Cancer 114
Posted on March 19, 2024 Leave a Comment
For the first time in about three weeks, I am feeling fairly normal. I am sitting in the rooftop restaurant in the hospital waiting for my chemotherapy. Having cancer is a little like being in the armed forces. There is a lot of waiting involved and at the end of it a serious risk of death. Yesterday was a good day. I was in the hospital in the morning (lots of waiting) and we then went out in the afternoon. I had a meal and we went for a walk. By walk I mean I managed a good half kilometre on the flat, up the Monsal Trail from Hassop station which, by the way, advertises itself as a cafe and bookshop. It is a good cafe but there are no books for sale, just an area selling typical gifty junk, the sort of things I can’t believe anyone buys, the sort of thing that is a monstrous unpopped boil on society, wasteful, pointless, and designed to separate a fool from her (it usually is her) money.
I was in hospital yesterday to have my PICC line refitted. You may remember the last one slipped out a little during my last treatment. I have no idea how, and neither did hospital staff. Anyway, it was removed and I have just had a blissful week without a piece of plastic sticking out of a vein on my left upper arm, covered by a dressing and a sock. The skin under the dressing is in a dreadful state. Though I am colourblind I can see it is red. It recovered a little during the week but is still very sore.
The procedure for insterting a PICC line is straightforward, at least for the patient, who cannot see what is happening. The line is a thin tube of plastic that enters the upper arm, goes up to the shoulder, and across and down to just above the heart, so that drugs can be inserted straight to the point at which they will be pumped quickly around the body. It is an effective system, ensuring that patients don’t need endless cannulas, which for those who are lucky enough not to know, are not small Italian cakes but needles placed in a vein in the hand or arm – or elsewhere – strapped in place with a valve so that drugs can be administered. I have one fitted for each CT scan so the dye can be injected.
First the length of the required line is measured and cut to size. My line is 52cm underground and 3cm above ground. The patient is covered as for an operation, a little peeky hole where the nurse will insert the tube, and local anaesthetic applied – which is administered by needle and always stings. The patient is made to look elsewhere with the pretence that he or she needs to be in a certain position. I do think it is to ensure they don’t see the tube disappearing into their arm, then after a few seconds it is in, the nurse is finishing off by sticking a small plastic tube cover to the skin using fish hooks, barbed needles which hold the line in place, ensuring any mess is cleared up, which is usually nothing or very little, and chatting the whole time to reassure the patient who is often very nervous. I was not nervous. After all, it was the third time. I can now put up with most procedures with equanimity. The worst things that happen are a) sticking a camera up your backside. Given that I am missing a chunk of colon I am hoping that won’t happen to me again, and b) having a big stick up my nostrils as a Covid test, which I really hate. I know lots of you will have had that test many times and wonder what the fuss is about. I have had it three times and for me I would rather have a 30cm slit cut into my abdomen and half my guts ripped out by the surgeon’s teeth. At least for that I was unconscious.
So, my PICC line is in and I now need to go to the cancer ward (no they don’t call it that but a little Solzhenitsyn does no one any harm) and have a few pints of poison thrust into my body. The phrase, ‘Whats your poison?’ used to mean something so much nicer in the old days.
Cancer 113
Posted on March 15, 2024 Leave a Comment
This is just a short post to let you know that I am all right again now. I feel as fit as a (rather decrepit) fiddle. No more talk of dying or pneumonia (at least for the moment), though my blood results are showing up some other issues. I have a slightly overactive thyroid, which they will retest later to see whether there is a problem. My potassium levels are a little low, so for the first time in four years I have been told to eat bananas, rather than be given drugs, so bananas it is. I am also running on the edge of Type II diabetes. That can’t have anything to do with eating too much cake and chocolate, as I have cut right down in the last few days. Apart from these minor issues, I am healthy. Well….
Only yesterday I would not have dreamed of going anywhere, but today we (I) drove to Birmingham, the big city. As some of you will know, I detest cities and spend my life staying away from them as much as possible with their buildings, their people, their smelliness, dangers, and noise. Today we went to the Birmingham art gallery to see an exhibition called Victorian Victorian Radicals, which focused on art from the Pre-Raphaelites to the Arts and Crafts movement. Being colourblind I know nothing about art, but I do quite like an exhibition. I have never been impressed by the Pre-Raphaelites and I felt justified in my views when I looked around at the paintings. Why did these people proclaim that a medieval approach to understanding the world through art was a good idea? There were a few pots and tiles that were OK, though I still prefer Andalusian tiles, and to be honest Denby Pottery. I know, I am artistically uncouth. I also thought that it was a shame that the people in the Arts and Crafts movement were influenced by these dullards. I love Arts and Crafts architecture but come on, their wallpaper is a bit dull.
Two general points about the exhibition, one good, one bad. The good point is that they supplied folding chairs for crips like me to take around and sit down wherever I felt like, which was a real benefit. One of my biggest problems now is getting around an exhibition without being able to sit down for a few moments. Well done Birmingham. On the other hand, and this is a universal problem, why oh why provide audio guides? At one level I don’t want people telling me where to look, but for those of us who do not want audio guides the constant noise from them is very irritating. Either cut the volume down or burn them in the street. They are a terrible invention. They detract from whatever it is the person is out to see, whether that is a painting or a castle. If you need further information buy a book.
We walked a little around Birmingham. I still cannot walk very far, so had to give up on getting to Waterstones, but we saw some magnificent buildings. Not just older stone and brick ones, but also modern edifices which blended well with the old. We went inside one, were confronted by reception staff, had a good chat and found out about an expensive restaurant on the 24th floor. Naturally, a certain person wants to go there. It won’t do any good to say I am a pensioner now.
Instead of that restaurant we went to Nando’s. Nothing wrong with Nando’s. Half a chicken, peas and chips, with hot peri peri sauce. Grand.
Cancer 112
Posted on March 14, 2024 Leave a Comment
I will apologise at the outset for bringing up a subject that some people responded negatively to in an earlier post, that of dying. Over the last three weeks, I have been having a bit of a rough time. Initially, it was pneumonia, then a general feeling of malaise, and yesterday I got a bug and was laid up in bed, feverish and with diarrhoea. The fever has gone but the diarrhoea is still playing its games. I have had to change my bag five times since last night, everything pure liquid, and one with a bit of a spill onto my body and the bedsheets. Lovely.
Throughout this time I have been coming back to the idea that I am dying. Being ill with a cancer that is going to kill you is not like being normally ill. When you are normally ill you think that the pain you are in, the sickness you feel, etc, is bearable because it will go away and you will be healthy again. I don’t have that. On the other hand, the feelings of pain and sickness are not like ‘normal’ pain and sickness. There is something else inside me that I am unable to name or really describe. It is a general feeling of illness and deterioration that is not all-consuming, but it dominates thoughts and feelings. There is a sense of lethargy. I can’t walk as far as I could even a few months ago. I don’t have the energy to do things. It is an effort to even walk up the garden.
There is a sense that I am being taken over by death (for want of a better word), that I can detect the growing number of things I cannot do, and that eventually I will stop driving, I will take to my bed, and I won’t get up again.
People say I am doing well because I get out and go places. We go for a drive, we go to a town or village (not a city of course, they are too big), we go on holiday. I am fighting my damnedest to keep doing these things because I know that if I give in then that is it. Yesterday we were going to Calke Abbey for a look around the house. We got to the cafe there when I said I couldn’t go in. I couldn’t walk as far as the house. I could have used the crip wagon that runs up and down, but I don’t think I could have got round the house. We had to come home. It is so frustrating, and goes entirely against my will to keep active. Then again, when I got home I took to my bed and slept, except when I was unloading the bags….
Cancer 111
Posted on March 8, 2024 Leave a Comment
At this point in an innings Mr Shepherd would be balancing on one leg. Superstition has odd effects on people. It hasn’t been a great week. It is now Friday afternoon and I am watching Inglourious Basterds for perhaps the 5th time. It is one of my favourite films.
I had a CT scan this morning to determine what my inglourious basterds are doing in my abdomen. I wasn’t looking forward to it because I have been feeling sick all week, perhaps because of the somewhat messy chemo experience on Tuesday.
Feeling sick still doesn’t affect my appetite. I have no idea why. I feel rotten but offer me meat or ice cream and I will probably say yes. I am only watching a film in the afternoon because I can’t face much else.
I was dreading the scan. I am unable to eat and drink in the morning beforehand, and I like to eat as soon as I am out of bed. Nevertheless, it went fine. I didn’t throw up as I did once when in hospital recovering from my operation ( see some long ago blog).
What did happen was that there was an anmoying man arguing unnecesarily with a nurse. The sort of thing nurses should not have to put up with.
The nurse came to me to remove my cannula. She asked me if I had previously had a scan. I said yes. She asked when. I said my first was when I was in hospital. Yes. She asked if I remembered her. I didn’t. Then she explained. She was the one I threw up on when I decorated the whole of the waiting room with the contents of my guts. It got in her eyes and she had to go to A & E. Apparently cleaning lumps of green puke out of someone’s eyes is very painful. I apologised, but she dismissed it as just part of the work of a nurse. The annoying man heard all this. He said nothing but I hope he was regretting his earlier words.
So, it is time to cross one’s fingers or stand on one leg and hope that my bastards haven’t grown and that my chemo will treat me as normal next time.
Cancer 110
Posted on March 6, 2024 Leave a Comment
My treatment didn’t go as well as expected yesterday. It was going perfectly well until nearing the end, where I should have my bottle/pump fitted, which I wear for the next 46 hours. Unfortunately, there was a problem with my PICC line. It had started to pull out. How? No idea, it is not supposed to move. It has a grippy thing that attaches to my skin at the point of entry, and then goes 52cm up my arm, past my shoulder, to just above my heart. It had been pulled out by several centimetres. There is a general worry here, as the previous day something similar had happened, and only a few weeks ago a whole set of PICC lines were faulty and had to be changed. My first thought is that the Government is issuing dodgy contracts to their friends, just like Johnson was doing with Covid. Or is that cynical?
So, I was all ready to leave the hospital around 1600 hours when this blew up. There was a long discussion between various nurses about the best approach, whether to attach the bottle anyway – a bad idea as the PICC line was functioning as a midline and so the drugs would not get to the right place, or send me for an X-ray to check whether the line was out of position. Sensibly, I went for the X-ray, which on inspection by a doctor, was found to be out of position. It was then back to the debate of when to remove the PICC line when to replace it, could I still have the bottled drug the following day, etc. In the end, it was decided to remove the PICC line and omit the drug Irinotecan (which blocks an enzyme so cells, particularly cancer cells, can’t grow) for this round.
I was a special patient for an hour or more. Several nurses and others were involved in working out the solution to my problem, what to do now, what to do in the future, etc. They were all excellent.
My only problem and it is a traditional problem but one that I thought was disappearing, was the doctor involved in making the decision. Once he had noted that the PICC line was in the wrong place and telephoned elsewhere for advice, instead of coming to tell me about it (he knew who I was, I had spoken with him at the desk) he went straight to the other side of the room to discuss it with a nurse. Very rude. No bedside manner. The nurse was embarrassed, calling across to me a couple of times, knowing that I should be involved in the conversation. I nearly got up and went over. I should have done, but instead, when he was leaving the room, still ignoring me, I called him over and made him talk to me, so he ended up wasting his time having to explain things twice.
Though I am in hospital a lot nowadays it is rare to have a negative experience like this. It is basic psychology. I was a patient distressed by problems with my treatment. Come and talk to me, let me know what is happening. The worst thing about being seriously ill is if people are not honest. The worst experience was the initial diagnosis of cancer. Just say I have cancer and that I am fucked. It is far better than being dishonest or trying not to speak at all to the patient.
Nevertheless, this did not ruin the overall positive experience of dealing with the problem. Hurrah for the nurses and those supporting them. They make life going into the unit more than bearable, especially certain ones. You know who you are.
My treatment should continue as normal next time. I should have a new PICC line emplaced (can you use emplaced here?) sometime next week, and for the moment I am enjoying not having a bit of plastic dangling out of my arm. On Friday I have a CT scan to see what is happening to my cancerous baubles in my abdomen. Last time the bigger one shrunk a little. I am not sure whether they can shrink much more, but they won’t go away.
Dr Nigel Hunt 