Bye bye bike

Last Friday, as I was cycling to Hove station, I internalised an ode to my bike. Although far from the best bicycle of land, it has been providing me a great service of late; the one mile ride to the station is significantly easier than the one mile walk and allows me to arrive at my workplace in a more composed condition. The cycle also saves me £2.60 a day, the difference between an off-peak bus and an off-peak train fare, and permits me to push my timekeeping skills to the upmost limit; an additional fifteen minutes lie in is always appreciated. And, no one is denying my quads could do with a workout, albeit merely a mile ride. So there I was, cycling along one Friday morning, not quite crazy enough to proclaim my love to an inanimate object aloud, but certainly complimenting my bike privately, thinking today would be an ok day.  

That evening I declared to Mike that my bike would become a character. I was not going to personify it, that would be a bit shit, but I was going to include it, somewhere. The odd thing is the finality of my ode was the theft of this now cherished, near immortal, bike. Imagine my surprise the following day when Mike, who had clearly practiced his announcement prior to delivery, informed me that my bicycle had indeed been stolen. They had bolt cutters, my bike lock was vulnerable, boom, bye bye bike. I would have been mightily pissed off had just a wheel been taken, a single wheel is barely of use to anyone, so initially I was glad that the bicycle (which I now regret not naming, as a pronoun would have made this an infinitely more interesting post) at least lived on to function for someone else, even if that someone was actually a thief. Then, with a wry smile as the cynical bitter Liv rose up within, I imagined the sharp incline we live on and the poor functionality of my said bicycle’s brakes.

The following Monday was one of those days. Westerly wind and rain lashing the bedroom window, the air temperature reminiscent of a New Zealand May rather than a British one. The gas faltered, hot water was intermittent, my shower cold.  Freezing, I dug through the wardrobe in search of my winter boots, slid them on, broke the zip, cast them aside in disgust and resorted to my chucks, an utterly inappropriate footwear choice for pouring rain. I did not have enough change for a bus, therefore the train was my only transport option, and you know what? At that point in time it would have been quite handy to have had a bike. I started off on foot, rain pit, pat, pat, plop on the hood of my raincoat, glaring at the all bikes on my street that had not been stolen. All the bikes with locks identical to mine. It was purely chance that my bike had been chosen.

The remains of a bike

I would not say I was angry, I was just frustrated at the inconvenience. Due to an overloaded NHS, my weekly PICC line care cannot be performed at the hospital I work at. I am required to attend a ten minute appointment at the hospital along the coast, three miles from Hove station, two miles from my house. Again, a bicycle would make that journey substantially easier. Without even really complaining (a rarity for me I know), just mentioning, casually, the theft to a friend of mine, her boyfriend immediately offered his bike for my use should I require it. What an exceptionally kind gesture. I would like to think that I would have made an equally generous offer had the situation been reversed, but one can never be entirely sure. It is probably by now apparent to you all that I do not hold the world in high esteem. I have lived a comfortable life, albeit shrouded in guilt, relatively unaffected by the worst of humanity, however it only requires a fleeting glance at media headlines to slump back in dismay. Slump back on my cosy couch, with plenty of food in my fridge.

With my cynical view of the human race in mind, receiving an offer of a bike came as quite a shock. Granted, you are friends with your friends for a reason, but a quick memory flick through the fog of my mind revealed that I do not associate with a single person that would steal a bike.  Yes, everybody is required to deal with a difficult personality or two, but I sincerely doubt that any of my difficult personalities would steal a bike. Put them in a room with corporates discussing profit margins and yeah, sure, they will probably make a decision decimating an entire distant community so they can continue to drive their Lamborghinis, but would they make that first hand, hot blooded, theft? Which is worse? A family of four starving due to redundancy brought on by record shareholder pay-outs or the theft of a pampered cancer patient’s bike? Unfortunately, I think I know which would make the headlines first. These people; the bicycle thieves, the advisory panels for billion pound companies, they are faceless unknowns. They are the humanity I get so irate about, yet in essence they are not humanity at all. I imagine a group human bodies, each body with a grey MS paint style block where the face should be. Most of us do not associate with these people in day to day life, yet I let myself become obsessed by their very existence. Independently each of these individuals would deny they have reached grey block face level, but when surrounded by others with grey block face tendencies, they are engulfed by the shade of solid grey.

And then it hits me. Here I am, almost indulging myself with a degree of self-pity - “Why do they not think of their victims?” – preaching, imploring, individuals to consider others, and yet I have not contemplated why the culprit took my bike in the first place. I gave some thought to the feelings of the bike itself, but not to the individual behind the action. Perhaps they were being pursued, in the dark, in the rain, rapidly, half panicked, half crazed, and chanced upon a pair of bolt cutters discarded on the footpath, my bicycle the first they saw with their new found tool, snip, heave, grind, relief; away they ride, my bike the hero. Or, rather, they had pressing family matters, at the hospital say, a desperate need to reach their father’s bedside, no transport available in the dark and stormy night, but, fortunately, access to heavy duty tools and a stranger’s bike, the theft made without further deliberation, summoning all their physical strength, battling the unrelenting gales, arriving in the ward, short of breath and drenched to the bone, wet black hair plastered across their forehead, the exact moment their paternal figure, in a harsh dying whisper, announces “I love you son” for the first time.  

Both are unlikely scenarios. What is probable, however, is that whoever took my bike was in a situation far worse than mine. Be their reasoning driven by finances, dependency, ill health; they saw velocipede theft as their only option. I have been inconvenienced; their entire life may have been destroyed. Should I leave my helmet and a note ensuring they are practicing cycle safety? Or should I shrug my shoulders, remember all the times I cursed my cheap rattling rusty bike, its limited gears, clunky tires, poor braking capability and general sluggishness; should I remember those faults and hope that whoever took my bike gained more convenience than I inconvenience?  

It is difficult, when things are tending to go awry, to focus on any positives. It is easy to be consumed by all that is wrong. I left the house allowing ample walking time to catch my regular train. A last minute platform alteration, a subsequent rush, half my coffee slopped over my hand and down my one pair of clean jeans, my phone, miraculously, lodged in my arm pit; right arm rising, attempting to stabilise the takeaway coffee, left arm squeezed inwards ensuring the phone does not drop to the ground, head tilting to the left as the falling phone tugs at my middleclass earphones, inappropriately yet instinctively staggering around the platform desperately trying to maintain my balance, despairingly watching my train depart from the wrong platform. All remaining emotional effort is spent trying to prevent the irrational tears from welling up behind my crocked, buckled glasses, and suppress the pressing urge to exasperatedly cry “Can something please just go right for me?!” This, of course, is when I appositely realise I have forgotten to take all my medication for the day. Again.

In these situations, which I regrettably admit are becoming increasingly frequent, it is difficult to remain, if remain is the correct word, pragmatic. When the weather is poor, the bus late, the traffic resembling a car park rather than a working road, each minute of delay dissolving my annual leave; it is difficult to remember that the bus is late for all on-board, others in the spontaneous traffic jam are also delayed, and it is raining on anyone who happens to be in Sussex. My friend has a saying: ‘this too shall pass’. I think mine shall be ‘Are you yet desperate enough to steal a bike?’ Ok, so it is not as eloquent, but hopefully it will allow me a little perspective when I catch myself in the wrath of Holden Caulfield like self-absorption, which is, in fact, my life.      

  

A blood and plasma transfusion; mixing both work and play

When I first started documenting my thoughts 21^st century style (i.e. online) I thought this particular subject matter would be an easy post. There have been many mental notes made, but now, as I take a break from designing New Zealand’s new flag, I am surprised and disappointed that I never committed these thoughts to paper. Or to file; whatever you call typing. Past Liv has let present Liv down as, five months or so later, shrouded in fatigue, I am attempting to recall these little gems. And gems they were, I can assure you, even if the content from here forth resembles quite the opposite.

Ok, I confess, the gem part was not exactly true. Initially I thought this entry would be rather interesting; a woman who works processing and issuing blood receives a blood transfusion – the next bestselling novel! But no. Each time I prepared myself mentally to write about it, I was struck down with vicious boredom.  Baring in mind that I am an awkward uber nerd – you should have heard my shriek of excitement when I discovered a monocyte participating in some hearty thrombophagocytosis on a blood film just the other day – yet still, writing this post was difficult and tedious. Even now I am procrastinating, two paragraphs and nothing interesting has been said. Except thrombophagocytosis. I am somewhat concerned that this will end up reading much like a reflective learning piece rather than a documentation of my thought processes, if this happens I do apologise, but be rest assured it will help me should I ever be audited by HCPC. The next paragraph, particularly, contains a bit of science. You have been warned.

We are flashing back to December 2014. My New Zealand readers are probably imagining glorious sunshine, the spring green grass beginning to turn yellow and their first sunburn of the season. Humph. I am yearning for a New Zealand summer, so I am dismissing your mental visualisations with contempt. No, this was Britain, so it was grey, bleak, cold, wind blowing from three directions, wet and the green grass was really brown sludge. Gumboots are fashion items over here. I had begun my sojourn in hospital. Upon admission my liver function enzymes were deranged, so my liver was not operating at its best. The liver produces some factors that enable coagulation. These factors allow platelets to form a plug and stop one bleeding to death. The liver dependent clotting pathway is measured by an INR test; most commonly used for monitoring patients taking Warfarin. Warfarin is a vitamin K antagonist, vitamin K is needed for hepatic cells to synthesise some clotting factors. I am trying really hard here not to launch into a full scale animated coagulation pathway lecture including an analogy where tissue factor is a fire alarm, platelets are firemen, contact activation is the water from the firemen’s hoses, and vitamin K is the dalmatian running around offering moral support. I could go on. And on. 

Warfarin patients tend to clot too readily, hence their need for warfarin. Fun fact, warfarin is also rat poison; the poor bastards bleed to death internally. It is the one flaw in Wild Tales. The therapeutic INR range for warfarin patients is 2.0 – 3.0, for non-warfarinsed patients it is 1.0. My INR was raised, 1.4 for those interested (which at this point I believe is probably no one) so I was at no risk of spontaneously haemorrhaging but if I was to undergo a procedure, say a lymph node biopsy, I had a high risk of bleeding.

Could this be New Zealand's new flag?

As I was to undergo a couple of procedures, the decision was made to give me three days of Vitamin K. This did not involve increasing my kale intake Brooklyn style, but intravenous administration. Some interesting notes, kale tastes better than intravenous vitamin K so eat your greens kids, and the vitamin K made me feel moderately unwell. Another amusing side note, I still received my tinziparin injections. After three days of vitamin K and no change to my INR, I was informed that a plasma transfusion was the only solution. 

I had recently undergone intense training in the occupation of issuing blood products for transfusions, and we all know that a little knowledge is a dangerous thing. What could go wrong with a plasma transfusion? Well, what couldn’t go wrong?!! TRALI, circulatory overload, anaphylactic reactions… not to mention CJD. I was not born in the UK now I run the risk of contracting mad cow disease? I do not even eat meat! I mumble a demand of methylene blue plasma. An attempt by the consultant to reassure does not mollify me ‘we only use Octaplas plasma so all viruses are deactivated’ ‘It’s the prions I am worried about, not viral transfer’. A scolding look from the consultant ensued. I assume my fellow transfusionists are shaking their heads at me; Octaplas treatment also damages prion ligands, so I was safe and sound and should have been well aware of that fact. But I was dying at the time (cue background violins), so please allow a little leeway. Another irrational concern of mine was they had not tested my INR since my morning dose of vitamin K. What if I became over coagulated? Skip the DVT, my brain is being exceedingly illogical here, it would be straight to pulmonary embolism and instant death. Have I mentioned it was an out-of-hours transfusion? Yip, 2am as my procedure was scheduled first thing in the morning. More first thing than 2am. I ask the night nurse to inform the lab of the midnight request. I have worked nights, I would appreciate the warning.

The plasma (FFP) transfusion itself is mildly painful. It is quite a viscous solution and, as it stored in frozen form, it is transfused at a rather coolish temperature. My already petite veins contract in protest. Being the middle of the night, I begin my obligatory uncontrollable lymphoma rigors, not perfect timing given I am thirty minutes into a product transfusion. I desperately try to reassure the nurse that this, for me, is a normal circadian response and not induced by the FFP. A sympathetic smile; this is my third evening under her care, she is quite aware of my nightly antics. Three bags of FFP transfused, no adverse side effects and a corrected INR. Oh and the procedure is cancelled. Too risky, the surgeon refuses. The large purple bruise on my right hand, a prominent feature for the week prior, heals in about twelve hours. Quite phenomenal.

By now it is Christmas Eve 2014, I have been in hospital for 10 days. The frequently promised lymph node biopsy is again scheduled. Once that is complete I will be discharged! The nodes are a little problematic, the abdominal nodes are massive but inaccessible. Small things like kidneys, bowels, aortas, they’re getting in the way. My neck nodes are more accessible but barley enlarged, and are nicely nested in a pod of blood vessels and nerves.  The biopsy has been planned and postponed three times already. Christmas Eve, however, it is a success and I profusely thank the radiologist. That biopsy was probably the best Christmas present I could have wished for. I wait eagerly in my bunker bed with Mike in anticipation of my discharge. Not since I was ten have I been this excited on Christmas Eve. The haematology team are rockin’ around the helium Christmas tree at the foot of my bed, it is 5pm. They announce they are going to ‘top me up’ as my Hb is 82. I am to receive a blood transfusion.

My helium Christmas tree

I, once again, respond irrationally to this. My heart starts racing, stomach flipping, abdominal muscles tense, if there had been any colour left it would have drained from my face. Why the prospect of a red blood cell blood transfusion provoked more anxiety than a gigantor needle protruding from my neck I cannot explain. But it did. I was unprepared for this announcement. Firstly, it was nearly closing time on Christmas Eve and I thought I was going home. And again a little knowledge…. 

At best a blood unit takes two hours to transfuse, and nobody has only one unit. I had at least four more hours of occupying my bunker. I have to admit I nearly turned the transfusion down. A haemoglobin of 82 is not that low you know, I can survive on that. I believe the only reason I did not decline it was because I was afraid they would refuse to treat me if I did not accept it. This, of course, would not have been the case, but at the time I was convinced it would be. 

When I am at work issuing blood I had never thought much about it; this was my job, you take the blood unit out of the fridge, you cross-match it with the patient’s plasma, make sure nothing nasty will happen, place it in another fridge then mentally give yourself a pat on the back for helping someone in need. But as a patient accepting their first blood transfusion, it was quite a big deal. I do not know why the red cells bothered me more than the plasma. If anything, it should have been the other way around. With the plasma I was paranoid about clinical manifestations, with the red cells it was almost entirely psychological. It is because whole blood is red, it made it more real, even though scientifically red cells are just another blood component. Scientifically, colour is irrelevant.

I did also have clinical concerns. I had intended, but never had the opportunity, to play around with my blood in the transfusion lab, for educational purposes of course. Blood typing is far more complicated than ABO D Pos/Neg. For example, there is more than one type of ‘A’ and so many variations of D that I do not wish to give a precise number as I will probably be wrong. Do not fear, I am not going to delve into the science behind transfusion medicine. If you are at all interested I encourage you to check one of my two internet crushes, blood bank guy. Sigh, blood bank guy. The other crush is Bo Burnham if you must know; yes I am well aware that he is far too young for me. Mike does know of both these crushes and funnily enough does not feel threatened.

I'm R1R1!

Anyway, although I knew I was A Pos from previous blood donations in New Zealand, I did not know my Rh phenotype nor if I had any other cool antigens. Nerdy excitement rose inside me when my first unit arrived and it showed that I was R1R1; how many times have I anxiously searched through our blood bank stock hoping to find R1R1 units! I was comforted that my blood may have possibly made some NZ medical scientist’s day back in 2010 or whenever my last successful donation was. I even WhatsApp’d a friend, who has been known to occasionally share my geeky enthusiasm, mid transfusion on Christmas Eve, an image of my unit. It is fair to say I got the desired response back. 

But suddenly, a feeling of unease overcame me. Not an impending feeling of doom, but a complete doubt of my phenotype. I have never been known for my convenience, it is highly unlikely that my genetics would offer such a thing. I cannot possibly be R1R1. It would make perfect laboratory protocol sense not to phenotype me and, as a woman of childbearing age, just issue R1R1 K neg blood. However I am currently a haematology patient and potentially facing further transfusions, although only the development of a little c antibody is clinically significant, if I do develop an antibody it will make any further blood transfusions a pain in the ass for both me and the transfusion scientist. 

Looking back, my logic was entirely flawed. Statistically, I was most likely to be R1r, so R1R1 blood would not stimulate any sort of cde antibody production. Also, I was that inconvenient patient that made some poor scientist, on Christmas Eve, search through the fridge for appropriate units! In fact, I was meant to have been that scientist, as I was listed to work Christmas Eve at the hospital ten miles down the coast. For the record I have subsequently found out that I am R1R1, and to be fair my immune system at that point was fairly incapable of amounting any sort of response, let alone developing a falsely concerning blood antibody.

The final note I make regarding my entwinement of work and leisure, is that I did not receive irradiated units. Hodgkin’s patients need irradiated units as they are at risk of GVHD (donated passenger white cells bury themselves into your marrow and start replicating as if they were your own, but they are not, so your body tries to destroy them and ends up destroying itself in the process).  At this point my official diagnosis was a mere formality, we all knew I had Hodgkin’s lymphoma, I was in the cancer ward and under the haematology team. I was obviously not at risk of GVHD, because they would not have chanced that particular side effect, so if anyone out there can tell me why I was not at risk then but am now I would be eternally grateful. I assume it has something to do with the chemo. Also, if anyone could tell me why Hodgkin’s lymphoma patients are more susceptible in the first place that would be appreciated, because I have not yet found it in scientific literature. Thanks!         

Neurotic ramblings and a startling blog discovery

At some point throughout this pesky illness of mine, I have become rather neurotic. To those of you who have slyly raised an eyebrow or two in a somewhat sarcastic and mildly patronising manner I respond – yes, well I know I have always been a little neurotic, but now, I assure you, it is far worse. I imagine I am not the only cancer patient with this problem. Prior to starting chemo we are told of all the possible side effects, in triplicate, so our mind stays vigilant when assessing bodily qualms. In my case I suspect there is also an element of control; mind over body. The conscious has no real control over the body, but it enjoys thinking it does. It is the mother of son who has recently left the family home; she would like to think she is still in charge but realistically the young man does as he chooses. He will check in sporadically, usually only when something is amiss. And so when my body, adolescent in metaphor only, begins to throw ailments in the direction of my conscious they tend to suffer an in depth analysis; the type usually reserved by media outlets for election night exit polls. I say mind vs body, but I think I am a little wrong here. It is almost as if there are three entities, mind on one side, body on the other, then, in the middle, sits Liv, trying to mediate the eternal grievances between the two. I am the Poland of my entire entity, a battleground between two longstanding enemies, divided up by outside parties, oppressed and largely forgotten about. 

Saturday evening was particularly concerning. With the longer days, the crepuscular light of the sky made it seem earlier than it was. The neighbour’s petite tabby cat had been coming and going throughout the day so the door to the balcony was still ajar. I was getting cold. My teeth were threatening to chatter - I could feel my jaw seize in anticipation - and my few remaining strands of arm hair were standing firm and tall in their follicles.  It took the imminent teeth chatter and a slight shiver for me to realise I was cold but I noticed, strangely, that my upper thighs were both quite warm. Unknowingly, almost innately, I had been scratching away at them for a good thirty minutes. When it came to bath time, necessary to warm me up, my thighs were red, a little hot to touch and extremely itchy. I caught myself indignantly frowning at this new forming woe whilst still a scratch, scratch, scratching. The whiteness of my British winter thighs emphasised the developing flaming red pattern, making it appear like a little flashing red emergency light. In the depths of my ever exceeding gut, a little seed of anxiety was sown. What is this? Is this a GCSF reaction? A reaction to chemotherapy? Bilateral necrotising fasciitis of the thigh? Is this how DVTs clinically manifest themselves? That must be it, I haven’t exactly been physically active these last few months….  After some gentle passive-aggressive prodding and then some aggressive passive-aggressive prodding, I finally got Mike to concede that yes, this was a little odd and we’ll keep an eye on it. Score one to Liv.

A visit from our neighbour

The following morning I observed two tiny itchy bites, one on each leg. Yup, all that voluminous worry for what were small, not even mosquito, but sandfly bites. They were gone come Sunday evening. I am, at least, a little thankful that I did not immediately consult Google and add to my list of unsubstantiated concerns. I have given myself a three day threshold for unexplained biological presentations. If a complaint persists for longer than three days, it is allowed its very own Google hit. To be honest, the three day rule probably ought to be extended as symptoms seem to resolve themselves the day or so after their said Googling. But I imagine the physical act is for reassurance value only. I need to keep that conscious of mine on side.

One particular complaint that did manage to breech the three day annoyance limit, lead to a rather startling discovery. I have been getting these odd bumps on my head. They are a little itchy and tender to touch. They are most certainly not itchy bites, in case you were wondering. My hair, which once resembled the unruly mane of a lion, is still thick enough so that, with a little effort, minimal really, these bumps are not visible to any chance onlooker. But they are bothersome and troubling so I asked Google, in computer speak, “Scalp lumps pain itchy lymphoma”.  As I slowly tweaked the search terms, a persisting site kept popping up, near the top of the results list. A pain in the Neck. Maybe this individual has suffered a similar issue and has some advice for me. Click. Oh it looks like a blog. I will skim through it to see if it contains anything relevant, I mean, who wants to read an entire cancer blog? I started skim, skim, skimming; Oh Hodgkin’s Lymphoma, skim, skim, skim, lingering look, small snort at a humours sentence, complete paragraph read, gentle nodding of the head in understanding, end of post, click, next post, engrossed reading, thrusting out of the bottom lip in the way only possible when you know you have been thoroughly outdone. This blog was good; far better than I could ever dream of writing. I started reading some excerpts aloud to Mike. Evidentially he could also relate to the content – so it turns out it is not socially acceptable to palpate your lymph nodes in public, other halves do not appreciate such behaviour. Woops, my bad.  

Irritation and despondency, both quick to rise and slow to dissipate given my current state of mind and body, were rapidly on the ascent.  A McEnroe tantrum was brewing. Writing has been my one outlet these past few months, and here was someone else, an individual unknown to I, summarising exactly how I have been feeling, only they were doing it in a finer manner. I was in full on blog binge mode by now, enthralled in her charming anecdotes, her positive yet realistic outlook and her sense of humour. And there it was, two little words “Freelance writer”. Liv exhales in relief. The author’s occupation, for some ridiculous and inexplicable reason, made me feel better. There was no violent slamming of tennis rackets, no verbal abuse hurtled at umpires, no Woolf-Mansfield jealousy, there was just me, reading a stranger’s blog, at peace with the knowledge that I would never be as good as her.  

I have attempted to read other cancer blogs prior to finding A Pain in the Neck, but usually I only achieved a mere skim, skim, skimming. She has been through significantly more than I, yet she seems considerably more mindful about her experiences. When I am in a fit of frustration, blabbering on about cranial painters and their daubing of my thoughts, questioning my mortality and almost branching into the study of eschatology, she calmly and simply summarises these low points into passages and situations that I cannot convey in words. I caught myself, quite often, thinking “that is what I was trying to say!” For those of you struggling with the morbidity of some of my thoughts, her entries at similar points during our treatment regime may make things a little clearer.   

And what of my head bumps? Well, she doesn’t appear to have experienced those, but there are numerous breast cancer forums addressing the subject. The most likely cause is that my hair regrowth, in its fair fine down like way, is inflaming my fragile follicles. That ah, that was more Dr Seuss than I had anticipated. Sorry about that. I was trying to be poetic. I think I will leave it though, oh and don’t feel bad about laughing at me, the sentence was utterly absurd, even for a cancer patient.

It is with a degree of hesitation that I start this paragraph. I have a fragmented continuation of thought, as always, on the matter regarding Googling of troubles. But as it appears I am of jovial disposition today (however it has taken me five hours to realise this) and as the thought pattern involves my psyche, I think I may postpone my intended deluge of incoherent thoughts for another day. The sun is shining, the balcony is beckoning and DH Lawrence is calling.

Happy Birthday to Mike

I am trying something new here, actually a few new things. Today is my husband’s birthday and as a super special treat, I am letting him take me to chemo and will earnestly attempt to keep all stomach contents either soundly in my digestive system or, at the very least, in the toilet bowl. No sinks today. For Mike, it must be the most disappointing birthday of his life. There is nothing I can give to him, say to him or write to him, that aptly expresses my gratitude and indeed reliance on him over the past six months. He has cared for me, tidied for me, tolerated my volatile moods and all I can give to him in return is a card with some excessively scrutinised yet still inarticulate words and this rather public outcry of affection. Happy birthday sweet. I am sorry.

This is my first pre-day-of-chemo post. I already feel nauseous and am disappointed because I know the queasiness is all in my head. There is no biological reason to feel unwell, it is purely anxiety. Which is odd in itself as by now I know the drill. I guess there is a little nervousness as to how my body will respond; it does seem to change with each session. I desperately do not wish a re-enactment of my previous session, however theatrical it may have been. So here I sit, a tap tap tapping away at the keyboard, hoping that my thoughts can successfully be transformed into words. I feel I am letting my little black notebook down; I am typing this out directly (thus it is missing an important editorial stage; forgive me) so my little black notebook misses out on my brain working this particular day.

In previous posts I have proclaimed my physical woes in the hope that I will keep the complaining to a minimum when or if I happen to speak or write to you. This I think, but please correct me if I am wrong, is having a small degree of success. However, that little bastard painter with his black paintbrush and his daubing of thoughts has managed to lodge himself firmly back into my psyche. I may not be complaining about my spleen in public, but not much else I say is very positive. The bitter old man rants spurt from my mouth before I realise what is happening. I have morphed into both Statler and Waldorf; acrimonious, horrible, nearly nasty pensioners in the body of a twenty nine year old woman. Amusing to watch if one is a fly on the wall, but for those actually living amongst these tactless tirades, well it is highly unpleasant. I am finding it highly unpleasant. I catch myself mid-rant thinking “Liv, have you said anything decent all day? You are really pissing me off!” Somebody has created a near exact duplicate of me; it looks like Liv, sounds like Liv, dresses like Liv, but the duplicate is a total asshole. Lines intended as jokes are spat out in spiteful tones, words upon words, ill-thought, if thought at all. An exasperated internal voice is screaming stop, please, just stop talking. But no. No, this duplicate Liv, with her intolerance and her perceived self-righteousness prances around spouting utter bullshit in a horrid splenetic tone. The worst of it is I can see others are, if not listening, at least aware of these stupid words, words that should be meaningless but, unfortunately, are the sort that one never forgets. And it isn’t anger or repulsion that I see in the eyes of my sufferers, it is pity. If I happen to have enough social awareness to direct my gaze in the direction of the particular victim of the moment, I am greeted with large unblinking eyes of the deepest pity. What has become of you, these eyes are asking, how will you recover? Not recover from the cancer, but recover from the bitterness that has lodged itself firmly in my brain, its own little tumour metastasising throughout my body.

So how do I deal with this? Illicit drugs maybe? I can’t exactly write post after post about my petty never-ending frustrations with the human race. I would require, at a bare minimum, a nom de plume if I were to do such a thing. It obviously requires a degree of self-awareness and energy to filter internal thoughts prior to verbalisation, and I am lacking both aspects at present. I need thought dialysis, although I guess that is essentially the role of the media these days. It is, again, with enormous frustration that I admit this rather large fault in my current personality. I don’t like it, I want it to stop. What I am trying to do here, I think, is apologise for my past actions and to let you all know that I am trying to rectify the situation. Hopefully, the outbursts of UKIP like hatred will soon cease, and I may be a moderately tolerable person to be around.  

For now I will use biblical inspiration and, with the strength of a unicorn (Numbers 23:22), prepare myself for the upstairs bus ride with the weekday Brighton eccentrics, in order to endure my next course of cytotoxins. If I am bitter now, imagine what poor Mike will be dealing with nine hours from now.