Day 18 - A long, hot day

I set my alarm for 4.30 so I'd wake in time to have breakfast, complete my extensive hygiene routine before I rode to the hospital.

Today was another double up for radiotherapy treatment. My morning treatment was scheduled for 7.20am, which meant I scheduled to leave home at 5.30am. It normally

takes me around 1 hour and 20 minutes to ride to the hospital, which meant I would be in the hospital for most of the expected very hot hours during the middle of the day.

Unfortunately, I set my alarm clock in my iPhone to 4.30pm by mistake, so the alarm didn't go off when I wanted it to. I woke naturally at ten minutes past 5am, so jumped out of bed and made a couple of bits of toast, one with vegemite and one with plum jam. The vegemite slice didn't go down too easily but the jam one did. It was wholemeal bread so I think this didn't help. Up until now I've been eating white bread toast, so will have to try this again before I decide whether or not bread is something I want to try to continue to eat. I also had and Up N Go drink.

Because I was running late, I hadn't had my Difflam gargle and mouth wash. My throat had gotten extremely sore overnight, so I decided to use the prescribed Lignocaine mouth wash instead. It is a more potent anaesthetic than Difflam, which you swish around your mouth, gargle and then swallow so it also anaesthetises your throat. My chemotherapy trial nurse suggested I mix it with Mylanta to also ease any heart burn I was experience when I burp (which is happening frequently and which I put down to the treatment).

However, because I'd rushed my breakfast and had only just eaten, the Lignocaine / Mylanta mix made me vomit. It is a thick liquid, not unlike a half set jelly, but I hadn't vomitted a lot, so the medicine still did its job and I didn't feel the pain in my tongue or throat until around 11am.

I also had Panadol and Nurefin again as it seemed to help last night.

Thankfully, I'd packed most of my gear the night before, so I only had to add my Kindle and reading glasses. I pumped my tyres up to my regular 110psi and headed off around 5.45am. I knew I had to ride faster to make it in time, but I also knew that I was getting fatigued a bit earlier these days. It was cool at that time of the morning and I added a few blocks of ice to my drink bottle. I figured I'd try to ride at my normal speed and if I was late, it wouldn't matter, I'd just register when I get there and take my turn as they move through the list.

After washing and changing, I made it into the radiotherapy day unit around 7.30am, 15 minutes later than my scheduled time. .

My radiotherapy treatement went without a hitch, so I left there and sat down in my now favourite reclining chair in the chemotherapy waiting area. I registered at 8.30am when the reception opened and went to sit back in my chair because my scheduled time wasn't until 9.30. Instead I was called in straight away.

It is becoming the norm now, but the doctors are expected to provide a weekly prescription for the drug and dosage to be administered to me, but it hasn't arrived when I was admitted. This has happened every week I've been there and the nurses have to chase it up. This morning was no exception. So the nurse installed the cannula and checked my heart rate, blood pressure and temperature while we waited. He must have known it was going to take some time because he started the IV Pump at a very slow dosage rate pumping saline to keep the cannula clear.

Eventually, the chemo drug arrived and my nurse gave me the anti-nausea drug and pumped steroid into the cannula. I then had to wait 30 minutes before the chemo could be administered. My course of chemo only takes about an hour these days, so I'm pretty much in and out in less than two hours.

I was pretty tired this morning, so instead of doing emails on my iPhone or reading my book, I reclined the chair I was sitting in and tried to sleep. I did ok, except the lady in the chair directly behind me was listening to SBS on the Russian News broadcast. She had the volume up quite loud and I could hear every word, not that I could understand any of it. It was good just to lie back and try to sleep.

I had a couple of bikkies from the tea lady. I didn't have a cup of tea because I wasn't enjoying the drink as much as I did before treatment began.

After chemo, I went up to the Level 8 cafeteria and bought beef goulash, rice and steamed vegetables, with a strawberry milk to drink. It was ok. I also had a Connoisseur ice cream to follow. I could feel my throat getting sore, but I was still able to eat and, importantly, swallow.

After finishing my lunch, I meandered down to the SolarisCare centre to just relax a bit. While there I decided to try a cup of tea, so I tried a half cup. It wasn't all bad, but still not as good a I remember. I read a bit of my book but then realised I hadn't brushed my teeth and I wanted to always make sure I had done this prior to radiation treatment. So I went to find a toilet to do this. I also took some more Panadol and Nurefin because I didn't have either Difflam or Lignocaine with me.

I then found my favourite recliner and had a snooze until my afternoon radiotherapy session. I woke up about 3.10pm. ten minutes before my scheduled appointment. I got to the waiting area just as the gentleman before me on their list went in, which meant I wouldn't have to wait long. Indeed, I waited maybe 10-15 minutes and I was called.

The treatment only took 15 minutes, but it was far too hot to ride home immediately. My weather app said it was still 37 degrees. I figured I'd get something to eat to replenish my energy levels because the ride was going to be hot enough in an hour. I knew it would be cooler if I stayed in the shadows as much as possible, plus the hospital is closer to the river and ocean so it was a little cooler. I went to a café just near the Cancer Centre and ordered a sausage roll with chips, apple pie with cream and a choc milk. Probably more than I needed but I wanted to make sure I was eating heaps before the ongoing side effects resulted in my losing weight. After eating this, I just sat and waited reading my book for around 45 minutes until 4.30. Then I went to get changed for the ride home. While there I also gave my teeth a quick brush, plastered Sorbalene all over my neck and lips. I also put the Cocoa Butter Lip Balm on my lips before I put my face sock on.

I took off at 5pm. I started out taking it easy, because I knew the heat would wear me out quicker than normal. I had plenty of water and had just eaten heaps, so I knew my overall energy level was not going to be a problem. However, I've noticed the last couple of rides that my legs have been fatiguing sooner than they did when I started riding to and from the hospital. I gather this is a consequence of the treatment too. Before treatment I would ride the 60.5km journey cruising reasonably effortlessly at around 31-33kph and averaging 25-26kph, however today I found myself pretty much spent at the 52km mark. I was still 8kms from home, and that part of the journey is made up of 6kms travelling almost entirely uphill on a gradient of between 3 and 5 degrees. Normally this gradient wouldn't trouble me, but now I was riding in my second lowest gear. It was a struggle. I managed to get to the top of the hill at around the 6km from home mark, from which point it was almost entire downhill to home, around 2kms away.

I have to manage my heart rate while riding. I've found that if my heart rate gets above 175 bpm for an extended length of time while riding, I wear out very quickly. I'm not sure why, but I've always been cautious when it reaches that level and generally slow down to reduce my heart rate. It normally happens when riding uphill. I found my heart rate creeping up in that first 6kms uphill stretch. It had reached 165 bpm by the time I reached the top of the first uphill section. Each uphill section is followed by a small flat section which gives me a little respite and time to recover. I got my heart rate down and managed it so that it didn't climb about 145 bpm for the remainder of the journey, so while I was tired, I was safe.

Funny thing is, when I'm running I can get my heart rate up to 220 bpm without any ill effects. Not sure why there is a difference, but maybe one day I'll figure it out,

I got home pretty well spent, so jumped straight into the pool, after packing my bike away and getting changed into some bathers. Vicki jumped in too and we just paddled around for around an hour. It was bliss.

Vicki had prepared beef goulash and rice for dinner, so she wasn't impressed when I said that I'd had that for lunch, but at least we both knew I could tolerate the flavour. Nevertheless, I had some Lignocaine around a half hour prior to eating to numb my mouth and now, extremely sore, throat. I mixed it with water this time rather than Mylanta but accidently poured too much water. I just wanted to dilute it a bit to make it easier to use. Unfortunately, the extra water diluted it too much and the effects wore off about 45 minutes later. I ate with some discomfort, but it wasn't as bad.

I sat down to complete a few blog entries, which took most of the night. At 10.45pm, I completed my M&T Routine and face and neck hygiene routine before going to bed. I was pretty much shattered.