Feeling good at last, then …..

Wednesday (3 Oct) and Thursday (4 Oct) I didn’t crash and need naps all day. In fact, I hadn’t needed daytime naps at all those days. Friday morning (5 Oct) I woke up feeling almost normal. WOW! “My red, white, and platelet blood cells must be approaching normal levels – in readiness to be knocked down again at beginning of Cycle 2 (14 October, 2024)”. It was great to not feel the need for constant self-monitoring of symptoms. Life just went on – lovely. Late morning (second or third breakfast time) I experienced a weird swallowing event. Felt like food needed to squeeze passed something in my oesophagus and the “something” did not appreciate being squeezed! Not exactly pain .. more, moderate discomfort. Next I found myself rubbing my upper chest because it was itchy. Went to the bathroom to have a look in the mirror … damn … a poxy rash. A wide section of skin from my left shoulder, across chest, to right shoulder was now mild sunburn red. It looked like a pashmina draped over my chest – some might consider that alluring? LOL. Anyway, as well as the pashmina there were tons of pimply bits (Nurse David: “Too much detail, Den!” LOL). I called the Cancer Nurse Coordinator and we set up a consult for after my radiation treatment that afternoon.

The radiation clinic was running late, but when my turn came, treatment was pretty fast. The radiographers, Elekta, and I are finding our rhythm. After radiation I met the Cancer Nurse Coordinator (CNC) and she had a look at my chest.

CNC: “Remind me again of where are you up to in your treatment plan?”

DF: “End of second week of chemoradiation.”

The CNC asked if the rash was on my legs. I dropped my pants … no sign of rash.

CNC: “A rash in response to chemotherapy is common. It generally emerges at the end of the second week or into the third week after infusion.”

Like a good patient, Den has a rash right on cue. At this stage, management is moisturising with QV cream. If it becomes itchy, use a cream (betnovate) that I have for when my dermatitis rages. If the rash gets very itchy, take an over the counter anti-histamine.

Seems that the rash is a sign that my immune system is recovering and now joining the battle with a strong counter-attack – an inflammatory response. Yipeee!!!

Swallowing issue is a “monitor closely” matter. It is likely to be the beginning of radiation “burn” which is expected to emerge as the most severe side-effect of my course of radiation. The radiation beam is hitting the oesophagus because the “intensely active” lymph node is close by. Although the radiation is targeted, it must hit the cancer and a margin of normal tissue around it to hit any “nasty tricksy” baby cancer cells that have moved slightly away from the mother ship. I was hoping that this side effect would not emerge until a bit later. Sadly, as radiation treatments continue, the discomfort will increase and swallowing food and drinks will become more uncomfortable to say the least. Maybe there are things that I can do to limit the impacts of the problem. We will monitor and find work arounds.