Cancer 102

Having cancer in the way I have cancer is a little like being sentenced to death and sitting in a cell on death row. Every two weeks I await the result of my blood tests to see if I am healthy enough to undergo my next round of chemo. If I am not healthy enough, then that may be the call to the death cell, at which point I hang around while the tumours grow until it all becomes too much and Bob’s your uncle. At one level, this is incredibly stressful. Have I got another reprieve? Fortnight after fortnight, relentlessly, permanently, for the rest of my life.

The thing is, if it really did cause me high levels of stress I would probably have hanged myself by now (any other method of suicide is equally acceptable), but humans are incredibly resilient. Just like other unavoidable stressors, we put up with because we have to put up with it. It is the only way to manage.

There are other, more difficult stressors. For me that is my stoma and my hernia, which can at times make things difficult, and I can find them very upsetting. It is these that make me emotional, and sometimes make me think death might be better than life – but not for long.

Last Friday, my blood tests indicated reasonable normality across most measurements. My liver is working, my kidneys are working, my white blood cell count, if a little elevated, is reasonably normal, even my cancer markers are not too high. The chemotherapy is working, but at some point it will fail. It always does, but it is not possible to know when it will fail. Next week? Another year?

All I can do is live. Then I will die. Just like every human dies. The key differences include knowing that you are under a death sentence, and variation in the amount of time a person lives.

I don’t expect to get to 80, or 70, or 65, but you never know.

Cancer 101

According to Orwell, room 101 is the worst thing in the world. I am not sure what the worst thing in the world is for me. I can think of quite a few objects or situations I don’t like, but the worst? It depends on timing. Whatever is bad at the moment is the worst thing in the world. What is gone is gone, so there is no point in worrying about it. What is coming in the future is in the future. For all of us the end is death, so there is little point in worrying too much about that. The focus, then, should be on the present.

Apart from my cancer, my chemotherapy treatment, my stoma, my hernia, my PICC line that has to be changed on Monday, and my side effects, the worst thing in the world at the moment for me is the way I have been treated over my retirement. Initially, it was the University of Nottingham, which as I have previously said, significantly delayed the process of retirement through incompetence and laziness. They have apparently reviewed the case and apart from a few errors they are wonderful. That’s good to know then.

My pension provider, the USS, was, I initially thought, not to blame for slowness in sorting out my pension. I thought they had just not had long enough due to the University’s incompetence, but no, after various communications this week it turns out they claimed not to have the documentation until a week or so ago, and they had ‘not seen’ communications with me indicating how I wanted my pension paid. It turns out they had all this information, so they asked me to confirm what I wanted via email and to fill in another form that they thought I had not completed, though I completed it a long time ago. They had permanently misplaced it.

I have still not received my pension, nor have I received notification of what it will be and when I will receive it. Nor is there an offer of an interim payment. The latest is an email received a few minutes ago saying that I should have received a letter this week with this information. That was the University again. I have not received the letter, and it is Friday afternoon.

Incompetence throughout. A refusal to accept responsibility. A refusal to act promptly to resolve the matter despite both the University and the USS being fully aware of my health situation. The other day I was more angry than I have been for a long time. Fortunately, I resisted any response. Is anyone aware of a link between illness and stress? Apparently, the University of Nottingham and the USS are not.

Funnily enough, no one is offering to pay the interest I am missing by not receiving my money on time. What a delightful failure of responsibility. I assume they think I am too ill to keep fighting. Perhaps I am.

On a more positive matter, my bloods are normal, apart from a slightly raised white blood cell count, so I can go ahead with treatment on Tuesday, but only after my PICC line is replaced on Monday because the NHS received a bad batch. Some of the lines are failing. Parking is going to be more difficult. The University has failed to respond to my request to keep my card active for a little while longer so I will have to park in the normal car parks at the hospital. Those of you familiar with Derby hospital will be aware of the lack of adequate parking, so despite my appointments not being until 1100 on both Monday and Tuesday, I will have to arrive around 0700 to make sure I get a parking space. Don’t suggest public transport. It is not feasible from here.

There is nothing to do in this hospital when waiting. There is a Costa, which stinks of coffee, a smell so vile, etc. There is the ‘restaurant’, which sells poor quality breakfast and has a Subway, which sells the most disgusting smelling food in the land. There is another cafe, which is mediocre. I could go for a walk but the hospital and surrounding area are ghastly, you walk out of the main entrance to the smokers, and then pass on to the cars and roads. It is undelightful. I can’t even go to the University library now, as I don’t have a card. Most of these places don’t open until at least 0800 so I am left with the corridors, watching ill people walk around.

We watched Oppenheimer the other night. It had the potential to be a great film, but the (usual US) failure to recognise that without the British research before the Manhattan Project, the atom bomb would not be ready for Hiroshima in August 1945 spoiled it for me. Perhaps Barbie will be better.

Cancer 100

As this is my 100th blog on my cancer I feel it ought to be somehow special, but it isn’t, apart from being longer than average, sorry. While I am not sure what aspects of cancer could be special in a positive sense I don’t know. To coincide with the 100th cancer blog there are significant points around now:

  • It is just over a year since I was diagnosed. That is good because I have survived a year with cancer. It is not so good because (though the reliability of the figures is poor) I was given two to two and a half years, so I am halfway through my cancer life. This corresponds well with my heart failure prediction, which also predicts death next January. Keep your diaries clear folks. Of course, apart from the unreliability of the figures, there is the argument about who wants to be average so it might not be January, in which case my apologies.
  • I retired from full-time work on Wednesday, but neither the University nor the pension providers have got their act together so I have still received no money and no final confirmation of what the money will be. This is unacceptable given the circumstances in which I had to retire. ‘Hi, I am dying of cancer, can you get this sorted out pretty quickly so I get some benefits?’ ‘No, we won’t bother. Can’t be arsed.’ That was basically the response from the University, as regular readers know.
  • It is my birthday this month. If you want the address for the huge presents please let me know. If it is cash (which I will have to live on with no pension) then I can send you my bank details. I thought not.

The anniversary and retirement have left me feeling somewhat vulnerable. That hard shell I try to have has its weak points. It is a little like the lining of my abdomen, pierced by the slings and arrows of outrageous misfortune. The biggest problem I have at the moment (apart from my little pet cancer cells lining said abdomen walls) is that I have a hernia around my stoma. It is getting a little big and the options are wearing a truss, which I am doing. It is not cool unless I treat it as a cummerbund, but no change there for me. Alternatively, there are two operations available. One to move the stoma and block up the current hole, the other to put mesh around the current hole and tighten it up a bit. The problem is that it is unlikely any surgeon will operate on me while I am undergoing chemotherapy. It is a little risky, but then my life is a little risky every day. One of the reasons I feel a little down at the moment is that dealing with cancer is bad enough without having to deal with what I feel should be a minor matter, the hernia, which seems to be getting worse. The worst-case scenario for the hernia is that it causes entanglement and blockage in my gut (apparently very painful) and I will need an emergency operation.

The stoma is sore at the moment and is bleeding. Apparently, the bleeding is perfectly normal but I am not sure that the most pleasant way to pass the dark hours of the night is to be cleaning both shit and blood out of a hole in the front of your stomach, especially when that part of your stomach sticking out because of the hernia. Well, it might be fun for some people but I am a little sick of it.

This abdomen of mine is like an old leather football people of my age had as a child, heavy and wet and with an inside bladder that bulged and eventually broke and needed repairing. It could not take many repairs before needing to be thrown away and replaced. The analogy fails because footballs are not usually full of cancerous cells and dangerous chemotherapy poisons.

The question is, am I prepared to go through any operation? After the last one, I signed the Do Not Resuscitate form and told everyone that I couldn’t go through that again. It was the worst experience of my life. Now things are a little different. Like women with childbirth, I have forgotten some elements of the pain and distress of the operation and its aftermath and have the feeling that life is still worth living and that I could go through an operation – as long as it wasn’t as awful as the last one – but I wouldn’t know that until afterwards anyway, so if it is offered I will probably accept. You can only give up once.

In addition to that above, I again have this tube sticking out of my arm which, when not pumping chemical poisons into my system is covered with a dressing and a tubular bandage which keeps falling off. The tube was there for six months. I had six weeks off and it is back again – in the same vein (literally, not figuratively).

Along with the chemotherapy, the pills to protect me against the side effects of chemotherapy, and seemingly permanent antibiotics, I am still taking my heart medication, seven pills a day. According to an article I read, 50% of people do not need this medication, but I don’t know which 50%, me or the other chap?

I have constant tiredness. When I was off the chemo I seemed to settle a little but now I am back to several hours in the middle of the night out of bed changing my stoma and reading. I did finish rereading Cormac McCarthy’s Blood Meridian last night. Great book but perhaps not the best choice at the moment with all the violence and death contained therein. If you are not under immediate threat of death I would recommend the book.

And then there is chemobrain. You must have noticed the amount of repetition in these blogs. As I have said before (sic) I don’t reread them, and with the chemobrain my memory is shot so I don’t always know what I have said. For those of you who see me be prepared to put up with it. I haven’t yet forgotten the name of a close friend or relative, but it is coming. Simple words often escape me.

Add up these problems and the water is rising to the top of the mental dam. Barnes Wallis may arrive with Guy Gibson at any time. OK, crap image.

This sounds a little negative so far so I had better buckle up that stiff upper lip. I am still having a good time. We have only just driven to the south of France and into Spain, and by which I mean me as I do all the driving. I love driving so it is great that I can still do it. We are planning lots of trips (assuming I get my pension paid, otherwise I am depending on those 10% of incomes you are supposed to be sending me, see Sopranos blog. Unsurprisingly I haven’t received any yet). I can still socialise, though not drinking alcohol with people who are drinking alcohol can be difficult, though my body is so gullible that pretending to drink with 0% alcohol can have the desired effect; and I turn into a pumpkin at 8pm so the evenings are rather short.

We have booked a couple of nights to a country house hotel in the Yorkshire Dales, and then a long weekend in the Lake District (it was supposed to be a week but the NHS gets in the way), so we are getting on with the important things in life.

I can still walk a little – a mile or two a day, better than nothing. I am hopeless with hills, which is difficult living in Derbyshire and enjoying visits to places such as the Yorkshire Dales and the Lake District. Norfolk is just not for me. I used to think that if I became so crippled I couldn’t climb up Kinder Scout that I would rather die. Rather melodramatic. There are other things to do.

I can still eat a lot. My appetite appears unaffected, though that is not so good when I am weighed each fortnight at the hospital. The graph has an upward progression – which doesn’t help the stoma/hernia. I have now officially started dieting, which means eating less of the cake that I eat to compensate for not having alcohol. We will see how it goes.

I can also talk the same old crap. I can offend people quite easily, which isn’t much of a challenge these days where some people seem to be offended by everything. Perhaps I may start to lose my inhibitions regarding what I say. In the end, what does it matter? I will blame chemobrain. Perhaps I will test that in another blog.

On a bigger scale, I have great social support from people, some of whom even say nice things (the rest of you know who you are). In terms of my working career, I think I managed to have a little impact, which is all we can hope for in a working life. I have made plenty of mistakes in both my personal and working life, and I will continue to make mistakes, but hopefully, overall the balance is on the positive side.

Please feel free to respond if you agree/disagree/getting bored with any of the above. I know some people don’t or feel they can respond, but despite my letting off a little steam above (note that in my book, Applied Narrative Psychology – plug plug – I argue that this sort of thing is healthy) my carapace is still intact so I can take anything – and I won’t be offended.

Cancer 99

Well, here we are. As far as I know, this is officially my last day at work, though given the standard of communication between myself, my workplace and the USS (my work pension people) I am still unsure. I said before that I only got confirmation by sending an email myself to both places with less than two weeks to go.

Fortunately, today, my last day at work, is going to be a little different to the last 350 days or so, or at least those where we have not been away. I am currently sitting in the living room with a cup of tea having had a very poor night’s sleep (thanks for asking). I have my chemo bag attached, hopefully dripping fluorouracil at a steady rate into my feeble body, or at least I hope so, the last one didn’t work, and after being attached only since yesterday afternoon it is difficult to tell with this primitive balloon pressure technology. It is meant to empty over 46 hours, ie from Tuesday afternoon to Thursday afternoon. It is difficult to tell whether it is working until late Wednesday/early Thursday.

What are my plans for today, my last day of full-time work assuming the money arrives tomorrow? Sit around in the morning. Go out for a midday meal to the Devonshire Arms at Pilsley to celebrate, sit around in the afternoon, and perhaps watch Sopranos in the evening before retiring to bed at an ungodly hour (but as there is no god every god is ungodly so that does not offer a clue as to bedtime).

I know, when you saw Devonshire Arms, you thought ‘Why is he giving money to that thieving old Duke of Devonshire? Two answers, hypocrisy and good food. It is too late in life to focus too much on the dire aristocracy of the country, though I hope you all celebrated the anniversary of the beheading of Charles I yesterday. It is a shame that whenever I point out this highlight of British history few people are already aware of the act and how it led to a few years of the republic before the reversion to the primitive monarchy.

The Sopranos. This is a re-watching, not just a watching. It is excellent television and I dare any male to deny that there is a little bit of him that wants to have elements of Tony Soprano. It might be the underworld glamour and lifestyle, the women (and the differentiation between the roles of men and women), the violence, the executions, or even just the house (but then you would be lying to yourself wouldn’t you?). Perhaps we just need treatment from the psychiatrist.

For those of you who said ‘no way do I want to be Tony Soprano’. I didn’t say Tony Soprano, I said elements of him. Dig deep, those who have a particularly thick veneer of civilisation. Unlock the depths of the unconscious if you have to. Men are built for violence and control – not that I have had any success at either. My veneer must be too thick.

Perhaps I have found a retirement vocation. Now, all of you send me 10% of your earnings each month and we will say no more.

Cancer 98

Well, here I am again, the day ward for cancer patients, receiving my chemotherapy. I have had virtually an 8 week break, and I was getting used to it. Now I am back to endless repeated questions about my name, date of birth, address, and allergies. I sit here in a chair that might be comfortable for someone much shorter than me for several hours at a time., surrounded by ill people and nurses. The view out of the single window is of the wall of the adjacent building. I have my PICC line in and my arm is already starting to itch. There are various lines attached to the PICC line, dripping poisonous chemotherapy drugs into my arm.

I am a little worried about the chemotherapy. I had 13 sessions between June and December last year. It seemed to work well, and my side effects were not too bad. Generally, tiredness was the worst problem. Unfortunately, any chemotherapy treatment can only work for so long, as I was reminded by a nurse yesterday – just because I come across as blase and confident does not mean every phrase or sentence just washes over me. I have not questioned anyone about the possibility of further treatment once this one fails. I don’t usually say it but sometimes it is better not to know, not because of avoidance but because there can be too many things to deal with at the same time. Under this stoic exterior, there is a neurotic worrier bubbling under, ready to cry and scream like a big girl’s blouse. Nevertheless, the stiff upper lip is the best solution, not only for myself but also for others, to keep things in order.

I get weighed when I get here. Unfortunately on most occasions, I am heavier than the last time. I am not the wasting away cancer patient of common parlance. Surely a cancer diet ought to be the most effective diet available? But not for me. I am going to have to embark on a serious diet, restricting all the nice foods and increasing consumption of you know what. Why is it that women seem naturally more able to eat healthily? I put it down to muscle mass. Men need more food, they need more protein, they even need more carbohydrates. Unfortunately, this should also be linked to more physical exercise, and more need for strength. Being an academic is not the best way to be an effective male of the species.

Having a ‘healthy’ diet does not fit with having cancer. Comfort foods keep the neurotic at bay. Custard builds stiffness in the upper lip. So, if I end up being a miserable moaner in these blogs (I know, I have already been there), then it is because my diet is successful and I am losing weight. Misery, here we come!