Institutionalised

I’m not someone who becomes rapidly institutionalised. Or so I thought, until I experienced my first-ever hospital in-patient stay just before Easter.

After the minor setback of having too low a neutrophil count the previous week, I returned to clinic last Tuesday to see if the G-CSF injections had succeeded in raising it. They had – the count was nicely in the middle of the ‘normal’ range. However, they’d also noticed an anomaly with my liver function. This meant that although I was admitted onto the ward that day, I had an anxious 24 hour wait involving ultrasound scans and further blood tests to make sure that I was fit enough to receive treatment. Fortunately, everything, in the end, was fine.

The slight pause in treatment gave me the opportunity to observe the ward routine without the chemo fog. It runs like a well-oiled machine. You can definitely set your watch by refreshment and meal times, ward rounds, observations … everything is very predictable. Predictability is good – essential – in such a complex environment. I estimate that I became thoroughly institutionalised by around early evening on my first day. I’m not exaggerating when I say that one of my proudest achievements in the four days I spent there was organising my own medicine cabinet and being trusted to self-administer. Little things like that help you to keep some sort of control – even if, fundamentally, the institution wants you to take this responsibility on!

Cycle 2 supporting chemo drugs

Unopened stock on the left; ‘as required’ medicines next, morning only medicines, followed by ones used both morning and evening.

The second chemotherapy cycle started with 5 hours of Rituximab on the second afternoon. This was followed by four infusions of high-dose cytarabine over 3 hours, given 12 hours apart. By the time the fourth dose had finished, on Good Friday, I was more than ready to come home. The evening cytarabine sessions were the hardest to cope with, as these started at 10pm and so finished around 1.30am. That left only around 4 hours for sleep before being woken up for observations …

Unsurprisingly I’ve spent this weekend doing very little and trying to get some strength back. It’s returning slowly, but I am noticeably more lethargic than after the first cycle a few weeks ago. I think that’s due to lack of sleep during the in-patient experience than anything more sinister.

I can’t speak highly enough of the care that I’m receiving from the Royal Derby Hospital so far. Everyone on the haematology ward, from the cleaners to the registrar, was professional, cheerful and thorough.

Chemotherapy is definitely the toughest thing that I’ve ever had to experience, but I seem to be in excellent hands. Here’s to the benefits of being institutionalised.

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