monday, tired

monday is a quick drip day. first to the cancer doc then to ivy clinic for a half hour drip, bleomycin. the b-drip is each monday of each three week chemo cycle.

deb is at work so i drive myself. for most of the weekend i'm too tired to move. monday i'm tired but moving. slowly. carefully.

blood levels are okay, says the doc. no actual numbers. i don't ask.

 i do ask about the current treatment: this chemo is for testicular cancer, the "curable" one. did i not get it right at the start because it's not wise to mix brain and ball chemo? true. okay... at the time i simply did as advised. now i have time to try to understand it. not to question treatment -- i have great faith in the medical expertise -- but i do like to understand what is going on.

i also learnt something about my knowledge and the doc's knowledge of *my* cancer.

way back, i was already committed to brain radiation and brain chemo when questions were asked, should the already spreading testicular cancer also be treated. radiation was extended to both brain and gut, to tackle both cancers. chemo was limited to brain chemo. the doc did not (today) remember that the ball cancer had already spread, that i had one chemo but two sets of radiation.

i am only interested in one pair of cancers, my own. i remember (or think i remember!) a lot of detail of my own treatment. the doc is managing dozens? hundreds? of cancers, on many, many patients. she depends on case notes to refresh her memory. not a worry...

except that my case notes are getting thicker and thicker. how likely is it that the doc will re-read all the notes before trying something new? for example, she did suggest radiation for the spreading ball cancer. did she notice that i had already had gut radiation, that it had worked, but the cancer has reappeared?

it doesn't really worry me. it's more a matter of, i will be aware of different levels of awareness of what came before... just in case.

but i wonder: is this a real problem for doctors managing a large number of long term patients? especially patients with complex and varying illnesses and treatments. how easy is it to overlook something which has -- or has not -- already been tried?

===

the monday drip is easy, painless. the nurse starts with the usual questions about falling over, allergies, mouth ulcers... at which point i ask, what is an ulcer?

the tip of my tongue stings, just a bit. is that an ulcer? an abcess? what about the tooth that aches? (i may have been grinding my teeth in my sleep.) what the nurse describes, no, i don't have that.

some time in the past i may have had an ulcer, i don't really know. i've had an abcess or two, the sort where you can't see anything anyway but the dentist pumps in anaesthetic, rips the crown off a tooth, gouges out poison and gives you a sweetie to stop the crying. (i may be mistaken about the sweetie.)

but do i have an ulcer? no idea... what is an ulcer?

it's a bit like "nausea", another standard question. yes, i have nausea, i snack a lot to keep it under control... no, that's not what the doctor or nurse wants to know. the correct question is, have you been face down over the dunny, chundering up your last meal?

for most of my life i have visited a doctor perhaps once every two or three years. i have not learnt the language of disease. i have no memory of illness and its effects.

it's a communication problem. i need to learn key words. doctors need to remember that not everyone knows the language of illness.

===

so i get the drip and drive home. via a garage to pump the tyres. to a shop for some groceries. all very slowly and carefully. so slowly that deb -- before i am home and have sent an email -- is worried.

===

i spend the afternoon resting, mostly sitting. with occasional bursts (slow bursts) of activity. two loads of washing. can't be bothered hanging out so i use the clothes drier. clean the toilets (one of my few household chores). rest in between each activity.

yes, i'm feeling a lot more active than i was on the weekend :-)

====    Dr Nick Lethbridge  /  Consulting Dexitroboper
Agamedes Consulting / Problems? Solved.
===

"If It Ain't Broke, Break It" … Meat Loaf
===

dying for you to read my blog: notdotdeaddotyet.blogspot.com.au :-)
====