Chemo drugs such as carboplatin work in cycles. That’s true for the side effects too such as low blood counts. The “nadir” is the lowest point of the cycle and it usually occurs 21 days after infusion. The only slightly better news is that recovery starts after 28 days.

On my Nadir Day I could certainly agree. Voice gone down to a croak, weary as fuck, and kidneys so knackered it made me look up the word “nephrotoxicity” in the dictionary. And Carboplatin is there, implicated as a cause of all of them.

But at least it was the nadir of cycle 4 and it’s the last one. Things can only get better, right?

Then came the phone call with the results of the last CT scan. The scan showed an increase in the upper right node from 23mm to 28mm. Not huge, but significant and evidence treatment did work briefly but has now stopped working. The doctor said that because my voice had not recovered he would refer me to an Ear, Nose & Throat specialist. They would study with camera etc. He told me they also found that my kidney / bladder connection is distended (explains a lot) and he will refer me to a Nephrologist for that.

I would not even bother mentioning the blood platelets were it not for the fact they’d recorded a staggeringly low count of 36.

We spoke about the voice and whether it was a tumour pressing. He told me they cannot see from scan if that’s the case but one of the nodes shares space in the mediastinum with nerves for vocal chord so they cannot rule it out.

Today I saw the ENT doctor. After a quick Laryngoscopy (the one where they look at your vocal cords using a thin, flexible tube down the nose), they were able to tell me my left vocal cord is paralysed. Something is probably pressing on a nearby nerve, causing it to seize up. Well, it just gets better and better.

There is some hope. Apparently they can “plump” or “bulk” up the paralysed vocal cord with body fat, collagen or another filler substance. This makes it bigger so the other vocal cord can touch it and trigger that wonder product of vibration that we call speech. I’m going to volunteer that they sacrifice my fat arse for the plumpest left vocal cord, ever.

But first I have to wait for the consultant to call me, maybe.

This is not a happy place. The trial drug only seemed to produce low platelets. We get reminded again that any chemo may work once briefly but cancer quickly adapts to overcome it. And now there is a new threat – living without the quality of speaking.

The doctor talked about future trials but I said “it depends on trial”.  To be more honest than I was with him, it feels like I am done there and my new battle is to get my voice back.