BACK ON THE JUICE - 6 JULY 2023 - ATOV TRIAL CYCLE 2

 So, I'm Patient 2 on the Atov trial, and have been randomised onto the adaptive treatment arm. This means that I start off with three cycles of carboplatin at three-weekly intervals. First one was on 15 June - 500mg by infusion as usual, followed by the expected days of sick tiredness, gradual improvement, then back to my new normal which is sadly not as good as the old normal. 

I was told not to expect a sufficient reduction in Ca 125 after this to allow a reduction in dose so soon. This managed my expectations nicely, but in fact Ca125 had dropped by 55% - memo to self to get the actual numbers - so I'm in today having an 80% dose of carboplatin (400mg) - memo to self to ask for the dose calculation formula. Same dose of anti-sickness pre-meds and think I'll be sent home on usual doses of anti-sickness post-meds but I'm very (self) interested to see if the side effects are less bad on this only slightly lower dose of carboplatin, or if they perhaps pass more swiftly.

One thing I've been worried about is the state of my  veins this time round as they were getting a bit crummy during the last rounds of chemo. But thus far they have stood up. On 15 June, the cannula was put in by a nice lad whom I've seen before but who, on this occasion, brimming with confidence, searched diligently for a long time without embarassment then got in straight away  - on questioning it turned out he was in his last week as a health care assistant and would be starting as a junior doc at the Homerton imminently. Congratulated him on the prospect of being one of the select group of doctors who can put a cannula in when they start off. And was reminded of a Whittington phlebotomist who took blood from me in the past who was working to fund herself through medical school, determined to be good at finding veins before she was let loose on patients.

Nurse new to the chemo ward had the first go today - hit blood after a good look but the vein didn't hold out. Her supervising nurse had a good look and feel but decided to call one of the health care assistants with an expert reputation - one of these people who seem to have a penetrative sense of where veins are running behind the skin and tissues. And success! This is a much better approach than people who try over and over, which has happened in the past, which results in getting sent home with four dressings dotted over the forearms.

Unsolicitated update on subscription to rapacious, tax-dodging tech oligarchs - sometime back in the gemcitabine days, I reported with pride that I had finally cancelled my Amazon Prime sub after years of torpid inertia and monthly payments for little use. This did not last long - after a few weeks, subversive household elements reinstated it - to watch a football match!!!!!!!! Currently back in torpid inertia, but this is the start of trying to get worked up enough about it to find the Unsubscribe button again.