Week 2 - Day 2

3:50am I was woken by the buzz of my phone on the bedside cabinet, it was a text message from Gail. "1st one was rough ride". Text went on... "Dose number 2 in at 3:15".  I texted back "Good luck with dose 2. Is back holding out? Birds already singing. Want you next to me. x". There was no reply to my text, no word on the rigors, no comment about her back.

Her back had been a real concern before arriving in Manchester yesterday. Last Monday, the day we got back from the first week on HDIL-2, a muscle in her lower back went into spasm. She was trying to get up off the sofa when she was frozen by the seizure. Her pain was excruciating.

Pain-killing drugs were on the breakfast, lunch and dinner menus. Together with some excellent therapies, chiropractic, massage and a gratefully accepted gift of craniosacral osteopathy from a friend and neighbour, Gail was carefully inching her way back to some kind of fitness in preparation for her second week on HDIL-2, taking every precaution, not wanting to aggravate that tentatively tamed back muscle.

So, at four o'clock in the morning, birdsong intensifying, I concluded that with no mention of any back pain or the rigors, she must be coping. At some point, I fell asleep.

8:48am: the buzz of a text message stirs me from my slumber. "8:45 + no rigors after 2 doses. Feel a bit weird. v little sleep. Hope u r rested. X love u".

I sprang out of bed, and got the coffee on the stove. I was suddenly feeling optimistic. Along the length of this unmapped road we've been travelling along since Gail was diagnosed with cancer, we have always remained optimistic, in a genuine way. We're always looking forward. The past and its failures no longer corrode our outlook. Gail's cancer has been a revolution in our lives. I'd even say it has been life-affirming. And I don't believe that feeling will ever change. The HDIL-2 treatment did, however, put our resolve to the test. I'd been empathising with Gail's buckling back pain and couldn't begin to imagine how she'd cope with the fitting convulsions of the rigors. But her partially restored body (and mind) was somehow defying the odds, and denying the rigors.

Text message received at 9:37am: The Prof had been to visit Gail to give her news about the ECG and lung x-ray she had done yesterday. "Everything fine" said the text. Apparently, Prof was untroubled about her heart. Her lungs, too were clear i.e. no infections, so all good there... Apart from the lung metastases, of course – we'll know whether IL-2 has begun to do its work on those gate-crashers in a couple of months time when Gail has her CT scan.

So I travelled the two miles to the hospital feeling buoyed by the news so far. Gail was still waiting for dose number three when I arrived on the ward at 2pm. She was asleep, but she wasn't far enough gone that she didn't hear my movements nearby. She woke and looked to see who it was, then she beamed at me. How does she do that? With everything she's going through, how can she smile so happily at me? Well, I know that I'm always smiling at her. Perhaps we're each other's mirror.

I noticed a 50ml bag of fluid on the windowsill as I rounded the bed to sit on my arm chair – it was IL-2 dose number three, sealed in it's protective bag, waiting in the wings. Waiting for Gail's blood pressure to stabilise. It was still too low. But by 3pm, Gail's blood pressure had recovered enough - 92/52. Finally, dose three could be unpacked and plumbed in. Might the rigors make a tentative appearance this time? Previous non-showings should not be taken into account. You might think it'll be OK, but the plot in the IL-2 story centres around the 'cumulative effect'. Well I had the ring-side seat and would be on hand if, this time, the rigors were to make a dramatic entrance.

And sure enough, they did. At about 5:30pm Gail started to shiver, her teeth began to chatter, her legs and arms shaking under the covers. I draped her throw over the hospital issue bedding for extra warmth. Her temperature is rocketing but until she starts to feel the heat we need to keep her warm.

Gail has already pressed the buzzer that alerts the nurses to her need of attention... it has been buzzing away down the corridor for several minutes, now; and with every minute that passes, the rigors will vex her straining body more. But the nurses need about 15 minutes for the process required to administer pethidine, the drug that Gail needs to help calm her quaking body. That's because this particular drug contains morphene. That puts it into the category of drugs that require two nurses together to sign for its use. Then, the key for the locker containing these protected drugs has to be retrieved from someone/somewhere. Then, both nurses have to be present while one reads the name and number on the identity band on Gail's shaking wrist, while the other nurse checks the details off on a form. Then, without further hesitation, the drug gets pushed  directly into the same line that all the other drugs get fed through – and straight into her heart.

Gail's neck arches back, short catches of breath, she throws her head side to side, her entire body stiffening and jarring, bouncing off the bed, electrified. "I'm trying to relax" she stutters through chattering teeth, then moans, "I can't take control" But then, within about five minutes, the pethidine takes over, pulling back the reins on the stampede. Gail's breathing restores to a sedate rhythm, her body settles back into the bed, sleep overrides the senses.

That wasn't quite the end of it, though. Gail needed another shot of pethidine only 15 minutes later. Same, procedure as before with the two nurses. But more worryingly, the same pattern as in the last day or so of week one, when the rigors made a swift come-back and then, as now, the pethidine dosage had to be doubled.

Only a sheet covers Gail as she sleeps, and the windows are open drawing a pleasantly cooling breeze across her corner of the room. The air smells reassuringly fresh and watery. I sit by Gail and wait for her to come round. It'll be about an hour. In the meantime, the ward has been inundated with visitors. Where there's people, there's noise. Chair legs screeching as they're dragged across the squeaky clean floor; plastic carrier bags rustle like there's creatures trying to get out, but it's hands trying to get in, searching around for something that's actually been forgotten; children whining; parents shushing them; the volume knob of the many voices competing to be heard is turning up, airspace filling with noise... But Gail's sleeping through it all!

When she eventually wakes, she looks around, I spot her movement, she stretches her arm out to me and searches for my hand. Fingers clasp together, and she smiles at me. "Hello" she says. Then after a momentary pause, "Number four." She's looking at the clock mounted high on a wall to our right and counting eight hours starting at three. "That'll be around eleven o'clock tonight!"