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Bag change day

Having written about a chemotherapy hospital stay, I think it’s time that I also described having my 5-FU bag changed, as that is the other side of my regular chemotherapy treatment. Once a week I travel to Worcester to meet the oncologist and report weekly progress before the bag that delivers my 5-FU and the dressing that covers the PICC line are changed. I aim to make a mid-morning appointment so that I don’t have to get up too early, which has the useful side-effect that I can usually find a parking space in the main car-park. Earlier in the day it can be a bit of a scrum, so that time is best avoided, if possible.

As with the hospital stay, I have to prepare for a bag change. The first thing is to take a packed lunch. Cancer patients are decidedly unpredictable, and there are often times when things take longer than expected, although it is usually another patient who takes the extra time. Not that it matters, as there are only a limited number of staff to deal with all of us, so any delay affects all the following patients. It’s definitely worth taking a packed lunch of some sort. Today’s was a couscous lemon and sesame chicken salad, with added dried pear, trail mix, and honey roast cashews. All the waiting means it’s also worth taking something to stave off boredom. I usually take a book, and Gillian will take a novel too.

The other aspect of the preparation is to think about the conversation I will have with the oncologist. I like to report how the week has gone, with all the ups and downs. I can’t remember a week without some adverse incident, probably a bout of nausea or vomiting, or some back pain. This week had more to report, except that it was already known because of the unscheduled trip to Cheltenham on Sunday and Monday. But it is also important to think about what has gone well, and I’m pleased to say that there are always good things to report too. Finally I need to know whether I am about to run out of any of my prescriptions so that I can restock. Last night, for example, I did an audit of my pills and found that five of them needed topping up.

When I arrive the very first order of business, after signing in, is to make an appointment for next week. The receptionist is well used to me doing this, and I find that if I don’t, I’ll forget, so it’s good to have a routine. It also makes it easier to get an appointment for about the same time, which suits me fine.

Then we wander along to the waiting room, where we greet all the other regulars and catch up on the week’s doings. I love it that we see the same patients week after week. We all get to know each other, and we’re very friendly. Most patients are accompanied by at least one loved one, so it’s never just a simple comparison of symptoms. Sadly, sometimes we see that a patient isn’t doing so well, and as he or she will tend to be a little listless we try not to over-tax them with too much idle chatter. Today when we arrived there was a treat: some fairy cakes and a home-made Victoria sponge. It turned out that the Registrar who frequently stands in for the Oncologist when he is on call in Cheltenham was moving on in her six-monthly rotation, and in celebration she had brought the goodies. I’m happy to tell you that the cake was excellent. Once we’ve exchanged the news, we start to wait. Today was one of the long waiting days, as it took over one-and-a-half hours before we got to talk to the Registrar, due both to problems with other patients and also sheer pressure of numbers, I think.

The meeting with the oncologist/Registrar comes next, in which we discuss the week’s events, think about variations to my anti-nausea medication, and plan the things I need to do during the coming week. This week I need to keep a diary of my nausea and vomiting, so that we have some evidence on which to base a better anti-nausea prescription for me. It isn’t that the nausea and vomiting is a big problem — more of a minor niggle, in fact — instead it’s an indication that something is happening in my body that we don’t understand, which might develop into something more major. But whatever the reason for sorting it out, I would rather not have the nausea, so I’m going to do my best to help solve the problem.

Then it’s back to the waiting room to wait until a nurse is free to change the dressing and bag. At least, that’s normally what happens. This time I had had my bag disconnected before seeing the Registrar, and the nurse doing the work had noticed a minor problem with the line, during the solving of which she had had to move it out of my arm a little. It’s important that its other end is in the right place in my chest, so I was sent off to get a chest X-ray, while Gillian went to the Pharmacy to collect my new prescriptions. That’s another good reason for being accompanied, as it allows some sharing of the waiting. But that didn’t fully occupy the time before my bag was due to be changed, so we ended up back in the waiting room. I ate lunch: delicious. So was the fairy cake I had for dessert. The patients were thinning out as more and more of them were dealt with, so I was able eventually to wait in one of the comfortable chairs in the treatment room.

At last it was time for the new bag to be fitted, and the dressing change completed. It took about 15 minutes and was trouble-free. As we started to go, one of the other patients commented about my bald head, which sparked off a general conversation about hair-loss amongst all of us who were left. To great hilarity, Gillian suggested that it would grow back ginger and curly. Most of the others thought that it would really be curly for a little while when it grew back. Then I put on my celebration hat (thank you, P+J!) to more general hilarity, and we left.

We were home by 3:30, approximately two and a half hours later than expected. Always take a packed lunch. If not, you’ll have to eat hospital food, which probably isn’t as good as your own.

Tomorrow I go back again, this time for a CT scan, but I won’t get its results until next week’s bag change visit.