T -10. The chemo begins.

Well, the phoney war is officially over.

Saffy started Busulphan, the first of her three chemotherapy drugs today. The others will be Alemtuzumab – aka Campath – and Cyclophosphamide. She will be taking these over a strictly-planned timetable over the next 10 days, during which some of the side-effects will start to become apparent. A lot of them will not happen until well after transplant, surprisingly.

Chemotherapy drugs target fast-growing cells and kill them off. This includes blood cells and bone marrow, but also things like hair. This is why BMT patients lose their hair. Other fast-growing cells are found in the mouth, throat and digestive system, causing nausea, vomiting and diarrhoea and she will be given various different drugs to try and control these symptoms, as well as getting pain relief. For the time being, though, she continues to be her old self, and I would be willing to gamble a few pounds that she will still be smiling in 10 days’ time. You certainly couldn’t tell that she was a chemo patient as she chased Reuben around a table at top speed this afternoon.

The three primary carers (Sonja, my mum Erika and I) sat down for what I can only describe as a tutorial with our assigned nurse today. We had heard a lot of this information before, but everything was really clearly explained and we are actually living it now, so we know what is expected of us, and what to expect, far more now. There is still a part of me that wishes I knew less rather than more, but anyway…

Our routine will include 9-point hand washing with soap and water and alcohol gel. I’m estimating around 25 times a day, based on today. We will save all urine and stools for analysis (I hope you’re not having breakfast right now). Teeth will be brushed 4 times a day, followed by swabbing with mouthwash. A new toothbrush each day. Sterile water only for tooth brushing and drinking. Moisturiser frequently applied to chapped lips.

Sheets to be changed a minimum of daily and placed in the appropriate bin according to the level of soiling. Bath daily. Oil in bath water and all over moisturiser afterwards. Check for any rashes and avoid any water getting into dressings or the Hickman line. There’s more (Sonja made 5 A4 sheets of notes), but that’ll do for now.

We’re moving into isolation (actually green, rather than red precautions as I said before – red is if you have an infection) on T -6 – next Thursday. Things will get really strict then.

I’m off to bed.

Martin