91. The Radiotherapy Fitness Regime

Having radiotherapy is really quite straightforward. It goes roughly like this.

1. Go to hospital (1 hour)

2. Announce your arrival and wait your turn (so far, anything between 5 minutes and 45 minutes)

3. Replace top half of clothing with unflattering hospital gown, which does a poor job of covering you up and in any case will have to come off again 15 seconds later (2 minutes)

4. Hop onto the machine and let today's Radiotherapy Duo line up your tattoos with the light beams (5 minutes)

5. Get zapped by radiation (2 minutes)

6. Clothing and hospital gown in reverse order (2 minutes)

7. Go home (1 hour)

Of these steps, numbers 1 and 7 are the most trying by far. I am looking at a daily round trip that takes three to four hours altogether, because the steps don't follow each other seamlessly. There is a certain amount of faffing in-between each one, filled with cups of hot chocolate from the machine or chats with the receptionist.

Sometimes, I just sit for an extra half hour before heading home, because both the wait beforehand and the welcome lie-down on the radiation machine were too short to be sufficiently rested.

BOASTING ALERT... I have managed to walk all the way there and all the way back again. Yesterday I even made a detour to visit a friend.

That was almost 15,000 steps, a good 7 miles (12 km). Yes, I'm tired, but it's the exercise, I tell myself. It's a different, more pleasant kind of tiredness. In fact I'm feeling quite invigorated by it all, walking a bit further every day and ending the week feeling stronger than I started. I only went by bicycle once, and that was because I left it too late to walk. Also, I had things to carry, including Owl (who needed his photo opportunity). Carrying stuff is much easier on a bike.

My favourite bit of the daily trek is Albert Bridge, with its quaint architecture, the view of Battersea Park Peace Pagoda and the sign warning that All troops must break step when marching over this bridge. (Blow up the picture and you can read it for yourself.) Also, it means I'm almost there.

Crossing Albert Bridge

My husband has been watching me, waiting for tiredness to strike.

"I'm feeling fine!" I tell him every day. It's beginning to feel like a disappointment.

"But they were quite clear about it," he says, confused. He is right. They were. We've been told repeatedly to expect two things: tiredness and sore skin, like sunburn.

So I google it. Why does radiotherapy cause fatigue?

Having waded through the vaguely patronising cancer-leaflet-speak, which mostly tells me that I will get tired and that I should try and take a short walk every day, or put chairs all over the house so I can sit and rest when needs be, or do easy things with the children, such as a board game (they clearly don't know about our household's potential for vigorously loud and very exhausting board games), I manage to find three reasons.

One: The daily trek to hospital.

Yes, I know. The thought of having to do it by bus or tube is enough to make me want to lie down.

I met a lovely man in the waiting room on Tuesday. Several decades older than me, twinkling eyes, infectious smile, clutching a box of chocolates for the nurses. The waiting room erupted in cheers as his name was called, "Your last one!" Fellow patients smiled at each other indulgently after he'd skipped into the zapping room, "Ahhh, such a nice man."

It turned out his course of radiotherapy lasted 7½ weeks. Seven and a half! It takes three buses and an hour and a half to get here, he told me when, fifteen minutes later, he emerged from his final zap.

No wonder it's the travelling that accounts for people's exhaustion. At least I live in London, not in the Outer Hebrides.

I am trying to turn the daily trek to my advantage with the walking plan. I hadn't expected to manage it for more than a few days, but so far so good. Although it's frustrating that my plan to go back to work is only half working, because so much of my day is taken up by the going-there-and-back. But I do credit the walking with my manageable fatigue levels. 

Two: The distress of having cancer.

It's very upsetting having cancer, I am told by the leaflets and the internet. It will make me feel tired and low in mood.

Let's cross that one off for now. I've left my upset and low-mood behind, safely shut away in 2014. New year, new start and all that. I am not fooling myself that I'm done with distress, but I am determined to keep it at bay until after these three weeks of treatment at least.

Three: The body needs to repair the cells damaged by radiation.

Aha, finally, here is a good physical reason, one that makes sense. Somewhere, it was likened to feeling tired after being utterly sun-burnt. My choir friend, who had a lumpectomy recently and is also undergoing three weeks of radiotherapy this month, was told by her doctor to imagine the kind of tiredness you feel when recovering from a bad cold.

Neither of these (sun burn, bad cold) sound half as bad as the exhausting effects of chemotherapy. A cold doesn't even register on the scale.

So I'm OK at the moment. Let's hope it lasts.

Radiotherapy itself is a bit of a non-event.

As you lie there, you are probably meant to look up at the sunshine through the palm trees, but I can't help keeping a beady eye on the large whirring disc. Sometimes it twists; sometimes it doesn't. Things inside it open and close, like a futuristic monster from Dr Who. The seemingly harmless ones are usually the most dangerous.

Sometimes the disc stays largely on my right hand side, and I'm waiting for it to start turning around me, but then half of the Duo comes back to inform me that I'm done.

The only thing I have noticed is a faint smell of burnt metal, which only happens when the Duo is out of the room, so I suspect it's the smell of radiation. Does the machine smell when it emits its dangerous beams? I like to think so, because I'd believe in the worthwhile nature of my treatment more if there was a bit of substance to it.

I was told about the non-event beforehand ("You won't feel anything, you won't see anything, it won't touch you"), in a way that was probably meant to be reassuring but I find somewhat disconcerting. At least with the chemo there was no mistaking the poisonous nature. The slow drip-drip-drip of vile-looking liquids into your vein.

The effects were clearer, too, and more immediate. One of my veins never recovered from the onslaught; I can still trace its path along my arm. A drug addict's vein, one friend observed, charmingly.

And the effects are on-going. My hair continues to fall out. My nails have gradually turned a dark yellow during the past month, with black splodges. My thumb nail is beginning to come off. I am clearly not yet purged of the poison.

In comparison, the vague pinkness of my chest skin is hardly worth reporting. Painful? I wouldn't know, because I've lost all feeling around my scar and under my arm. Permanently, it seems. They must have cut a couple of nerves during surgery. I'm sorry about that, but right now it has its advantages. (Also, I can pretend that I'm not at all ticklish, as long as I offer only my right armpit as evidence.)

I am not taking Owl with me anymore.

It's not just that I don't want to carry him. It's that he can't be bothered.

Spot the blatant projection. I am probably not engaging properly with this radiotherapy business, or with the whole cancer business for that matter. I'm too busy focusing on getting fit and healthy again.

Or perhaps it's my children who have moved on. They rarely ask after Owl these days. They simply ask after my cancer, or better still, they ignore the whole affair altogether.

That's fine by me.

That's where my head should be, with my arms raised onto the blue stirrups

Keeping a beady eye on the whirring radiotherapy disc