This is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.
The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook
For a chapter-by-chapter breakdown of what's in the book (in its online version, in the PDF version and in the paperback version), see:-
Table of Contents
CANCER PATIENT is a medical memoir which deals with the author's autobiographical experiences which involve, amongst other things, chemotherapy, radiation therapy, a brain biopsy, a lumbar puncture (and then some more lumbar punctures), treatment with Ara-C, treatment with vincristine, treatment with methotrexate, treatment with radiation from a linear accelerator, and a vitrectomy (an operation to remove the jelly from an eye). This is a non-fiction account but it does contain a couple of fictional stories, clearly identified as such, and it also includes some poetry.
The cancer patient's life continues, long on days, short on drama. Dinner party. Vitrectomy canceled, to be rescheduled later. Life is flat enough for trivial problems to loom large, the prime example being mysterious (trivial) skin problems.
* * *
Tuesday 12 July 2005.
Yesterday I spent a substantial amount of time tied up with the mechanics of being a patient, starting with the taking of two different tablets, the insertion of the first eyedrop of the day (the first of four), and the application of two different creams (hydrocortisone for face and arms, aqueous cream for legs).
Then there was a phone call from the hospital in the morning to tell me that the vitrectomy (the jelly-removal operation) originally scheduled for the right eye for the 28th has been canceled, to be rescheduled for a later date, eventually.
I was glad of this as I'd discussed the operation with my radiation oncologist, Doctor Campbell, who thought it would be better to allow a more substantial gap between the end of radiation therapy (currently tentatively scheduled to next week end on Wednesday July 20th) and the surgery, in order to let the cells settle down properly.
Additionally, as I've grown progressively sicker from the radiation therapy -- on the pharmacy scales, my weight is down a bit, now about seventy-four kilos fully-clothed, suggesting I've possibly lost a kilo, or maybe a bit more -- my confidence in undergoing the operation and coping with its aftermath has ebbed.
On the one hand, I'm eager to reach the end of my treatment route. On the other hand, eye surgery is eye surgery, and it seems reasonable to exercise patience in order to optimize success conditions.
I'll be seeing one ophthalmologist, or maybe more than one, on the 28th to see how I'm going, and I may find out more then.
If there's a substantial wait time before the vitrectomy, I can amuse myself by going to the dentist to have a cap put in to replace the temporary filling that was put in, shortly before I started chemotherapy, after I ignominiously snapped a tooth clean in two while eating spaghetti.
Anyway, to continue with my account of the mechanics of being a patient, late yesterday morning my father took me by car from the suburb of Devonport on the north shore of the Waitemata Harbour to Auckland Hospital in the city of Auckland, on the harbor's southern side. We parked in one of the free parking spaces reserved for oncology patients and I sat in the car while my father went inside to get the magic piece of paper from the oncology reception desk, purpose of the said magic piece of paper being to ward off tow trucks.
The parking is very well organized: there's one guy on duty through the working day supervising things.
We then went inside. Go straight, go down the precarious spiral stairs to the fern tree level, hang a right and go straight through the fire-stop doors and you come to the radiation therapy reception desk. The desk people, who have recognized me at sight almost from the very start, checked me in on their computer, which I guess lets the computer at Treatment Room Six know that I'm waiting.
I then went to see a nurse to ask about the possibility of seeing a doctor about my inflamed left eye, and was told, sure, no problem, as long as you're prepared to wait a bit -- bring your treatment folder with you after you're finished with today's radiation therapy.
Shortly, despite me having arrived early, Treatment Room Six told the radiation therapy reception desk, by intercom, that it was okay for me to head on down, so I did. Once there, I asked if my treatment folder could be ready afterwards for me to take upstairs for a consultation with a doctor. I waited briefly in the minuscule Treatment Room Six waiting area before being admitted to the room which holds the linear accelerator.
As usual, my personalized headrest was already in position, so it was simply a matter of putting my spectacles down on a counter (I'd brought along my spectacles case) and lying down on the table. The clear plastic mask was put on my face and the position adjusted, causing various noises, loud, like noises heard underwater, which drowned out the radio playing softly in the background.
Then the linear accelerator beamed X-rays at me first from the right and then from the left.
Then I was done, and it was time to pick up my treatment folder and head upstairs to wait.
I was eventually (reasonably soon, given that I was asking for an unscheduled consultation) seen by a mild-mannered guy called Doctor Lao. I shorthanded the history of the left eye. Vitrectomy back in January, no post-operative complications, fine when seen by an ophthalmologist early this month, optic nerve is trashed so the left eye doesn't see very much, but it's healthy, or was, until it became sore and grossly inflamed (red sclera) on Friday. Felt at one stage almost as if there might be a foreign body in it. Pain has receded to pretty much nothing. A little exudate from the eye in earlier days but nothing worth mentioning today.
Doctor Lao proposed an antibiotic, Chlorsig eyedrops four times a day, and, having first discussed this option with my radiation oncologist, Doctor Campbell, and having gotten her approval, wrote me a script.
Returned to Devonport by car and had lunch. The high point of lunch was that there turned out to be some birthday cake for me. I'd been permitting myself to indulge in squalid suspicions: They forgot the birthday cake I was promised would be saved to me! I got that promise last night!
The good news is that the squalid suspicions were unjust. The better news was that there was quite a considerable amount of birthday cake on hand, a fairly rich fruit cake complete with homemade marzipan and white icing. The bad news was that my body declared that it was only prepared to cope with a piece of cake so small and timorous as to be almost chaste.
Fortified by birthday cake (spiritually fortified, at any rate -- I couldn't eat enough of it for it to really do anything for me physically) I allowed my mother to drive me down to the Devonport shops where I abandoned my mother and went alone to the pharmacy, weighed myself and filled my Chlorsig script for antibiotic eyedrops.
I then posted a letter and then went to see my general practitioner, my family doctor, who holds open surgery from 1400 on Mondays, meaning you can roll up without an appointment, check in at the reception desk then take a seat.
When I got in to see him, I described my three rashes:-
(i) An inflamed red rash on the forehead, easily explained as a radiation reaction, being treated by one percent hydrocortisone cream. Rash started some time after radiation therapy commenced and got progressively worse.
(ii) A scabby rash in discrete scattered blotches on my arms and legs, possibly some kind of eczema, being treated with a daily Razene tablet and (on the arms) with the hydrocortisone cream and (on the legs) with aqueous cream (which probably won't do much to help, but limits the amount of hydrocortisone cream I'm using). The scabby rash has been around for weeks, predating radiation therapy. I had something similar a couple of years ago in Japan which went away after being treated by some kind of steroid cream.
(iii) A fine rash in the form of red dots scattered over my arms, the backs of my hands and my legs. This has come on during the last few days.
My GP, Grant, identified the fine rash as "petechiae", which means small dots of blood which have bled from capillaries. He indicated that he'd assume that rashes two and three have a common allergic cause, and that at this stage we wouldn't do blood tests.
I said I'd had blood tests anyway, on Friday, locally, at Diagnostic Medlab, and the results would be ready at Auckland Hospital when I met with the oncology team later this week -- on Wednesday. I'd be certain to call their attention to the petechiae.
We didn't go into the details of what the petechiae might possibly mean if they're not just an allergic reaction, but I believe I remember (or possibly misremember) from somewhere in my reading that there's a possible association between leukaemia and petechiae.
I'm assuming that there's no such association in my case. However, even so, I can't guarantee that there's not.
Auckland Hospital had indicated that my GP might be the best person to sort out my rash problem, and Grant told me to continue taking the daily Razene tablet and to try, for a week, treating all three areas (forehead, arms and legs) with a different cream, Locoid Lipocream, the active ingredient in which seems to be hydrocortisone 17-butyrate.
So I toddled back to the pharmacy, another place where they know me by sight, and filled a prescription for the said cream. Then walked home in the rain. It's solidly winter now, here in the southern hemisphere, with long days of gray rain.
I had an "I'm glad I'm me" moment today in Grant's waiting room when I was reading an article by a TIME editor in TIME magazine. The editor was writing about his treatment regime for cancer of the esophagus, the tube linking the throat and the stomach. The regime included a nine hour operation to remove the entire esophagus. "With this cancer, you get the full sushi."
All going well, my delusionary inklings of leukaemia will turn out to be as groundless as my objective analysis takes them to be, my vitrectomy (when, in the fullness of time, it happens) will go well, and my story will turn out to be a milder one. With, I hope, a happy ending.
All things considered, though we're well short of the ending, today was a happy day.
The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.
This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.