Week 2 - Day 4

What a test of endurance this has been for Gail, it's Thursday evening and she is worn out. Just one day to go she tells herself, then on Saturday it'll be all over for a couple of months, and we can go home – all being well. But Saturday still feels a long way off for Gail.

At ten o'clock this morning she had her sixth shot of IL-2. As we know, the treatment schedule the patient is required to keep to, is to have the IL-2 doses at eight hourly intervals. At six o'clock, then, it would be time for IL-2 number seven. The results of the hourly observations, however, were not following that timetable. Gail still wasn't ready for the next dose. Her temperature hadn't dropped down far enough and oddly, her heartbeat was racing at over 100bpm. But that isn't the entire story. What the obs' (observations) don't tell you is how tired you are. Nor can it say how poorly you're feeling.

She feels totally depleted. And at this moment she feels she couldn't face another bout of the rigors whilst she's at such a low ebb. She can't manage another dose. Not now; in reality, not even today.

At eight o'clock this evening, the obs' showed things had improved slightly, but even before the ward nurse had begun to ask Gail how she felt about going for dose number seven, Gail had already made up her mind. She promised the nurse that she'd resume IL-2 tomorrow morning. But she was firm in her desire to explain to the nurse that all she wanted was a chance to get over the diarrhoea she'd had since the day before, to rest her bruised and aching muscles, to allow the fitful episodes of the shakes, echos from the awful rigors, to fully subside. She wanted her temperature to be totally under control. She wanted to feel better, stronger. Gail was listening to her instinct, heeding the signs her body was manifesting.

Her engorged, fluid laden body has been itching terribly and her skin dry, flakey and sore. And following yesterday's concerns around her systolic blood pressure, today the new concern has been her weight gain. Gail is weighed every morning. It's a good way to check on how much fluid has been retained by her body. Since her arrival on ward at the start of the week she has put on 10kg – that's all in fluids. If the weight gain figure goes over 15% of your normal weight, the administration of IL-2 will be put on hold – even stopped, unless your body can release some of the excess fluid. Gail's weight gain is at a crucial point. It's borderline.

The irony is that Gail has hardly eaten anything this week; she has lost her appetite, but to make matters worse, what food she does try to eat stings inside her mouth and lips. Watermelon is good, though. I brought Gail a little fruit salad consisting just of melon pieces, honeydew, cantaloup,  and watermelon. Watermelon worked best because not only did it have no adverse effect, but it was soft, melting in the mouth and cooling. My task tomorrow morning is to see if anyone it selling watermelon anywhere. Could be a tall order as it's out of season.

So, the plan is to continue with dose seven at 8am tomorrow. And the hope is that Gail can catch up on some restful sleep in readiness for, what may well be, the last of these demanding encounters with IL-2 for this week, and for the next two months.