Thursday, July 19, 2007

Neupogen report

I don't sleep well on Tuesday nights. At 8:30pm, without fail, I have my weekly injection to get my bone marrow to shake its booty and produce some neutrophils. About an hour afterward, I get achy and tired, and feel a headache coming on. I try to go to bed about 9:00pm if possible, in an attempt to get some sleep before these side effects set in. I curl up under the blankets and make myself a little flannel nest. But I am already aware of how the night will progress: I will wake up every two hours in a sweat, with a dry mouth and a pounding headache. And it can take up to half an hour to cool down again, and to rebuild the nest.

Somewhere around 3:30am, I usually give up the pretence of sleeping, and I lie awake with my thoughts until 5am, around which time I manage to doze until the alarm goes off at 6:45am. The process of getting up, dressing myself, and leaving the house before 8am, begins. I've been trying to implement ways to cope with this series of events, because each movement takes a lot of energy. I have a shower on Tuesday night, so that I don't have to stand for too long, or twist, bend, and turn around too much, when I am aching on Wednesday morning. I lay out the clothes I want to wear, cutting out the need for rambling around the house in the morning, trying to find something clean. (And this outfit usually involves cardigans, because raising my arms above my head to put on a jumper is too painful.) I pack my bag the night before, with my notes, pens, and whatever else is needed for class, except for my lunch, which I probably would have planned sometime around 4am.

Throughout the day, I keep on top of a four-hourly Nurofen schedule, starting around 7:30am. It helps to reduce the aching, which means I can walk from the bus stop to school without my body complaining. Sometimes it also helps with the crazy headaches; another side effect I've developed over the past few weeks. When I mentioned these to the specialist recently, he said that the skull is one of the richest sources of bone marrow. There's a piece of information you probably didn't know.

The housework goes on hold on Wednesdays, and washing doesn't get done until Thursday. That's okay - we both have lots of clothes. Jeremy usually cooks dinner on Wednesday nights, so I can lie on the couch and rest. Sometimes I take a bath in the evenings, with lots of bath salts and bubbles. And if I'm lucky, Jeremy gives me a shoulder massage - though, only if you can call 'the lightest touch possible' a massage. It hurts too much otherwise.

I've been on this medication for 4 and a half months now. After three months the side effects seemed to be getting better, but the last few weeks have been noticeably worse. I have, however, been getting fewer sore throats and mouth ulcers, although this week I do have two particularly vicious visitors - one on each side of the mouth, both just large enough to make eating painful. But overall, the medication is working.

Being tied down to a specific time for each injection is becoming irritating. Jeremy and I had to turn down an invitation this week that we were both interested in attending, because it would have been untenable for me to 'shoot up' in the bathroom in the middle of it.

You see, one of the annoying things about Neupogen is that it must be stored in the refrigerator, until half an hour before Injection Time, when you have to let the syringe return to room temperature before you can use it. This restriction was the main barrier to venturing out from home on Tuesday nights. Then, about a month ago, I learned that diabetics use 'refrigerator bags' to keep their insulin cool when travelling. So I visited the Wellington Diabetic Society, and the elderly gentleman manning the office was of great help. He showed me this fantastic little product that diabetics use, and I bought it straightaway. It is a fabric pouch about the size of an A5 piece of paper, filled with little crystals. 20 minutes before you need it, you immerse the bag in cold water for 5 minutes, then let it dry out for a further 15. The crystals swell up into a gel, creating a little refrigerated bag.

I tested it for the first time three weeks ago, when Jeremy and I went to a family dinner at Jeremy's aunt Sarah's house. At 8pm I snuck out to the hallway to get the medicine out of said pouch, and at 8:30pm went into the bathroom to inject. Jeremy came with me, because I tend to get nervous when I have to inject anywhere other than the comfort of our own bathroom. It's all psychological, and I don't know why it happens. Anyway, Jeremy injected the medication, I stuck a sticky plaster on my tummy, and returned to the dinner party, without drawing too much attention to myself. And now, three weeks later, without any further soaking, the bag is still cool. It is the best $39 I've ever spent. And it gives me hope that Jeremy and I could travel to places without readily-accessible refrigeration (e.g. backpackers hostels, Asia, or a combination of both), and still be able to keep myself healthy. The places where fridges aren't freely available are probably the places where it's even more important that I inject myself, to avoid bacterial infections. So our world-travel plans are once more on the cards.

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