may 2010

4th May 2010

knock and take a seat

If you were a TV producer looking for a suitable location – particularly interiors – for a 1950s-60s nostalgia type Hospital Drama – Heartbeat meets Last of the Summer Surgeons – you could do a lot worse than The Churchill, Oxford.  Not the front with its beautiful Entrance Hall (complete with Grand Piano for the use of passing visitors/patients/staff – ‘you tickle the ivories while we tickle yours….’) nor the spanking new Cancer and Haematology Centre.  I mean round the back where respiratory conditions are treated.

Annie and I follow the blue line along the floor, through various departments, wards, offices, snaking this way and that until we arrive at Respiratory Medicine.  The smile on the face of the staff nurse more than makes up for the surroundings – which aren’t bad – they’ve had a new lick of paint – it’s more the contrast with the front of the building that surprises.

Is this living proof that cancer gets a bigger slice of the resource pie than lung disease?  Roasted Mediterranean Vegetable quiche versus Fried Scotch Pie?

Before the Broncoscopy I need a lung function test.  Another wander through the maze until I arrive at a door with the sign Knock and take a seat. The amazing thing is – nobody does.

Everyone who happens upon this door is clearly able to carry out the first part of the instruction; it’s the second part that they have trouble with.  Having knocked they wait.  And wait.  Nothing happens.  After a few moments of self conscious staring at the notice – (have I read it correctly? – perhaps if I stare at it a bit longer it will change into something I can deal with) – the gaze inevitably turns to the row of people sitting in the corridor who are all clearly following quite competently the second instruction.  They in turn look up at the lost soul, and then a sideways glance at each other, a knowing look upon their faces.

How did they manage that – did the door open and someone tell them to take a seat? Or is it The Knowledge? – a kind of mystical unspoken law handed down through generations of people who have arrived at this door for a Lung Function Test.  Perhaps understanding the notice is the first test.

Some helpfully volunteer the secret; “Knock and take a seat”. Ah – that’s how it works.

My fellow sitters are a mixed bunch but all share one thing in common – apart from me that is – they all cough.  From a discreet, almost apologetic ‘ahem’ to a hearty, well lubricated, ‘get it up my son’ – they try and get it off their respective chests.

There is a mix of good humour and irritability – some people have appointments and are kept waiting because others, like me, are gatecrashers – sent down for a test before a procedure.  So the waiting list is now in chaos and it relies on honesty to make it work.  Every so often the door opens with a cry of “next”. It gladdens my heart that we British can still be proud of our queuing.  It’s a shame that it has not become an Olympic event because it would certainly be in the tradition of the Olympic spirit – at this we are amateurs through and through – we do not do this sort of thing for money.

After 50 minutes of serious queuing it is my turn.  Not a bad performance on the whole – I only rose once when a woman sitting next to me started to play the ‘I have childcare arrangements’ card.  A collective swivel of heads and she retreated into her Guardian.  That simply would not be allowed in the Olympics.

I am led to a machine with a computer screen and a long plastic hose attached to a plastic bag; the hose has a mouthpiece – I engage with this while a clip is placed on my nose.  There are two tests; one involves blowing into the mouthpiece – the other involves sucking.  I blow first.

The clinical physiologist stands beside me – encouraging, cheering me on – while I take a deep breath and then on his command, exhale.  “More, more, go on …” A line on the computer screen slowly rises.  There is no more but still he shouts me on.  My lungs will surely end up in the bag.  Eventually he allows me to breathe.

Inhaling is harder – it’s why I can’t play the harmonica – again the cheering as the spidery line slowly makes its way down the screen.  Afterwards my competitive wife wants a go feeling she can easily beat me (which she can).

Back in the Ward I sit on the bed while a canula is inserted into my arm and my medical history is repeated yet again.  Eventually I am led off to the ‘theatre’ where the broncoscopy is to take place.  Everyone is kind and explains what is to happen.  A camera will be inserted up my nose, down my throat into my left lung.  Having taken a few snaps it will attempt to grab a piece of the tumour for analysis.  I will have some nice drugs, fall asleep and when I awake, a few hours later, I will have no memory of the procedure.

What looks like shaving cream (but ice-cold) is squirted down my throat, the canula turned on and I begin to drift off to the sound of two doctors huddled round my scan excitedly pointing out to each other .. “There, there, look, there it is ….”.

A little while later I awake coughing and spluttering – my natural reflexes trying to eject the foreign body from my lungs.  A hand soothes mine and I drift off again.  Then it is all over and I am taken back to the ward wide-awake.  So no relaxing sleep then.

One of the doctors comes to see us bearing a couple of photographs.  Annie and I gaze at them like proud parents.  One picture shows the ‘thing’ peeking out of valve in my lung, much like the head of a conger eel (or similar) in the entrance to an underwater cavern.  The other picture shows the blackened remains of the biopsy.  If only that were it; but like a dandelion in the lawn, pulling of the head and leaves does not deal with the roots.

At this stage the jury’s out as to its origins.  It’s either bowel cancer on the move again or something new – like lung cancer.  I don’t smoke (apart from the odd acorn pipe in childhood but you can’t actually inhale those) so although not impossible, it seems more likely to be the former.  So further tests.

I’m starting to feel a bit dozy so the doctor tries to explain it all in terms of (simplified) probabilities to Annie.  Little does he know he’s picked the wrong person.  She patiently explains (as if to her class) that in order to arrive at the chances of it being lung cancer, it’s not simply the probability of a non-smoker getting the disease but that figure multiplied by the probability of me already having had bowel cancer.  His eyes begin to glaze and I fear he’s going to get a detention.

But she warms to her theme and convinces him that if it is lung cancer, in my case, the chances are slight.  But never say never.  We agree to return in a week’s time when we’ll have a better idea of what it is we’re dealing with.

I turn and smile at her in admiration.  I love it when she talks numbers.

6th May 2010

OMG – I’ve got a Typo…

Here’s an idea; if you want to persuade anyone to give up smoking do not quote statistics at them or show them photographs of cancer-ravaged lungs.  Let them spend a few moments sitting in the waiting room of the Respiratory Medicine Outpatients department in an Oxford hospital.  Let them sit on threadbare chairs among elderly men – sallow-faced and hunched – surrounded by posters declaiming a positive spin on the early diagnosis on lung cancer; a bit hard to swallow for these men for whom diagnosis has come far too late.

We’re shown into a consulting room by a doctor who was not on the original team that investigated my lung.  As he reads my notes (for his benefit as much as mine he explains) I stare transfixed a large ball of human hair beneath his desk.  I cannot begin to image how it got there or to whom it belongs.

We have three questions; what is it? How do we deal with it? – and when?  The first he manages – it is a Bowel Cancer Secondary.  But the rest he cannot answer.  He reads my notes on his computer screen – he is apologetic and we feel embarrassed that we have put him in this position.  He leaves the room to consult.  I will require a PET scan to determine if there are any more tumours – smaller than the one identified by the CT scan.

Annie is getting edgy and frustrated by the lack of response to what are not unreasonable questions.  It appears I am to be passed on to a new ‘multidisciplinary team’ who will meet on Monday to determine my fate; after further consultation he confirms I am on the list for Monday.

And then the show stopper; as he goes off to consult for a third time he offers to print of my notes so we can read them – this seems as much a ploy to placate us to offer a free exchange of information.  But perhaps that’s a bit harsh.

My eye is drawn to point 3.  I will reproduce it in its entirety;

‘3.  There is skeletal metastatic disease is evident’.

I ask him what this means.  “It’s a typo”. I point out that it’s a bit more than a typo (knowing of someone with bowel cancer who succumbed to the disease when it spread to her spine).  I begin to feel like Hancock; “it may be a typo to you mate but it’s life and death to me”.

“I’ll erase it from your records”. If only getting rid of cancer were that simple – imagine an application that can remove all traces of disease with the click of a mouse.  I ask him to leave it until we find out what it means.  He stares at again trying to make sense – but now he’s not sure of its meaning.

I am more than a little concerned that a number of highly educated and highly intelligent people, who have responsibility for my future wellbeing, have all read this report and not seen anything amiss with item 3.

On the whole I guess came away with the information I wanted; I thought that if it was a bowel cancer secondary I would need a PET scan (that happened with the liver).  But an anxious wait until we get clarification of the meaning of point 3.  Let me tell you – a typo is a lot scarier than a tumour.

7th May 2010

the phoney war

We’ve been here before; people of a certain age will recall the ‘Phoney War’ – that period during late 1939 when hostilities had been declared but nothing actually happened until Hitler’s invasion of France.  Like then, the sirens have sounded and we are preparing for War.

As with every army, it’s the kit that takes priority; can I honestly wear those pyjamas in hospital again?  And a dressing gown – what will be this year’s Day Room fashion hit?

Then there’s the Home Front; is the car due for a service?  Are there any credit card bills outstanding?  Is my Will up to date?  Will Annie remember to earth up the spuds?  All the things that we fit into our busy lives without a second thought, but which now loom large.

Of course I’m getting ahead of myself; this is a little premature.  All we know at this stage is that Cancer is on the move; the sighting in my left lung could simply be a few stragglers – the remnants of the Great Cancer War – holding out for reinforcements.  Or it could be a scouting party for a newly rearmed and vengeful army – looking to repay the chemotherapy and surgery that wreaked such havoc last time.  So now we wait for a PET scan to confirm enemy numbers.

After a sleepless night fretting about The Typo, the hospital has just rung to confirm it is NOT in my bones.  Tick that off the list.  But this is quickly replaced by other anxieties – how do we deal with the next few months?  We have a big family summer holiday booked – we have visitors from Australia – and gigs galore.   Do we carry on as normal? –  Cancel?  It would be very convenient if we could arrange a ceasefire for a couple of months while we went off and had some fun.  But Cancer is no gent.  It does not play by the rules of the Geneva Convention.  If it did Annie would be spared a lot of heartache.

The biopsy has made breathing a bit easier – the bit they managed to chop off was around 2cm in diameter – so my next job is to get back to the gym and improve my level of fitness.  Cancer treatment is like a sporting event – you have to train, physically and mentally, for it – Dig (deep) for Victory.

For her part Annie is looking at tin helmets; pink of course.

11th May 2010

but you look so healthy

I take a long hard look in the mirror.  Not a sign of this thing lurking in my breast.  The Mercedes scar has now dulled to the point where my eye is no longer drawn automatically to it.  There’s a blotchy patch of red on my forehead – no idea how long that’s been there – but I’m sure it’s recent.  Or perhaps it’s my noticing that is recent (if people now shift their eye line to a couple of inches above mine, I’ll know that this bit of self-analysis was a mistake).

People say “but you look so healthy”. I share their disbelief.  Which is why I stare in the mirror.  They also say things like “you can beat this” and “you’ll breeze it”.  If collective good will and confidence were all it took I’d have no need of hospitals.  I’m glad they talk like this – they do not underestimate the seriousness of the situation but simply give me hope.  I do not want sympathy; sympathy is of no use.  Understanding and tolerance and hope – yes – I’ll have some of that please.

What else haven’t I noticed?  Or are all the changes internal?  Can you spot a person with cancer – could you pick them out in an ID parade?  Context is everything.  In the waiting room – probably; in the street?  No.

Cycling to work the other day, I passed a man – mid-thirties I’d guess – leaning against his bike at the side of the road.  What’s his story, I wondered.  Lost? Tired? Ill? Or perhaps he just fancied a stop.  Everyone has a story, but we rarely notice.

My hair is going grey and the pants are tighter; I can see those changes.  But the view from inside my head seems little changed – OK my eyes don’t focus quite as well as they once did – but my perception of the World seems no different from when I was in my 20s.  I still see myself as young – and healthy.  Although it has to be said – sometimes I feel as if there’s a monkey playing the drums inside my head.

Perhaps I’m not actually ill but simply living in some sort of parasitic relationship with Cancer.  I was tempted to say ‘symbiotic’ – but I can’t quite see the benefit I get from it.  Although – this fact cannot be ignored – it makes me want to write.  When I stopped writing this blog at the beginning of 2007 a number of people (OK – three) asked if I would carry on.  I have tried on numerous occasions and failed; pages of half written ideas, thoughts, shopping lists – but nothing to say.  Annie bought me a small black moleskin note-book (“it’s like the sort that Hemingway used”).  It has two entries; my name.  And the date.  Now with the cancer come words.

And there’s a review on Amazon of ‘It’s not over till the bag-lady rings’ (my previous account of dealing with bowel cancer) in which the reviewer says, I only hope the author writes more!” Be careful what you wish for ……

Looking healthy implies normality – and we try to get on with life as best we can.  Annie suggests that when ‘this’ is all over we just go away for a while – rent out the house and go and live in the sun somewhere.  I manage a non-committal grunt and then, in an attempt to fill me with some sort enthusiasm for this project, she makes the sort of suggestion that once uttered cannot be retracted – there is no facility for saying the sender would like to recall this message.

Now Annie is quite happy up to her neck in water or squeezing through muddy passages in underground caverns as long as she can plug her toolkit (hair renovation paraphernalia) into some sort of electrical socket.  She likes her home comforts.

There is a look of utter disbelief (did I really just say that?) on her face after she suggests we rent a motor home – an RV – and spend 6 months travelling around Europe.  Too late – the words are out and I’m there – Willy Nelson singing ‘On the road again’ has replaced the monkey in my head.  I see camping on a beach somewhere, lying under the stars, her little Fiat 500 hitched to this grand hotel on wheels.

She smiles gamely in the face of my enthusiastic onslaught – I milk her discomfort a little longer before putting her out of misery; perhaps a month or two instead of six?  I promise her that these vehicles have electrical sockets and that her hair will not suffer from neglect.  And I assure her that being together is the most important thing.

In the end it doesn’t really matter whether we do this or not – the important thing is to want to.  To make plans.  Planning implies a future.  Planning gets us away from now.

My friend Neil was in a music shop in New York one time holding a $3,000 mandolin in his hands.  If anyone could do justice to such an instrument it would be Neil.  As he handed it back the storeowner said, “you’ll never run out of money – you’ll only run out of time”.

So – if ever there was a time to get the cheque book out and buy a few dreams it’s now.  While I’m looking healthy.

16th May 2010

just talk to me

Imagine the following scene; it’s a warm summer afternoon and you’re lying on your back gazing up a clear blue sky.  Into view comes the tell tail sign of a passenger plane miles above your head.  You can’t actually see the plane but the vapour trail signifies its presence.  You point your mobile phone at the head of the trail, tap the screen a few times and in a few seconds you know the type of aircraft, its flight number and destination.  Imagine that.

You come indoors and the radio is on – a piece of music is playing.  You point your phone at the radio, tap the screen and in a few seconds you know the title, composer, recording and where you can buy it.  Amazing.

Finally, you decide to get a progress report from the hospital – you look up the number in the phone’s memory – tap the screen and in a few seconds …………

Hello – I had a scan a few days ago – I’d like to know what happens next.

Your results were discussed at a meeting today.

So what is the next step – I need to make plans.

Well, the tumour in your lung needs to be removed.

I realise that – so what happens next?

You’ll be contacted by Dr B.

Who is he?

A surgeon.

So it’s surgery then?

It’s an option – he’ll discuss it with you.

What other are options are there then?

He’ll discuss it with you.

Do you have any idea of timescales? – I just want a rough idea.

He’ll discuss it with you.

But I’m very busy at work right now – I need to let people know.

He’ll discuss it with you.

I have a summer holiday booked……… I need to know whether to cancel it or not.

He’ll discuss it with you.

My wife will shortly be going away on a week-long school trip – she needs to know whether to cancel it or not.

He’ll discuss it with you.

When can I expect to hear from him?

He’ll discuss it with you.

Can I have the boil on the end of my nose removed at the same time?

He’ll discuss it with you.

He’ll discuss it with you.

He’ll discuss it with you.

He’ll discuss it with you.

19th May 2010

now be thankful for good things below

Now be thankful for good things below, Now be thankful to your maker

For the rose, the red rose blooms for all to know

Although this is a bit of an emotional rollercoaster I can truthfully say that I am not angry.  Nor am I depressed.  My overriding emotion is one of inconvenience. Or rather, irritation.  And just occasionally – fear.

It’s always in the mornings; I hear Annie get up about 6 o’clock (those blonde tresses won’t straighten themselves) and my mind drifts easily between the distant sound of a hair dryer and this ‘thing’ that is happening to me.  ‘Why precisely now?’ – I have some spare time in the autumn to be ill, but not now.  And the not knowing what’s happening just makes it worse.  Very occasionally I get scared – it’s when I imagine it spreading throughout my body – particularly to my brain.  I’m very fond of my little grey cells – I would hate to be without them.

And then, about 7.30 she’s gone.  I wander around the house, coffee brewing, taking in all the little things that make our life together so good.  I need this quiet time.  It’s strange – quite time in bed is not the same as quite time sitting with a coffee.  Perhaps it’s the negative association – bed equals illness – fresh coffee equals living.  And then, as if by some miracle, the healing begins.  If the sun is shining the process always seems to take less time.

If I have time I have a quick inspection of the garden – right now the blueberries are showing signs of disease (hmmm) – according to Annie they are suffering from ‘mummy berry’.  I think she’s pulling my leg – but apparently it means the berries have mummified.  Whatever the explanation they do not look good.  The lettuces and potatoes do however.  At the bottom of the garden the canal is noisy with the sounds of ducks making their plans for the day.  How can anyone not feel good?

It’s on the way to work that I usually I mess up; I always do this really stupid thing – if I see someone ahead of me I always have to chase and overtake them.  I’m quite happy to potter along in my own world and at my own sweet pace until the back of another bike comes into view.  Then I’m off.  By the time I get to work I’m worn out.  So I have to take the lift, under the disdainful looks of those who can so easily fly up stairs.  Breathing has become easier since the biopsy.  But I feel as if I’m going backwards.

Back in 2005 Annie and I were riding our bikes through the ups and downs of Burgundy – not a care in the world.  In 2007 the best I could manage was a 10 mile charity ride.  Things had improved by 2008 – we took our bikes to Spain and France – and last year we completed the Hadrian’s Wall cycle route (Irish Sea to the North Sea) in 3 days – not a care in the world Part 2.

Annie is concerned about my level of fitness – she knows I have lost my motivation to go to the gym – so at around 7.00 on Sunday morning she drags me out on my bike.  There’s a route that I often do on my racing bike when I want a bit of a spin – head down, it usually takes me about an hour.  She suggests we just do part of it.  I take the lead and settle into a steady pace – any slower and I’ll actually fall over.  After a couple of miles Annie comes to the front and the pace picks up, 14, 15, 16 and then 17 miles per hour.  She’s dragging me round now – I couldn’t manage this on my own.

And then we hit a hill.  Sometimes we spice up our bike rides with a bit of competition (never at my instigation I might add).  She can beat me on the flat (coming from behind, the element of surprise and her superior fitness can leave me trailing).  But on the hills I’m usually first to the top. So this particular morning she thinks I’m letting her win.  But I’m not.  Not this time anyway.

I’m very lucky to have my own personal trainer.  It’s impossible to be anything other than optimistic with support like this.

26th May 2010

the squeaky wheel does not get the grease

I think you’ll agree that, up to now, I have been a model ‘patient’.  I have displayed that quality which shares the same spelling, if not the same meaning; the adjective rather than the noun.  I have borne my trials and tribulations with a sense of calm and good humour.  I have been patient.  OK – a couple of wobbles here and there – nothing that would register on the Richter scale.

But now?  Well – I could go to the foot of our stairs.

Two weeks ago I had the PET scan.  I telephoned the hospital to ask when I might get the results and what the next step would be.  As the results showed a bowel cancer secondary in my lung I would now being leaving the care of Upper Gastro-intestinal and moving to Cardio-Thoracic.   I was pleased – it felt like a promotion.  The parting words from Upper G were to phone Cardio-Thoracic – “you don’t want to get lost in the system”.

So I duly phoned my new best friends and discovered that Mr B (consultant–surgeon) had asked his secretary to put me on his list for next Thursday (May 27th).  A very nice sounding young lady explained that, as his secretary, she doesn’t actually make the appointments – she simply passes them on to the person who does.  Let’s call her AL (for Appointments Lady – and she is a she).  But she (secretary – not AL) offers to find out and confirm the appointment;  “I’ll call you back”. You can probably guess what’s coming.

Four days later I ring the secretary again:  “I’ll call you back”. I give her a day and try again.  Apparently there’s a problem; AL’s been on holiday for a week and so the appointments are a bit ……..  I’ll say they are – she’s booked me in for June 6th.   I rant about the delay before I realize that June 6th is a Sunday.   Again the offer to call me back.  Again the disappointment of waiting for a call that does not come.  OMG – teenage angst all over again.

I try a new approach – I explain that I understand people are busy – if they could just see their way to letting me know if I am to see Mr B on the 27th, as he requested, I’d be so very grateful.  Finally, today, May 26th, Mr B himself phones me.  Wow.  I’m so taken aback that all the questions I wanted to ask go out of my mind.  It appears that the PET scan shows only the one tumour.  And then; “I think we can offer you surgery – if everything’s OK when we meet”.  Hmm – what can he mean?  A brown envelope full of used £20s?  Or perhaps something a little more personal?

I explain that I’m a bit confused about when this meeting might take place.  “Can you still make tomorrow if I can fix it?” Fix it? ‘Yes’ I say.  Now I am convinced he wants money. “She will ring you back – one way or another”. I start to panic – I’m going to have a staring role as corpse*1.  Or have I been reading too many Raymond Chandler novels?

Well, well, well, you learn something every day.  I was going to type ‘corpse hash 1’ – in keeping with the numbering conventions of American crime novels – but I discover that there is no hash key on an Apple keyboard.  I’m just going to have to settle for corpse*1.

Of course ‘she’ does not call back.  By now Annie is home and I explain I need a brown envelope and a visit to the cash machine.  I make myself comfortable on the naughty step while she calls the secretary:  “I’ll phone Mr B now and I’ll call you back, or he will”.

I count up the phone calls – 10 in all.  A lot of squeaking before the wheel finally got the grease.  But no – the phone remains silent.  And as far as I know I still have an appointment for Sunday 6th June – I think they keep this date for people who are lost in the system.

28th May 2010

a big test

But.

It’s obvious that there will be one so I thought I’d get it over with first.  There’s also an ‘if’ coming up.

It’s about half way through the consultancy when I realise that I’m being tested.  And I am having a consultancy – the secretary and AL worked wonders and phoned me at work on Thursday morning offering me a slot – but I’d have to get over to Oxford pronto.  It won’t be with Mr B, but with one of his colleagues.  A quick call to school for Annie to arrange cover and off we go.

“If surgery were to be offered would you take it?” This turns out to be a much harder question than I had expected.

We had just spent about 15 minutes hearing why surgery was not an option.  Or rather, him seemingly convincing himself it was not an option.  If it was easily accessible he could do a segmentectomy (remove a segment).  If it was in just one lobe he could do a …… lobectomy.  But (there it is) – it’s smack bang in the middle straddling major blood vessels and between 2 airways.  He’d have to remove the whole lung (pneumonectomy).   And he’s not happy about this.  He’s not happy…?

He talks about the poor quality of life I could expect with only one lung.  As if the quality of life with a growing tumour is somehow better.  He explains that it’s a risky operation – air leaking into the chest cavity (painful apparently) – blood transfusions (no problem for me – I lost 5 pints when I had the liver resection).  He stares at my scans – it was not there (or rather not visible) on the scan I had in 2008.  “…If it’s grown that much in two years …” He is weighing up the odds.   I keep expecting him to suck his breath in between his teeth and tell me that if I’m going to replace the head gasket I may as well replace the entire engine.

We discuss chemo as an alternative – apparently the oncologist is prepared to offer this.  Annie asks what happens if chemo doesn’t work; “I’m going to pass on that one”.

And now I’m thinking – he’s not going to do it – I’m stuffed.  This was the one outcome I had not rehearsed.  I had hoped for a segmentectomy, but was prepared (sort of) for a pneumonectomy  – indeed, the first thing I did when the tumour in the lung was diagnosed was to Google ‘lung cancer+cycling’ and came across a triathlete who had his left lung completely removed and was still able to compete.  I mention this to the consultant – he’s dismissive “must be a pretty slow triathlon”.

What I had not been prepared for was that surgery might be too difficult.  That the only option I would have would be drugs to keep it under control.  But as he’s already explained that it’s growing fast, then how long could I expect the drugs to remain effective?  Drugs do not appear to offer much chance of a cure.

He admits that, among the team, surgery is the first (only?) option.  He looks directly at me and asks the question.  It dawns on me that this is some kind of test.  Am I up for it?  I lean forward in my chair and answer an emphatic ‘yes’.

As I see it – with surgery there is a chance (albeit a slight one) that he can remove all the cancerous cells.  I do not have that chance with chemo.  It seems a no-brainer (or rather – a no-lunger).  I do not actually use that phrase – I don’t want him to confuse lobotomy and lobectomy.

He appears to brighten up a bit – and now starts explaining the procedure; an incision under the arm from shoulder blade to breast bone, the drains, the white surgical stockings (nice).  “But you know all this?” I nod. He’ll discuss this further with Mr B and if they are happy to go ahead it will all happen in the next 3-4 weeks.  Annie asks who will make the final decision.  He nods at me and says “him”.

He’s wrong of course, it’ll be ours – Annie’s and mine. We both have cancer – I have the tumour, she has the consequences.

We discuss it in the car on the way home.  We should have time to sit down with an oncologist and go through the chemo options – how much, how long, risks, benefits … and so on.   But cancer is an impatient disease – always wanting the quick answer.  There is no time for reflection – no ‘my people will talk to your people and we’ll get back to you in a few months time’.  Annie points out that this is probably my only chance for surgery – I may not have a choice in a few years time.  So I guess that’s it.

There will be a ‘suitability for surgery’ assessment to go through first; as well as assessing my physical fitness, I’ll be presented with a diagram of the human body on which I have to identify, colour in and correctly label the appropriate lung to be removed.  This is a much for their benefit as mine.

I’m already pretty good at colouring in so we start a fitness regime as soon as we get home.  I’m fortunate enough to work with a team of sports and fitness experts – a colleague advises me to do as much endurance training as I can in the next few weeks “so that your VO2 max is as high as it can be going into the op, then you’ll be left with 1 strong lung”. So I get my trainers on and wander down to the shed with a glass of wine and a dictionary to look up ‘endurance’ and ‘V02 max’.

I also learn that it’s important to eat after exercise to replace lost ‘thingies’ and as we have a few strawberries, meringues and cream in the house, I make my favourite dessert – Coalition Pudding – or as it’s more commonly known, Eton Mess.


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