Tagged Health

Cell-Bye Date (part II)

 

nolan

A stem cell transplant is supposed to save your life, but there are times when you don’t feel alive. First you’re hit with high-dose chemo and radiotherapy – total body irradiation, that is: lying in a kind of human fish tank while a machine shoots you with waves of 14.4 Grays. It’s like you’re a computer being fitted with a new hard drive; before they can install the healthy bone marrow, they want to demolish all trace of your own errant cells. The whole process, I’ve been told, inflicts the same kind of destruction on the body as a nuclear attack.

The first bombshell came for me, though, when the question of donors arose. My sister had already been tested and found incompatible (siblings are only a match in around 25% of cases).

Then came the uncertainty, and the sense of powerlessness, as the search for an unrelated donor began. All I could do was wait and hope that a match would be found. The consultant warned that it might not be possible due to my ‘mixed background.’

I’d never thought of myself as mixed, but it turns out that having a Jewish-Hungarian father and a Croatian mother is far from ideal. In fact, the chances of finding a match with a Jewish background, I recently discovered, are only around 40%. (‘As though being persecuted down the ages wasn’t enough,’ my dad lamented).

Donors are matched according to cell tissue, of which there are millions of different types. I was astonishingly lucky to be found a 10/10 match in a matter of weeks.

But not everyone is as fortunate as I was. Some people go for years enduring gruelling rounds of chemotherapy while they wait for a suitable donor to appear on the register. Others don’t survive.

The more people join the register, the better the chances of finding a match for everyone with a blood cancer. All it takes to sign up is a bit of saliva in a sample tube.

The things people say

Cancer, when it’s curable, is like North Korea. At times the prospect of imminent danger slips from your mind, and it fades into a dormant kind of fear. It is terrifying. But you don’t think it’s going to kill you. It becomes a nebulous constant in the background. At times you can even laugh about it.

Then suddenly it’s threatening you with missiles.

Or false alarms. You never know.

There are certain anecdotes you don’t want to hear first thing in the morning from a burly man equipped with a full set of needles, when you’re receiving blood transfusions and a nice batch of platelets before breakfast.

‘Girl in this room,’ the nurse told me. ‘10 years ago. Serbian. They were going to deport her. There were lots of delays. Then they tried a stem cell. The treatment wasn’t working.’

I didn’t know what to say.

‘In this bed here,’ he continued with a smile. ‘I remember it like yesterday. Such a nice girl.’

He stopped for a moment, cradling the packet of blood in both hands, then began again:

‘She was given three months to live.’

I felt cold.

He paused for effect.

‘She recently finished her degree. She’s a practising lawyer now.’ He was digging out his phone. I saw lots of hair and smiling teeth. ‘There she is with her fiancé.’

Not everyone, though, can manage to confront mortality and then raise a smile within the space of a few moments. I know that most people have the best of intentions, but some of the cack-handed questions and comments I’ve come across are stultifying. The ambulance driver who asked me brightly, with a big grin, ‘What are you going into hospital for?’ I had been diagnosed with leukaemia an hour earlier. I was in tears at the time. Or the message I received from a former university friend, some weeks ago, after posting several links to this blog on my personal page (as well as an accompanying explanation): ‘Hi Hannah, are you not well?’

Then there’s irony. Often best considered the privilege of the patient. I remember the smug-looking medical student who came in to examine me, bent my elbows at lots of awkward angles and asked too many questions, until a certain picture of a virtuous healthy lifestyle began to emerge. Never eaten meat, light drinker, keen swimmer and runner, tried a handful of cigarettes at most.

He threw his arms up in sarcastic lamentation. ‘Why, Hannah, why?’

On the other hand, I don’t mind being told how inordinately brave I am. It does scare me a little, though. It all seems very ominous. I feel like asking, do you know something that I don’t? I thought the prognosis was encouraging.

The same goes for all the tower of inspiration rhetoric. I don’t agree, but I lap it up anyway. Or people praying for me.

But when there’s any doubt over what to say, an anonymous gift never goes amiss. I’m still trying to establish who sent me this. Thank you to the mystery sender:

teddy

Why me? Why not.

I’m writing because I have a white blood cell count of 0.

Because for a month now I have been confined to a sterilised room, and on the rare occasions I leave it I have to wear a mask, as the slightest cough of a passer-by could result in pneumonia for me.

Because for that same reason I’m scared to let my friends visit. Even my parents are terrified to touch me.

I’m writing because I feel weaker every day. I can’t walk a short distance without leaning on my dad; I have to lever myself up every time I crouch down to open a drawer.  After dimly imagining my hair might stay intact (I’ve been lucky so far) it’s now falling out in large handfuls. And I’m scared the ability to write, if I don’t, like so much else, will slip away from me.

I’m writing because now – as I’m loaded with drugs bearing oddly alluring names, which leave me barely able at times to remember my own – now is not the time to write and yet now is the time more than ever.

Because somewhere at the back of my mind, somewhere way beneath the why-me is the why-not; under the cheery post-chemo gleam is the unvoiceable, lingering sense that my time left to write isn’t as long as I would hope it to be.

Last week on the wards the new consultant hit me with it. He isn’t the most rhetorically-gifted man.

‘Well, this is something that looks like a Bad Thing,’ he said.

I wish, at least, he’d said ‘less promising’, or ‘less encouraging’, or ‘inauspicious’. Dress it up for me a bit, embellish round the edges.

After a lot of fumbling and prevarication – and a lot more repetition of ‘looks like a Bad Thing – but possibly isn’t!’ – it came down to this:

‘You have a cytogenetic abnormality. Your chromosome 21 makes too many copies of the AML1 gene. And while we don’t really have anything in the way of statistics – it looks like patients with your specific brand of leukaemia fare worse than others. So we’re giving you a higher dose of chemo just to make sure!’

I’m such a lucky girl.

I thought it was already rare enough for my white blood cells to go off on their merry way in the way they have – only 400 adults in the UK are diagnosed with ALL (acute lymphoblastic leukaemia) every year. But apparently my little chromosomic idiosyncrasy is limited to 4-5 in the country, according to the consultant. So it turns out I really am one in a million. (Or one in 15 million, if you want to split hairs).

And I have a pink lunchbox with my name on it. Well, it’s my drugs box, but it looks like a lunchbox, and it’s Alice-in-Wonderland-fallen-down-the-rabbit-hole-brilliant. HANNAH PARTOS stamped on one side in capitals and CYTOTOXIC!!! on the other.

I suppose it’ll have to do if that teddy from Pippa doesn’t arrive soon.