Wednesday, 6 November 2013
Agony and Ecstasy
What a day. What a hospital. What a team. The CTC is a bright, clean, totally modern, totally self contained unit at the back of Basildon Hospital. It is run with the crisp efficiency of a movie type model and is a far cry from my beloved West Suffolk. This is a criticism of neither and I probably prefer my slightly frustrating queuing and ambling round the WS - all the crispy co-ordinated cattle trucking from one test to another, without a blip, slightly unnerved me in CTC.
I arrived in a treatment room, papered with edifying posters of ulceration and necrosis, on the 4th floor on the Chelmer ward and was happily munching my way through some fruit salad and reading Country Homes and Interiors when, to my surprise, Mr Shah, the consultant, walked through the door. He is very grown up, mesmerising eyes and as blunt as Dr W, which is a good thing. He did all that "House" thing of ordering tests, after having a look at the hideous lump and prodding a bit. He said he would see me later and left me with his 2-I-C.
Jacob, the doctor assigned to me by Mr Shah, was a very tall, immaculate, New Yorker. Charming, slightly nervous, urbane and did have the grace to laugh when I repeatedly head-desked my "treatment table", yelling "I had a brain before bloody chemotherapy!". I was trying to list my medication. I did explain that one of my best friends was American and that it was OK to prefer coffee over tea but only if you didn't force that issue first thing in the morning. He was fun but definitely way too young to flirt with - especially sitting semi-topless, covered in scars, bruises and with a hideously protruding lump in the cold grey light of a November afternoon, topped up those unforgiving "super bulbs" strip lights they have in hospitals nowadays. It was hardly a candle-lit moment….
The lovely man with the heart thingy came up to my room to see me. As a 48 year old, mother of two, with breast cancer, stripping off and having people attach things - wires, stethoscopes, ultrasound dongles etc - to various parts of my chesticles doesn't bother me or my modesty one iota. To be honest, I gave up with my bra after Examination 1 by the surgeon, Mr Shah, first thing. My heart monitor man was tact, diplomacy and dignity personified and eventually gave in and brought the machine round to the side of the bed where I could see it (I can't lie flat on my back). Cool machine with lots of bright, coloured lights - blue, red, gold, fireworks - and cool sounds - bit of African drum, bit of drum and base, bit of squelchy. Amazingly good heart for someone who has had as much chemo as me, apparently. Not sure about artery damage to the sub-something-or-other one that supplies the arm. Darn cancer in the way. Seems to be pumping fine from the heart.
I was sent down to the ground floor for X-ray, where the nice man was in a slight twit because I was the second person sent to him, without a hospital number. I had also gone to grab something to drink from the Costa in the foyer - dying for a cup of tea after a 2 hour car journey and an hour of tests and talk thus far, but only the chance to grab a bottle of water and yell "Keep the change."
"Have you got a bra?" he asked me.
He must have thought I was mad as I rummaged though my handbag and dangled my unattractive but functional flesh coloured Bralelluliah from my left hand.
"I meant on. I was going to ask you to remove it."
Ah. Wanted to do a repeat of the head-desk thing that I did to the nice New Yorker but thought better of it. Two second chest X-Ray and I was back out again, being told to report to the phlebotomist.
She was a joy and we had a long conversation about my port. She couldn't get blood out of there but was fascinated by it and how easy it was. She promised to take herself off to the chemo ward to see how it was done. The good news is that the veins in my left arm are still not blown and she did a quick, efficient, blood test with little pain. She smiled a lot. She was very reassuring and so quick that I got a chance to grab a cup of tea and a nutty flapjack, the fruit salad having been long abandoned.
By this time, it was 3.45. I had arrived at the hospital at 1.30 - slight blip with the Tom Tom, which HAS to go…
4 o clock was time for Lilliput land aka Lung Function testing. Sitting in a plastic box, breathing and blowing into a tube, sharp breath in, long breath out, sharp breath in. The minute I have to "manage" my breathing, I panic. It was horrid. My lovely Portuguese girl, who saw me through the whole hour of this torture - I kept blowing the tests by either giggling uncontrollably or breaking the machine - was calm and charm personified. However, I never knew breathing could be SO exhausting. Or uncomfortable. Or difficult. Definitely my least favourite part of the day and definitely not a good experience for a "tallie".
She gave me a lecture on smoking. I asked her if she had ever smoked. I then asked her if she only had a few months to live whether she would go back to smoking. She just looked at me.
Then out again to wait to see Mr Shah. The phone signal in the hospital was intermittent so I rang HWISO from the nurses' station and told him to leave home and come and get me. He seemed a little discombobulated and asked if I didn't want to stay the night? (Told you the thing with the Tom Tom was a little traumatic. We ended up in a housing estate in Laindon!). I pointed out that he had my overnight bag, toothbrush and medicine in the car and I had a handbag, a diminishing supply of cash and a bra - by now I had lost the magazine - and perhaps it would be nice to sleep in my own bed? He promised to leave straightaway.
I went to see the very honest Mr Shah. This is where it gets complicated so pay attention folks.
He hadn't had time to review all the tests - not surprised - so we are still unsure whether I am match fit or not. He needs to talk to the plastic surgeon. Now I KNOW what he is called and I can say his name, Mr Ramakrishnan, perfectly well but it was another head-desk moment. I just couldn't get it out. I was WAY too tired by this stage and needed to concentrate really hard. (I have been practising all night and it now trips off the tongue mellifluously.).
There are a load of upsides and downside.
Firstly this is an "all-day" operation. A long and complicated one. We have NO idea of what is going to be found when they open me up because you can't see from the scans. At one angle, my shoulder looks like a solid mass of cancer. From another it looks like a piece of cheese. The grainy grey coloration of a CT scan doesn't help. Then I got distracted by a shiny line (which was my port line). Mr Shah doesn't do distraction. So a long 5 hour plus operation has its own inherent risks. An bespoke operation that we don't really know how or what is going to happen could go on a lot longer.
The damage to the artery and veins is an unknown - vascular surgeons may be required.
Damage to the nerves is unknown. They may be able to take out the lump and remove the pressure but the pain may still remain.
I should keep my arm.
I may not gain any more movement or usage in my arm, depending on the damage down already.
I may not be match fit anyway.
It may give me a fighting chance with more chemo.
I may not make it through the operation - there are figures on mortality or morbidity for this type of "one-off", so weighing up the risks is not an option.
The cancer may have spread very quickly over the past few weeks and it may be a pointless exercise.
So many unknowns.
I was all gung ho to go for it until he told me I would have to spend at least 2 weeks in hospital afterwards. Now, that may not sound like a big price to pay but when you are on a very limited time scale, it IS a big decision.
He told me it was my decision but he wanted to get on with this asap, to give me a chance. I said I would talk to the family and let him know this morning. He will let me know about all the other stuff. We shook hands. I came away feeling he was a good man.
HWISO and I talked all the way home. I texted the girls and my brothers and phoned James.
I am definitely going to have the operation if they will have me BUT only if they put me on anti-depressants to get through two weeks in hospital.
Now off to find out about spray tans, fake nails and watch back episodes of TOWIE.