensure there were no issues with my heart before the treatment began.

Vicky asked me whether I was interested in trying the cold cap when I had my treatment. I’d heard about the cold cap before as a friend who underwent the same treatment for breast cancer years ago had used it successfully and managed to keep her wonderful head of curly hair. Losing my hair was another of the issues that I had managed to put in a carefully sealed box in my mind, parked there for another time, for when I absolutely had to deal with it. The thought of losing my hair was terrifying and I really hadn’t focused on it for too long. Vicky talked me through the details. If I wanted to give it a go I could but she warned me that, on the dosage of the chemo drugs I would be given, I would be likely to lose my hair even with the cold cap. Despite that minor detail I was intrigued. I’d heard that most people can’t tolerate the cap but how cold can it really be? (-5 degrees apparently!) . So the theory is that by putting a tight fitting gel filled scrum cap on your head when having chemo and cooling that gel to sub zero temperatures, the blood flow to the scalp is reduced and therefore the amount of the chemotherapy drug in your blood to reach your hair follicles is also reduced which can prevent or at least lessen the hair loss. I would need to wear the cap for every treatment and for at least half an hour before and for an hour after the treatment has been given. It sounded insane to be honest but given the insanity of the whole situation I found myself in I decided that I may as well give it a go. “In for a penny” and all that. If I have to go through this hideous experience I may as well try everything. Worst case scenario is that I can’t tolerate it (I thought about how cold my hands and feet get when I go skiing……… I am going to hate having a cold head!) in which case I stop and gracefully accept my bald headed fate.

Last topic for discussion was the dreaded PICC line. Vicky explained that they require all of their patients to be fitted with a PICC line which is essentially a more permanent cannula positioned in your arm to allow the medical team easy access to your veins for the purpose of putting the poisons in and taking blood out. I mentioned in a previous post that I am not the biggest fan of needles and cannulas make me feel a bit queasy so the thought of having one in my arm for 4 months wasn’t great. That said I could see the sense. Even though I was only having 6 rounds of treatment I was now one arm down not being able to use my right arm for anything post op due to the risk of developing Lymphoedema and in addition to that I would need bloods taking every three weeks. Vicky also said that in the event I was rushed to hospital with any complications due to my treatment hospital staff would be able to start treating me very quickly. I parked that bit of info in that other box in my brain marked “Not happening”. Vicky gave me the details of the PICC line doctor that would fit the line for me. I was amazed to hear that I would have to go to a hospital in the grounds of Mount Vernon to see him. I thought that something as straightforward as having a line fitted would be done by the nurses. Apparently not, this poor doctor appears to have cornered the market and was an industry specialist in the fitting of these lines. Who knew?

After a bit of a debacle over the appointment timings I found myself driving around the M25 the following Tuesday to have my line fitted by the PICC specialist. The hospital was an hour away so a decent schlep. The doctor came to get me from the waiting room and took me into what looked like a science lab with an operating table in the centre. All of a sudden this felt like a bit of a bigger deal than I had given it credit for. Whilst I lay on the “operating table” the doctor took X-rays of my upper left arm and chest and then used an ultrasound to check the positioning of my veins. There was a bit of confusion over what sort of line they were putting in resulting in the doctor sending his assisting nurse off on what seemed like a wild goose chase to find the kit he needed. He was eventually happy with what she brought him and unpacked it. It seemed like a crazy amount of kit for such a small job. I asked him if all of that was going in my arm as he was measuring out lengths of the tubing? “We need 52cm of tubing for you, that’s what we have been measuring on the scans” WHAT!!!! I thought it was just a cannula? Some sort of needle plugged into a vein in my arm? Apparently not, the tube was going to be inserted into my veins and would run from mid way up my bicep to just outside my heart. I felt a bit queasy, good job I was lying down. I quickly clarified whether he would be putting me to sleep or giving me some sort of anaesthetic before inserting half a metre of tubing into me? Just a small local anaesthetic to numb the top of the arm but no need for anything else.

To be fair it was all fairly painless, I think the thought of 52cm of tubing being pushed through your veins was far worse that the reality. I was quite mesmerised watching him studying the ultrasound in the dark and guiding the tubing where he wanted it to go. He finished off by attaching some sort of clip under the skin that he told me would help stop it being pulled out (yuck!) It was all finished in about 30 minutes and after making me sit in the waiting room for 15 mins to make sure I was ok and giving me some final instructions (no shower for a couple of days and then after that it would need to be covered every time I showered as I wasn’t to get it wet) I was allowed to leave.

It felt really strange having what were basically two long tubes with plastic nozzles on the end hanging out of my arm and it was starting to throb a bit as the anaesthetic was wearing off. I wondered if I was ever going to get used to it? As I drove home I started to feel a bit odd, was it palpitations? That’s what it felt like, oh god, had he made a mistake measuring the tubing? Should it have been 50 cm instead of 52 and was that extra 2cm now tickling my heart? Should I go back or am I just imagining it? I was on the M25 by this point so turning back wasn’t that easy. I started imaging the pile up I would cause if I dropped dead at the steering wheel so I did what any sane, rational, 49 year old would do, I pulled over to the slow lane, reduced my speed to that of a snail and rang my dad. I kept the conversation going all the way home just to ensure that if I did cause the mother of all pile ups due to dropping dead at the wheel someone would know. Thankfully I made it home without incident.