8. Cancer Diaries - RAID log

In the world of project management there is a RAID log to keep track of the items that are associated to the project and deemed to be listed as Risks, Assumptions, Issues and Dependencies. No project is risk free, that's kind of the point of a project in the first place; you are moving from one state (often a secure, fluffy, happy place) to a new scenario and not everything can be envisaged on how it will land.

It's the same with treatment and so I am going to dedicate this chapter, entitled the RAID log to the effects of chemo. 

Let's start with Risks. Chemo is a rather brutal tool to stun and shrink the cancer that has been found but also, and possibly more importantly, to stop any cancers in the body that tests haven't identified from setting up home. Chemo does this by targeting and killing the quickly dividing cells in the body. Unfortunately, chemo isn't that sophisticated to know which of these cells you'd like to keep and which to kill so that means it hits everything. 

The main risk with this approach is whether the person is healthy enough in the first place to take on this treatment. My tests showed that I was in excellent health prior to treatment so this risk was manageable. 

Assumptions. When you think of chemo you are often transported to visions of people spending all their time throwing up in the toilet and losing their hair. It was the same for me but the reality can be different. For a start, there are different chemo chemicals that are used for various cancers. They can be administered differently and will have their own range of side effects. Essentially, don't fully believe what you see on the TV and also, chemo is very much a personal journey, we all react differently to it. 

Which brings me onto Issues and this is where I will list the effects that I have been feeling over the course of 3 sessions so far. 

In my cancer treatment record book I have a list of side effects that my cancer care team are really interested in. Should I have any of these then, based on the traffic light assessment, then I should act. Some are serious and could land me in hospital as they could lead to sepsis and risk of death, which was what affected my friend each time she had chemo and was one of my other assumptions and ultimate fears of chemo. Fortunately, I've only dabbled in green ones so I've been very lucky. 

It's all the other stuff of chemo treatment that are the side effects that most people associate with and it's these that have the biggest impact. 

Energy

At the end of a chemo day I am absolutely battered and all I want to do is flop onto the sofa or go to sleep. My body has to fight the chemicals injected into me and it's tough. The feeling is like heavy jetlag and my head feels like it is swimming. I am told to accept the tiredness and take naps to help but interestingly, the best way to overcome the chemo hangover (as Piers calls it) is to walk. Gentle physical exercise helps the body to climb back out of the fug. I can feel my brain whorling back into gear again which makes me happier and able to take on this beast. The first 2 sessions I bounced back quickly, because I started healthy, but the 3rd one hit me harder. I was grateful for the long Jubliee weekend so I could potter around the house, and not be much use. Chemo is making me have to reset my energy levels. I'm a natural bouncy person so I know that I have to pace myself during this treatment. and that is quite an adjustment.

Hair

This was the one I was really worried about prior to chemo. It was my main assumption. Chemo treatment for breast cancer affects the hair. It's a bit cruel, considering most people affected are women and we use hair as part of our identity. It frames our faces, it's part of our look. Losing hair was the largest symbol of looking sick and for me in particular, looking vulnerable. When I'd like to consider myself as pretty bullet proof (I already have metal in my back) so this was a hard concept to swallow. I prepared as best I could by getting my hair cut short and liked the look - I was ready. 

I also agreed to use the cooling cap. This is a cap that is applied during chemo treatment to cool down your hair follicles to stop the chemicals from attacking and effectively killing the hair. I would still lose my hair, up to 40%, but the idea of the cooling cap was to help preserve the rest. Some people can't cope with the cap and give up. For me, I channelled a holiday memory of being back in -20 degrees in Finland while ice driving and breezed through it. I worried the chemo nurse so much that she thought the machine was broken and checked if everything was still connected. It was. 

Day 17. I was told that around day 17 post first chemo treatment that I would start to see hair loss and yes it did start but it was on day 20, when I attempted to wash my hair in the shower, that it really hit me. As soon as I put shampoo on top of my head my hair just came away in massive clumps. I produced a small kitten's worth of hair in my hands. Fortunately I didn't have time to cry, we were away from home and had friends downstairs and a glass a fizz with my name on it waiting, so instead, I went into crisis management mode and rescued the hair that remained into a style and got dressed for dinner. After that my hair would drop out with the slightest of touches. It made my shoulders look messy and I didn't much like it. As soon as I got home I went back to my hairdresser who cut my hair very short all round to make future hair loss manageable. I'm ok to have my hair out while at home but I do choose to cover up with hats and scarfs when in public. Many people have suggested to me about getting a wig but I'm starting to think this is more for their coping benefit than mine. I've looked into them but they seem to be a lot of effort and maintenance and I'm not quite bought into it. Also, the lack of hair thing is temporary. When I move onto the next chemo drug (July) then my hair should start to grow back and I hope to be rocking a cropped hair style very soon. My hair may also come back grey and wavy (great?) so I took a few locks of my hair when it was initially cut to remind myself of its natural colour as people literally pay for my colour tones. 

Eyes

It was only when I popped into my local Optometrist to pick up contact lenses that I found out that chemo can affect your vision too and so my general checkups are postponed until after the treatment as the results could be adversely affected. This is all temporary again, so any changes now will go back to my prescription. I have noticed that, in addition to tiredness that can affect general vision, I am more reliant on using glasses than before. I also have seen that, especially a few days after chemo, I  struggle to read car number plates fully. Don't worry, I was a passenger at the time. 

Skin

My skin is getting dryer as this is a classic fast reproducing cell. My moisturising routine has grown and I'm getting through more product. Fortunately I have been given lots of lovely gifts so I am working my way through the smellies.  

Diet

This was one of my assumptions, in conjunction with being sick all the time. I thought that I would lose my appetite and have weight drop off me. In fairness, straight after a chemo session I do find it difficult to swallow so I have little interest in eating. My portions have also shrunk a bit too - but then I should have done that a long time ago. I've lost a few kilos but that's it. So much for the chemo diet! I was hoping to get some benefit from this shitstorm, maybe lose a stone? It would seem that this girl still loves her food. My mouth has changed though and I no longer find drinking a glass of water to be refreshing. I am now exploring other drinks to help and have rediscovered my love for Bloody Mary's, all be it the virgin kind currently. Which brings me onto booze. My consumption of that has been majorly affected with my current rate at 1 glass of fizz per 2 weeks, pitiful really - talk about a cheap date.

The last element of the RAID log is Dependencies so I should make a point here and to wrap up this chapter. We talk about dependencies in projects when something is affected based on another item. My issues listed here are all dependent on the chemo treatment. If I wasn't having chemo then I wouldn't have these. They are temporary and as much as I am not appreciating them I know they will go soon. As I change chemo drugs I may expect to see different side effects - something to look forward to so my issue list will get updated and I may write again about the new challenges facing me. This is certainly a journey, just like any other project and I will do my best to mitigate my RAID log along the way.