Tagged cannula

Bad Blood (part II)

 

Central line

 

On the Cancer Underground, you can take the Acute Lymphoblastic Leukaemia line. I don’t recommend it, personally. Lots of delays, frequent disruption and constant complications (especially if you have a stem cell transplant). Only 40% of passengers make it out alive.

But back to where it all started. Here I am, out of breath, faint, waiting in A&E, expecting a jab in my arm. Blood test and then take the bus home.

The registrar. She looks at the swollen glands in my neck. She winces.

‘Haven’t you been to your GP?’

‘I did. They said swollen glands are normal.’

‘That doesn’t look normal to me.’

I’m told to wait in a side room. No one comes. I go out looking. Outside are corridors, a bustle of men shifting beds on wheels. I head back to the waiting room. Toddlers clawing at the skirts of their mum’s hijab. A man sits on his own as blood gushes from his nose. He holds a toilet roll to his nostrils to soak up the flow. The entire roll is drenched red.

A boy of about 12 in a wheelchair waits patiently next to his dad. A couple of porters approach them, apologetic. ‘We urgently need a chair. Is it alright if we borrow yours for a minute?’

The boy smiles, nods. His dad helps him out and onto one of the seats.

Eventually I find a nurse. She frowns at me. ‘You should be on your own.’ She leads me back to the side room.

‘What’s going on?’ I ask.

‘I don’t know what to say,’ she says. ‘Your haemoglobin levels are 5.’

I’m sorry?

‘They’re half what they should be.’

She runs off to attend to someone. I keep waiting. A man comes in and pulls me by the arm. ‘Right you, off for the kidney scan!’

What?

‘You are Maria, aren’t you?’

A few hours later I’m taken to an isolated room on a ward upstairs. I’m put on a drip. Fluids. The rest follows in my mind like a montage from a film. Because only in films have I seen drips and machines and medical equipment. A blood transfusion. More fluids. Scans. Needles. I remember the needles, the hurtling pain, the probing. A shifting panel of different nurses try and fail to insert cannulas in my veins, to give transfusions, to take blood. Cannula, I say now, over a year later, because I know the word. It was only another needle then.

Back then cells were rooms in prisons. If I heard the words ‘Central line’ I thought of the red stripe across the Underground map, not a tube inserted under the skin of your chest.

central line

 

When three doctors arrived the next day, and shook my hand, and shook my mum’s hand, and told me I had leukaemia, they might as well have been speaking another language. They had waited for my mum to arrive before they gave me the diagnosis. They were very careful, very polite. They handed me a Macmillan booklet and left us alone together to ‘talk things over’.

ALL

I looked down at the booklet – ACUTE LYMPHOBLASTIC LEUKAEMIA in green letters. It hadn’t entered my mind that there might be different types of this disease.

‘Leukaemia,’ I said to my mum. I was 22, I had heard of it before, obviously. ‘How is that related to cancer?’

My Perfect Match

thankyou

 

How do you thank someone for saving your life?

Today is seven months exactly since I received a bagful of stem cells from an anonymous donor. Six million of them, via my Hickman line. I lay on a hospital bed, wiped out from a week of chemo and radiotherapy; I’d just had the most intense treatment that can be given to a human being without killing them.

A nurse hovered around, intermittently checking my blood pressure and heartbeat for signs of a reaction. As the cells flowed through the tube and into my veins, the room was permeated with the unmistakable scent of boiled sweetcorn. (I was warned this would happen. For some reason stem cells smell like sweetcorn).

I thought of the stranger who had willingly given his cells to save my life. Who had undergone various blood tests, an ECG, then four days of growth hormone injections to stimulate his cell production – and the side effects of aching bones. Who had sat for four or five hours with a cannula in his arm while his blood was filtered through a machine. For someone he’s never even met.

All I know about my donor is he’s 24 (a year older than me) and a ‘chunky lad’. In two years’ time, I’ll be allowed to meet him if I want – and if he agrees. Until then, the rules say, I can send him an anonymous thank-you message, as long as I’m well enough.

Up until now, I haven’t been well enough. The last few months have been rough. For a while it looked like the transplant hadn’t worked – I hadn’t ‘engrafted’, my bone marrow wasn’t producing blood cells. I was finally discharged from an isolated hospital room 53 days after the transplant, but with no white blood cells, my immunity was non-existent, so I was virtually house-bound. I couldn’t go to public places. I could only see a handful of close friends and relatives. Every couple of days I had to go to hospital to have blood and platelet transfusions, since my body wasn’t making enough to keep me going. I had to inject myself daily in the thigh with growth hormone factor.

In the end the doctors asked Chunky Lad for a few more cells, and he obliged. I received a top-up in autumn – though by this time my lazy marrow seemed to have woken up anyway, and was beginning to produce cells. Whatever the reason, I could finally escape the transfusion room.

But then there was the Graft versus Host Disease. Tell people you have cancer and you get some well-deserved sympathy. Tell people you’ve got Graft versus Host Disease and you get a blank expression. GVHD occurs when the donor’s cells recognise yours as foreign and launch their assault, usually attacking the liver, the digestive system – or in my case, the skin. For months now I’ve suffered from constant itching and rash. My skin got so dry that the soles of my feet cracked and bled; walking became painful. The surface of my whole body was splintering off like dandruff – I couldn’t move without shedding a flurry of white flakes. No amount of ointments or creams seemed to have an effect, and I was forced to take high doses of steroids, which weakened my muscles, and kept me awake at night.

It’s still a daily struggle, and I have to spend several hours each day applying creams just to keep the itching at bay. But now I’m having specialist photopheresis treatment at a dermatology clinic, where I’m plugged into a machine for a couple of days a fortnight. It’s a pain having a Hickman line, and the treatment will carry on for at least six more months. But the GVHD seems to be slowly improving a little. And now his cells are attacking mine a bit less, I think it’s time I wrote Chunky Lad a thank-you note.

The only question is what to say. To this total stranger whose blood is now flowing through my veins. To this person I’ve never met, who by a complete accident of chance, happened to have the same HLA tissue type as me – closer to me than my own sister, who, like the majority of siblings, was not a match.

With all the complications that arise from a transplant, it’s hard not to feel downcast, at times. Sometimes the future does look bleak. But I remind myself that it’s because of my donor that I can even contemplate a future.

He’s probably saved my life. And there’s no way I can thank him enough.