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     A loud buzzing noise was the only indication that the beam was active and doing its job.  Initially I felt relieved that the treatment had begun, but a little disappointed that I couldn't feel anything as the X-rays bombarded the tumour. I found it hard to believe that something called a linear accelerator did not invoke discomfort or even the slightest tingling sensation. 

     The first five days of treatment produced no noticeable side effects and I was able to enjoy  food and wine  as before. At the start of the second week my body suddenly began to react to the radiation. Firstly, my sense of taste became very restricted and was dominated by an unpleasant metallic taste and smell. Secondly, it became difficult to swallow due to discomfort and a reduction of saliva. Areas of skin on my face and neck exposed to the radiation started to turn red, and by the last session were peeling and very sore. Hair ceased to grow on these areas, which was a blessing since shaving would have been impossible.

     As my tongue and mucous membranes became more and more inflamed, the discomfort turned to pain and I lost the ability to swallow completely. My saliva was replaced by thick, sticky mucous which had to be periodically scraped out day and night. I had to sleep with my head lower than my body to prevent choking, but still woke several times in the night to clear my throat and mouth. This was the most distressing side effect of the radiotherapy as there was little that could be done to mitigate the situation.

     Controlling the pain was, fortunately, straightforward. Initially, a combination of codeine, paracetamol and an anti-inflammatory (Voltarol) provided sufficient relief but, for about three weeks, I found it was necessary to use more powerful opiate drugs. Morphine sulphate worked well as a pain suppressor but produced nausea. I switched briefly to Fentanyl patches, but the nausea persisted. A combination of morphine for pain relief and metoclopramide plus cyclizine to suppress nausea, worked best for me. An unwelcome side effect of the more powerful pain killers was constipation, against which codanthramer proved effective.