Of course any support in times of crisis is crucial, but that’s particularly true when it comes to one’s spouse. The problem is that with each relapse and each round of chemotherapy what I can only describe as ‘cancer fatigue’ has set in. My feeble cough, followed by a weak look in the desperate hope of some small flicker of sympathy now serves only to antagonise. Admittedly this might be something to do with the timing. The cough only seems to come on within seconds of being asked to do something. I haven’t asked my consultant about this, but then I forgot to ask him whether I’d need another bone marrow biopsy yesterday. Funny that. Sometimes it’s nice to collapse into the loving embrace of denial.
So, the phoney war is almost over. The Nivolumab has done the trick. The final session is at the Churchill on Friday and undoubtedly the team there will be bidding me an emotional farewell. I have a date of 12th October for hospital admission and 21st October for the donor transplant, which will happen after 9 days of conditioning chemo. I spent yesterday having heart and lung tests to see if my body can take the punishment and also to provide a set of base line readings that the medical team can use should I encounter any unforeseen problems during the transplant process. My sister, who is kindly donating her cells to me, had a similar series of tests today to ensure that she has a clean bill of health. Pending final blood test results, we’ve both passed and the route is now clear for us to get on with the fun part. For my sister that means having her cells harvested and for me that means 5 to 6 weeks of incarceration while the medical team keep infections at bay and manage the progress of my new immune system. This will be followed by many months of recovery and probably an awful lot of whining and, finally, wondering where my wife has gone and whether she’s taken the joint credit card.
I have now signed the consent forms, so there is no turning back. As I may have mentioned in a previous blog there is, in theory, a choice at this stage. I have no ‘avid cancer’ in my body now, so am technically in remission, could carry on without the transplant and hope not to relapse again or I could go for a cure now. The ‘cure now’ path consists of the transplant and while the reward is getting rid of the cancer once and for all the risks are that the treatment itself could be fatal. The two key dangers are infection, due to having little or no immune system, or graft versus host disease where the donor cells take something of a dislike to the ‘host’ body’s organs. It’s always slightly sobering to be presented with mortality rates, but we’ve admirably dealt with that by ensuring that we’re ‘unsobered’ not long afterwards. Perhaps it’s the vinotherapy, rather than the Nivolumab that has put the Hodgkin’s to the sword?
So, Katie and I are facing the next 6 months or so with a kind of grim determination. It’s going to be rough, there’s not doubt about that. The autograft I had in 2010 was the most physically difficult thing I’ve ever had to deal with and a good deal of the conversation with doctors and nurses over the past month or so has served to underline the fact that the allograft will be a more difficult experience and will involve a much longer recovery period. This is partly due to the three month course of immune suppressants post-transplant that will keep the incoming immune system in check. There are some cool bits – I’ll be in a pressurised room, so I can spend the entire time in hospital pretending I’m in a space station, an illusion helped, no doubt, by the fact that I’ll be on a mainly liquid diet after a couple of weeks of chemical bombardment. The pressure maintained in the room stops the air whooshing in when the windows and doors are opened, hopefully keeping any nasty bugs at bay. I requested a room with a view this time, which at least raised a smile by the doctor.
So, my lovely wife will at least get 5 or 6 weeks off while I bitch and moan and thrash about on a plastic mattress in Oxford and generally drive the nurses round the bend. I’m not sure whether I’ll be capable of writing too much while I’m banged up, so in the words of Jim Lovell before Apollo 8 disappeared behind the moon for the first time, “See you on the other side” (I mean after the transplant of course….nothing more metaphysical than that).