Cancer 7

I have a date for my operation, Wednesday 15 March. Beware the Ides of March. Apparently this is the day in the Roman calendar when debts were settled. It was the date Julius Caesar (the real one, not just the one in Shakespeare’s play) was killed. He was stabbed by a number of senators, so I hope that the surgeon isn’t wearing a toga and that his knife is a scalpel rather than a dagger! I know, I have an ego problem, comparing myself to Julius Caesar. Anyway, back to the story.

One of the main complications with my cancer is that I also have heart failure and atrial fibrillation. It is probably rather careless to have two of the biggest killers in Western society at the same time, but hey, what’s the point of moderation?

It is a challenge to defeat them both, as I hope to do so for at least for the next 20 or 30 years. I have lived with heart failure for the last three years, taking a cocktail of drugs morning and night.

Furosemide is a diuretic which helps to reduce the build up of fluid in the body. It is meant to make someone want to urinate after about 30 minutes and then again after about two hours. Having a man-bladder, I tend to go about every 10-15 minutes for a couple of hours. I know every stopping point by the side of the road for a 30 mile radius.

Ramipril is used to treat high blood pressure by widening the blood vessels, making it easier for the heart to pump blood around the body, though since I have had heart failure I don’t seem to have any blood. Whenever someone wants to take a sample they end up poking the needle around in my empty arm for ages.

Rivaroxaban is an anticoagulant. People with an irregular heartbeat are more likely to experience a blood clot. It is also used after operations, so that could come in handy soon. It does make people bleed more easily, which is partly why I was not initially worried about blood in my stools.

Bisoprolol is a beta blocker used to treat high blood pressure and atrial fibrillation. It slows the heart rate.

At first my heart failure severely restricted my ability to do anything, but once I had a cardioversion I could get on and do most things. The cardioversion is used to treat atrial fibrillation. Basically, it is a large electric shock that stops the heart and restarts it again in rhythm. It is a bit like turning your computer off and on again to make it work properly. It is done under general anaesthetic. At first I thought I could do it under a local but then I saw a video. The procedure is that you are strapped onto a bed, cushioned at both sides. large electrodes are attached to your back and front, and then several thousand volts are pumped through your body. Seeing the response of a person to the shock is what made me accept the general anaestheic.

Cardioversion does not always work, and when it does work it can be temporary. I had mine two and a half years ago and my heart is still in rhythm. One worry I have now is that the cancer operation may mean my heart reverts to arrythmia . We will see.

Heart failure does change your life. Apart from trying to remember to take the drugs twice a day I am restricted in how far I can walk, and how long I can do any kind of physical exercise. It is an odd feeling. I do, say, gardening or walking for an hour and that is it, I suddenly can’t do any more. It is not because I feel exhausted or my limbs ache, I just cease to function, so I have to sit down and that is it for the day. I also get very tired at night, but whereas Cinderella could keep going until midnight, I fade by 9pm.

Sometimes I wonder about havng the stength to deal with these two diseases, but in the end there is no choice. Get on with it or disappear into depression. Depression certainly won’t help with my treatment so it is important to follow the wartime statement, now sadly abused by endless posters and word changes, but still powerful in its original form: ‘Keep calm and carry on’.