Today we presented ourselves at Darwin's Alan Walker Cancer Care Centre for an 'Education Visit'.  As it turns out it was well named 'cos we learned quite a lot!

The Centre is on the grounds of the Royal Darwin Hospital but presents as a modern, friendly and 'not too clinical' environment. That facade was maintained in reception and other spaces visible from there. We were met by a very pleasant young chemotherapy nurse who lead us deeper within the centre. Once we entered the treatment room, all pretense that this was anything other than a medical treatment facility was gone. It was wall-to-wall nurses, gowns, masks, drips, trays, trolleys, gauze, needles and (not surprisingly) patients. We remarked to each other that things had suddenly got more serious!

We then sat down with two nurses and were 'educated'. It was primarily a description of how the chemotherapy drugs are administered and a run-down of the list of more than 20 possible side-effects of various liklihoods and possible intensities. Helpfully they gave us a sheet with all the information summarized! We were not inclined to believe one nurse who surprisingly said in her best reassurig voice, "But you probably won't have any of these and just sail through it all". Hmmmm.

As a finale, they took about 10 vials of blood (all from Sue, fortunately!) for all manner of tests to confirm that she is free of all unwelcome bacteria, viruses, parasites and other nasties (HEP A, B & C, HIV, TB, strongaloides etc etc). I can now cuddle her with increased confidence!!

So what did we learn?

Three significant things we learned (that you possibly already know!) were:

    1. Chemo kills 'goodies' in the cross-fire
      In simplistic terms, chemotherapy drugs target fast-dividing cells. Cancer is essentially misguided, maladjusted, malignant, malevolent fast-dividing cells. There are other fast-dividing cells in the body including hair, skin, fingernails and bone marrow. Some of the side-effects of chemo are a direct consequnece of these good cell types getting caught in the cross-fire. These include hair thinning, skin issues (e.g. dryness, sores, sun sensitivity), nail damage, increased risk of infection and so on. Makes sense really........

    2. How hot is too hot?
      For a chemo recipient, the answer is 38 deg or more. We were warned that Sue must monitor her temperature closely and if it reaches 38 deg to go to hospital immediately. The reason is that high temperature is the only one of the body's immune responses that is not suppressed by neutropenia (low white blood cell count). Neutropenia is caused by damage to the bone marrow and reduces the capacity to fight off infection. The usual indicators of the body fighting infection can therefore be absent (e.g. swelling, redness and pus around sores; sneezing; coughing) or already present because of the chemo itself (e.g. vomiting, diarrhea, aches & pains and fatigue). As an aside, we didn't actually realise that the body goes into fever (temperature over 38 deg) in order to destroy heat sensitive viruses such as flu.

    3. Your spouse can turn toxic!
      Because of the strength and toxicity of the chemotherapy drugs they can cause bodily fluids and excretions to become toxic also. This means that those living in close contact need to take some special precaution, especially in the first week of the chemotherapy cycle as the drugs are being broken down in the patient's body. I have heard of toxic relationsips but not toxic spouses!!

I accept that some of the 'medical' information above may not be complete, or completely technically accurate. What is abundantly clear though is that as human beings we are God's intricate creation and are 'fearfully and wonderfully made' - Psalm 139:14.

PS: Sue starts the first round of chemotherapy at 8.30am on Tuesday 10 September.  So the next chapter begins.........