Category: Fatigue

nick abrams tortoise turtle unsplash scaled - 56 days slow and bald
August 25th, 2020 by Janine

56 days since my stem cell transplant (SCT). I’ve now been home for the same amount of time that I was in hospital, 4 weeks.  Hospital seems like a year ago.  Life can be summed up by two words; SLOW and PATIENCE. 

I’ve been slow before (when temporarily injured or after a knee op or three) but this is a new slow. Walking from room to room is slow, sitting down, getting up, slow. Asking muscles to work, their receipt and action of requests, slow. Stairs well, they may as well be Everest! All the yoga flexibility and strength pre transplant has evaporated. Turning on taps, opening containers, putting on shoes are all a huge challenge. Stretching is a mammoth task, let alone trying a forward bend or downward dog.  I’m feeble, weak and extremely fatigued.  Putting feet up after a shower, afternoon naps (usually two hours) and early nights are a daily must.  Sitting down on the closed loo seat mid-way through brushing my teeth is novel yet frequently necessary; standing for two minutes in front of the basin is a tall order.   The pace of my life has almost ground to a halt and my new norm is slow.

 

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Stairs may as well be Everest

C-diff (Clostridium difficile)

I am so happy to be home.  The night I was discharged I was ecstatic to be out. I’d recovered from the worst of e.coli, was on the road to recovery from SCT when WHAM.  Another infection turned up and walloped me in the face.  Well, more precisely it whacked me in the stomach and bowel, attaching me to the loo once again.  At least it was my loo, with nice soft paper, a wide sink in which my hands actually could be washed without splashing the floor and my feet, with predictable hot water, familiar sprays with berry aroma and none of that hospital cleaning fluid smell.  At home, even the loo was heaven.  The nurse apologised for not being able to pronounce the intruding infection’s name. I laughed and reassured her it was fine.  Unfortunately I could pronounce it all too well.  The last word was Italian for difficult!!  We agreed it was aptly named and settled on the more commonly used c-diff! 

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Slow slow slow.  Taking it slowly and doing everything to prevent going back into hospital was the name of the game.  I fended off the doctors for a week. I reassured them I’d be fine, reminded them that my temperature spikes were nowhere as bad as two weeks previously and that I could handle the infection at home if they just gave me a nice heavy duty antibiotic.  Being readmitted would have taken the last bit of happy I had left in me and zap me of any remaining optimism about the transplant outcome.  To the doctors’ credit they gave me their dubious looking faces but didn’t push it.  They settled for giving me a three hour drip of fluids and the antibiotics.    I didn’t realise how rough I looked, sitting in my own room in Haematology, having been assigned my own toilet in order to keep me away from everyone else and no doubt keep everyone else safe from me.

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Hubby Hero

Home is only safe because hubby is here.  His hidden talents and remarkable loving caring personality have come completely front and centre. I know I’ve said it before and I’m going to say it again, I am so grateful and extremely lucky to be loved in this way.  My heart hurts for those going through SCTs without the support of a caring partner, friend or special loving family member (even when those people prefer space). 

Hubby’s been doing all the cooking, washing and stuff around home with no input from me.  I don’t do his amazing dinners (perfectly cooked fish with burnt butter caper sauce, delicious lamb with salsa verde or Persian aromatic salad) justice as my appetite has not fully returned and my taste buds are just weird.  He gets up in the night (2am, 4-5am) to check I’m ok, to make sure I’m not stuck or being sick, to see if I’m wide awake (often at times the checks took place in hospital) or to see If I have fallen asleep on the sofa.

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Our pond with gentle fountain – such a pleasure

He drives me to hospital, often twice in one day.  He frequently waits for hours or goes away and comes back again like an on-call chauffeur so I’m not standing around for longer than I need to. Hubby has made sure the garden is immaculate and created a pond with a water feature because he knows I love the sound of running water.  If chia seeds, baobab and pea protein are super foods then he is a super being (or bean, my new nickname for him)..sought of sung like superman except SUPERBEAN! 

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Hospital, new look for waiting

Waiting and self as benchmark


Waiting is the most predominant and draining feature of hospital now. I go twice a week for checks.  It starts with an early morning (7.30am) blood test, a wait for results and then an occasionally short but usually long stint in the Haematology Supportive therapy clinic.  Though from today I only have to go once a week (whoop whoop!).  Other than the general stuff the results the med team are most interested in are my Neutrophils and Platelets and the question asked is, do I have any?  The good news is that while my Neutrophils (immune system) have been roller coastering around between .69 and over 1, teasing me as they get towards 2 before falling back again, my platelets have been doing a fairly steady climb and are now at 123 (well out of the woods of the 30s when I would need to be given a blood transfusion).  The rise in platelets mean my body is generating new cells.  Lets hope they are clear of Myeloma.  Once my Neutrophils get over 2 and start staying there, it means I will have some semblance of a rebooted immune system that might just be capable of having some childhood vaccinations and allowing me to be around more people.

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Daily look

The slow, the fatigue, the compromised sense of self, the need to avoid boom and bust, the extreme patience needed with myself about every little thing I try to do and decide not to try to do, is all normal for this point in the transplant recovery process.  I tell myself to remember this and to not worry about what others that are post SCT have been able to achieve, start again or do before I have been able to.  Instead I focus on using myself, yesterday or two hours ago as my benchmark.  Have I been able to do anymore, any faster, any more normally than yesterday or this morning?  Yes, great.  No, great.  It will get better.  I will get stronger.  My platelets and neutrophils are my friends and working on supporting me as soon as they can.  Give them time.

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Channeling Audrey

I’m not good at waiting.  Though I’m much better than I was before I was diagnosed.  Hospital and appreciation of the NHS can do that because waiting is part and parcel of hospital life.  I’m still rubbish at it.  Last Thursday I waited 1.5 hours with only a 30 second conversation with a nurse letting me know they are waiting for the doctor. It’s understandable but frustrating as I see other patients’ doctors arrive, see them receive their treatment and leave before me, especially when their appointments were later than mine.  Still I try to remember the overall amazing service I have received over the last 3 plus years. Some days it is hard though and I want to be angry, upset and cry. Unhelpful thoughts drift in; I booked this early appointment so I wouldn’t have to wait so long (again), this is wasting my life, it doesn’t take this long for blood results to come back or can’t you see from your board I’ve been waiting an age – do something! 

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Uncovered

In therapy

My clinical psychologist side eventually kicks in and internally speaks to me – the person living with cancer, the Janine living with cancer treatment and its impact. Notice your thoughts and feelings, acknowledge them fully, connect with them (allow yourself to fully experience them, where and how they show up in your body, their nature, their depth, their source) and then once you have given this process time, engage.  Engage with the present world around you (notice three things you can see, hear, smell right now, notice three things with yellow in them). 

It’s ok to be angry, it’s ok to be upset and it’s very ok to cry. It’s also very ok to find your voice and ask the nurses again, what is happening and will the doctor come soon? Breathe, stay in this present moment, remember too who you want to be in the world, with others, with nurses, with doctors. I want to be kind, calm, clever and clear. Good, there is clarity in your values. It’s fine to say, calmly, to say gently to the nurse that you are upset. It’s ok to show tears.  You can still be kind, still recognise the wait is not her fault, that she is doing her best. You can ask her to see if there is anything else that can be done. 

Remember no matter which thoughts come into your mind, acknowledge and connect with them, engage with this moment, right now, moment by moment and then choose to place your attention on thoughts that are helpful, on actions that are supportive. If you are sitting in that hospital chair or waiting anywhere, choose to read, catch up on messages, listen to the radio, write a few notes for this blog, laugh, smile, marvel at your ability to shock yourself as you go past a mirror not recognising the person looking back at you  (I so often forget I am bald and look like others’ common perceptions of a cancer patient). Do this rather than sit, feeding the anger and anxiety by watching nurses and other patients, dwelling, being hooked by, ruminating on the thoughts that are leaving you feeling angry and upset.   

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Knobbly head

Hey self clin psych Janino, you are pretty handy at times.  It was no coincidence that I met that side of you/me before being diagnosed and travelling life with cancer was it? Thanks for being there.  Thanks for helping me apply strategies to lift myself from the fog, the negativity, the anger and sadness.  Thanks for helping me notice the little things as well as the big things.  I laughed when I discovered my trackie pants were on around the wrong way today.  I was thrilled when a café gave me my favourite jacket, having kept it for me overnight after I walked away leaving it on a chair outside. Thank you.

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Keeping cool

Hubby, our 14 year wedding anniversary comes up this week.  Thank you, from the bottom of my heart to the top, for everything you are, you do and for putting up with my slow.

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Acknowledgements

Images: 

Me & Hubby – headshots

Unsplash:

Yogi Purnama – Superman

Michelle Henderson – Mr and Mrs

Macau Photo Agency – Waiting

Erik Nielsen – SLOW

Martin Jernberg – Everest

 

 

© 2020 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in C-diff, Fatigue, Myeloma Treatment, Psychology for Cancer, Stem Cell Transplant SCT Tagged with: , , , , , ,