Fear Can Keep You Prisoner. Hope Can Set You Free.

Friday was a bit of a blur to say the least. What with catching up on phone calls, organising my uni accommodation and having my first load of IV chemo, it was a bit of an exhausting day all in all.

My extended family have been especially great. We have been though similar experiences with my Uncle and his lymphoma, my Aunt and her breast cancer, and I still can't get over how my Auntie Boo manages to still know all the right things to say! Especially when she's battling with her own treatment as it is at the moment. She is one truly amazingly strong woman!

My housemates have been absolutely lovely too, and considering the incredible amount of stress Grace is having to go through with her research project, I cannot thank her enough for taking on so much extra stuff for me too. I phoned her yesterday and found out that half the proceeds for Sweet Anatomy (a veterinary-related cake baking competition run by the final year RVC students), which I had been organising and have since had to hand over, are going towards Teenage Cancer Trust. It was amazing and humbling to hear, so if there was ever a good reason to bake a cake - now is the time! 16th February - get it in your diaries! 

I can't write this entry today without thanking my landlady too. She has been so helpful in sorting my accommodation and rent out, and I cannot thank her enough for taking the strain away of having to scrape together the rest of my rent for the year. On the same note, if anyone knows of anyone who may be interested in renting a room on a temporary basis in Potters Bar between March and the end of August do let Grace know :).

I received my first lot of IV chemo yesterday too, which was the Daunorubicin (a rather terrifyingly bright red/pink coloured liquid) and Vincristine. I'm on daily Dexamethasone 5mg PO BID, Allopurinol SID and Lansoprazole 30mg PO SID (a kind of gastroprotectant for the steroids - wouldn't want to actually end up with stomach ulcers now would I, considering that's what we thought the initial problem was to begin with!). All went smoothly, so happy days!

In addition to all the 'cancer-fighting' drugs, fertility is obviously a concern for any female going through this disease and regimen. The nurses and doctors have been most helpful and are able to give a drug called Zoladex every 28days SC to help send your ovaries to sleep (it's a kind of GnRH analogue). Fertility with this regimen is somewhat affected regardless of what you do, and your chance of being infertile creeps up only slightly against that of the general population, but it's good to know what options there are. Due to the rapid onset of treatment required for my condition, the Zoladex is by far the best option for me, and I'll be honest, I didn't think much of a subcut injection every 28days when it was offered. 

Then, however, it comes to the injection... The Zoladex itself is a small pellet, about the size of a grain of rice, which sits in your subcut tissue, slowly releasing its drug and disintegrating over 28 days. The only issue is, did I mention, it's about the size of a grain of rice, or to those people in the vet world - a newer style microchip... The needle and contraption itself is about the size of that we use to give microchips! Cue me being a wuss and requesting EMLA cream! In my defence, the student nurse performing the injection had already admitted to me twice that she hadn't done one of these before. But everyone's got to learn somewhere, and I certainly can't complain when I'm in the same position myself! (Even though every part of me was then on tenterhooks!) So anyway, we apply the EMLA, let it do its magic, and I try to lie as still and relaxed on my bed as physically possible. Lottie is sat watching everything at this point, and once the needle is in, and the student nurse is having to squeeze the handles of the contraption to insert the pellet, she helpfully encourages the nurse with "Give it some welly!" Pellet is inserted and the rather large needle removed. Cue a slightly shocked look on the nurse's face and her going "OH GOD!", as she grabs a swab and puts pressure on the bleeding hole in my stomach. I'm guessing she's not seen a microchip done before! :P But like all bleeders, after a bit of pressure, all is fine. Although, I do advise her that in future the aim is to not look panicked and say "OH GOD!" loudly in front of the patient - doesn't necessarily put them at ease! :P Thank god us vet students get to practise most of our skills away from our patients' owners! And we all have to start somewhere, and I'm more than sure that there are plenty of vets and medics out there who know exactly how that poor student nurse felt! :) Just makes me want to get back training again as soon as possible now!

My main aim today was to spend some well deserved R&R with Phil, and seeing as there is minimal going on this weekend, my next update with probably be Monday :). If anyone wishes to chat to me the best thing to do is download the Viber app for your phone, as signal in this place is poor to say the least. But if that's all I have to complain about, I think I can more than live with that!!

As you can see below, Dad's certainly been enjoying some well-deserved chillaxing today! Am so glad he can feel he's allowed to relax through all this drama! Everyone does need to remember that - you all need to look after yourselves too!

Don't think Flo is impressed by the smells protruding from Dad's feet at this point! :P

Much love to you all, and thank you to everyone who has been so kind to send cards, and donations.
xxxx

Let the Steroids Begin!

So, a not-so-brief catch up as to what has occurred so far:

After speaking to 3 separate GPs over the course of 5 days, I end up dragging my sorry self, on Wednesday 21st January, (with thanks to Phil) into A&E at Pembury with pretty horrible abdominal and shoulder pain. Following blood tests, high dose of Omeprazole, IV fluids and a chest xray, I'm told I'm free to go with likely stomach ulcers. Only thing is, as I'm about to leave, the doctor can't find my blood test results on the computer any more so wants to chase up the lab before I go. Not thinking much of this, we sit and wait in the waiting room. When he calls us back into the exam room, I'm thinking something's not adding up. 

I'm then told that although my white blood cell count is normal, my neutrophil count is 0.8 and my platelets are low too. Instantly I'm thinking - hmmm we'd be considering IV antibiotics at this point for animals with that count, this isn't sounding great... He explains I'm now being admitted, to have IV antibiotics (ABs) (surprise surprise), fluids and to be seen by a haematology doctor the next day. He does explain this could just be as a result of a virus, however...

The next day, medical doctors visit, still thinking it's most likely a virus. Haematology doctor, however, isn't so convinced and informs me I'll be moving to Maidstone that night to have a bone marrow biopsy performed the next day. Again, to me, these aren't the decisions of someone who thinks it's most likely a virus, so am slowly preparing myself for the worse. 

Thursday night I'm moved to Maidstone in a bit of a blur and the next morning have my bone marrow biopsy done. Just to put it out there - I would recommend people actively avoid this as much as possible. Don't get me wrong, I've not given birth, but the pain with this has certainly put me off slightly - though I am a complete wuss! Following some truly amazing organisation from the NHS I get my preliminary diagnosis of Acute Lymphoblastic Leukaemia (most likely B Cell) at about 6pm on Friday. It's a shock, but from what I've been reading I know it's one of the better ones to have by this point, so I actually also feel some relief. Also, I have been given the name for it, which is the best thing for me - I now know what I'm dealing with. Obviously, Phil and my family are crushed by the news to say the least...

Saturday I get transferred to the Royal Marsden in Sutton to be on the Teenager and Young Adult Ward. The doctor at Maidstone insists she feels this is the best place for me to be for the best treatment, the best facilities, and the best for me psychologically. She is not wrong. I mean, sorry RVC but this puts your SU facilities to SHAME! Just so people are aware - wards are girls and boys, 4 beds to a ward, there are also 9 individual rooms, each bay and room has it's own TV, there are two 'chill out' rooms with 3 massive TVs, Sky TV WITH movies and sports, XBoxes, PlayStations and Wii's coming out of their ears, a portable 3D TV, a jukebox, a kitchenette, a quiet room, a pool table, a conference table for those having to study, computers and FREE WIFI :) Jealous yet? :P I have failed to mention the daily menu, from which everything is freshly prepared to how you want it, and if there's something not on there that you want, they'll cook it for you anyway. I still can't quite believe it... There's a pull down bed for people to stay, and family and friends have their own kitchen facilities to make their own meals in etc. There's also a rooftop garden terrace, which is lovely to just get a bit of fresh air, but they also do picnics and bbqs on in the summer. These guys have done a good job to say the least! And that's without even mentioning the staff - all the nurses, registrars, doctors, health care assistants and chefs are amazing!

What has been making the situation more interesting, however, is the frequent discussions I'm having about being a vet student... And every doctor is more and more interested in what animals I have come into contact with etc. etc.. So cue mild drama over the fact I had a Chinchilla practical the day before I started feeling unwell... I can't work out which is more funny - the fact that the doctors and nurses are having to Google what one looks like, or the fact they're quizzing me over what diseases they get! - Yea, because I know all that random stuff! - I find myself referring them to my university for details and the Hospital for Tropical Diseases (which they don't know exists :/) So guys, next time you're moaning about Wednesday lectures - they taught me about that at least!! lol

Also, the doctors aren't finding it as amusing as I am about the number of cat scratches I've potentially had, especially the one I had ABs for in the summer.. Nor when they ask about if I've had a needle stick, and my response is laughing at them because I have lost count! I mentioned the one on my Anaesthesia rotation, but when I explained the needle had only been in either Methadone or Acepromazine, and they didn't know what that was, I left it there... Definitely forgot to mention the ones on lambing in first year... Oh the wonderful life of a Vet Student!

Naturally, following these revelations about the clinical rotations, hard-core exams, and the amount work experience we have to do, when the doctor asks how much alcohol I consume she's expecting a fair amount.. Only problem is, I'm the most boring student in the history of students - No, I don't smoke and have never smoked; No, I don't do any drugs or have ever done any drugs; and yes I drink, but the most I drink in a week is a pint of Cider... Cue the doctor's turn to laugh in my face! So she asks me again, "No, how much do you really drink?" Me: "I went through fresher's sober, the most I have ever drunk was a bottle of wine on my 21st birthday, and on a 'heavy' week I share a bottle of wine with my housemate. Seriously, that's all I drink." There's a stunned silence. So, I explain again the 12hr night shifts, weekend work, on call work, and potential 14hr days we have to do on rotations, and only then do I think she might possibly believe me.... I still don't think she does!


So - after a lot of waffle, where am I at now?
Yesterday, I received my confirmed diagnosis of B Cell Acute Lymphoblastic Leukaemia, following another bone marrow aspirate, more blood tests than I can remember (they also didn't like the fact I went to an abattoir apparently...had to explain yes, there was a risk of me getting Bovine TB, no, it's not the same as human, and yes, I have had my BCG, and no, I have not been near any badgers (?!?!) ...) still had a blood test to check for that though! Yay!

My not-so-attractive bone marrow biopsy 'hole' in my back, with a nice lot of bruising thanks to my lack of platelets!


Today, I received my first lot of chemo - I had an intrathecal dose of chemo (into my back), which delightfully can cause 24-48hr headaches due to the increase in intracranial pressure (standard), and the steroids (Dexamethasone) began. I have received a couple of packs of platelets so far too, which has all gone well, which has been nice.

Steroids are definitely my new best friend though. I have an appetite again and I feel like I have some energy - these are the bees knees I'm telling you! If I ever get that case where I feel "well all that's left is to try steroids", sod it, I'm trying them! Before I was a bit hesitant, not any more!! I'm also on Allopurinol to protect my kidneys, which is indeed the acute treatment of choice in Dalmatians with urate stones! Was thinking I'd heard of that drug before...and indeed we have!

Tomorrow sounds less fun, however, I start Daunorubicin and Vincrinstine IV, and the following day have some Pegaspargase. We shall see how it goes though, but it definitely is not going to be a walk in the park! Least there are drug names I recognise and have seen being used :) strangely brings me a weird kind of comfort. Also, having worked in the QMHA, hospitals aren't an alien environment any more, and I'm afraid I'm THAT irritating vet student who actually really enjoyed my time in the QMHA as a whole. This doesn't feel all that strange to me bizarrely, probably to the annoyance of my family! :P

Finally, the thank you's:
- To Phil, who after a bloody long early shift, took me to A&E on that Wednesday evening, and is being so amazing and supportive through everything
- To my family for being incredibly strong and supportive through this rather appalling situation, which has obviously been a massive shock
- To all the people who have sent me messages and have been so incredibly thoughtful and supportive too - those at home, uni, and the people who I am ashamed to say I can't remember the last time I spoke to, but thank you all so much
- To everyone else out there supporting my support network!
- To all the incredibly generous people who have donated to Lot's justgiving page - it has been so  humbling to see the amount shoot up so quickly!
- To the RVC for their truly amazing help and support with taking time out
- To the lovely people taking over the organising of Sweet Anatomy
- To everyone in the NHS and at the Royal Marsden for doing such an incredible job - I have not got a single complaint about any of my treatment - it has been superb!
- And to anyone else who I may have forgotten in my slightly drugged up state!

Look out sometime next week for details on visiting. I'm only receiving close family and friends at the moment for visits until I get into the swing of my Chemo and then will be able to give you details on how to and when is the best to visit as I understand many people would like to :) I hope this is ok, and thank you all for your understanding in the mean time. I'm anticipating being here for the next month so there's plenty of time to see you all :)

I do hope this hasn't been too much of a tedious start to my blog, but just felt this is an easier way to keep everyone updated as my phone battery life is somewhat struggling at the moment to say the least!

You're all amazing, and thank you all so much for everything.
xxxx