It's on my conscience that I haven't blogged for a while. People have been asking how I'm getting on with the nuance that at one extreme had I died; or at the other, had I totally recovered and just forgotten everyone. Well mercifully, neither. Certainly while my treatment was ongoing, there was a long period when I felt no motivation to do anything at all apart from drag myself along to hospital for the treatment itself. However, it all needs to be said. This is for Fellow Man more than for me, after all. Apologies now for having to go back a year, but at least you are getting the bits that have been remembered. As before, this blog does discuss medical topics in a frank straightforward way. As before, the [get-outa-here] button is available to you.
It's not just remembering bits of course. The bits are the easy bit. Some of the important bits aren't actually bits as such; they are the feelings, such as “Why is it taking quite so long to get shot of this catheter?”. That was, for me, worrying because you can't have radiotherapy done with a catheter in; and you can only have the catheter taken out once you have shown that you can pee normally. Because I had grown a large capacity bladder because the enlarged prostate was squashing the plumbing, it took what seemed like forever.
Aug 2nd 2019: The TURP surgery
Any surgery under a general anaesthetic is gong to be a risk, an invasion of one's body. I remember as much as anything else, feeling relieved that at last things were moving again. Considering what the surgeon actually does, it's fairly surprising that the effects aren't worse. Access to the prostate is achieved by inserting an instrument into and through the urethra with an electrically heatable wire; the hot wire being what does the cutting. This of course was only the prologue to actual cancer treatment: a necessary prerequisite job to slice a piece out before they could even begin to administer any radiotherapy. The configuration of the male anatomy being what it is, obviously it's all done under general anaesthetic so no pain involved, just the realisation that bing fitted with a catheter was the new normal. And yes, one does get used to it. Being told that one would die without it helps the issue of acceptance of course. It did seem to be a very long time between the TURP and the radiotherapy.
Aug 20th TWOC (Trial With_Out Catheter). That's a day when they remove the catheter, get you to drink plenty of water, and see if you can empty the bladder by peeing normally. The residual volume being measured using an ultrasound scanner. Ideally the residuum should be less than 100 ml. Alas mine wasn't which was a disappointment because I really wanted to be catheter-free before…
Aug 27th – Sep 3rd. A trip to France with close family. I had carefully rehearsed what I might have to say to Airport Security, complete with a copy of my letter from Addenbrookes. Mercifully, there was no body search requiring me to remember expressions like sonde urinaire avec petit robinet, traītement contre cancer de la prostate.
Sep 12 Another TWOC. Again I failed the residuum test. Dear FM, if you are reading this for encouragement and reassurance for yourself, read on and be reassured! I was having a really difficult time with the completel empty your bladder question. Desperately wanted to do it all by peeing naturally until a kind and determined urologist pesuaded me to try ISC. That's Intermittent Self Catheterisation. The very thought of having to insert a tube, (which does look rather long the first time you see one), into oneself is, understandably off-putting. However, hashag-positive-side, it does enable the radiology-radiography team to do their very precise measurments accurately. That in turn enables the treatment to go ahead.
October
My sister died (well into her nineties, so very much more celebrated in the life than mourned in death). For strict accuracy, my half-sister; or for family solidarity, my sister. Anyway, this time a family funeral when I could honestly answer the …and how are you question.
November 15th: I am tattooed. No, dear reader, no I love Joan Forever surrounded by dragons, roses, crucifixes or whatever. Just three tiny dots, neatly artworked by a radiographer to line up with the laser beams that guide the X-ray machine to be used for my radiotherapy. They take this calibration image, then at each treatment the first step is to line up that day's image with this first one so that exactly the right spot on the prostate gets hit. This is the critical measurement that I mentioned earlier.
November 27th – December 24th: Radiotherapy. There is nothing inherently painful or unpleasant about the treatment itself. In fact the regular same-time-every-weekday routine is actuall quite pleasant and calming. Also there's the cameraderie of seeing more or less the same fellow-patients every day, exchanging how do you feel stories; wishing them well – and happy Christmas – when their treatment finished before one's own. What I didn't quite notice at the time was the tiring, debilitating effect of the radiotherapy, which only really kicks in a few days later. My last radiotherapy session was Christmas Eve. By then the delayed feeling of physical weakness was beginning to kick in.
I'll wind up this blog-set on my personal health with a note about COVID-19. February 6th saw the Young Voices concert. Some eight thousand children in their school choirs gather in the O2 Arena with an orchestra and conductor to sing to an audience of their loving families. It is a movingly beautiful show; I was there for my granddaughter together with other family members. Getting there meant a train from Cambridge to London King's Cross, whence another train to Greenwich. At the end, the Arena empties and the order of 20,000 people all want a ride home. Nobody in the first week of February 2020 gave a thought to whose hand touched that rail before mine? a week or so later I felt so ill that for two days I couldn't get out of bed. There was the blinding headache followed by inability to draw breath. COVID-19 had not hit the news yet, but a bit later [consults calendar] February 25th I had a doctor's appointment on a totally unrelated matter. I said "I couldn't have come to see you a week ago", and described the symptoms. "Oh yes", she replied, "that's a virus, a lot of people have had it". Only weeks later did I analyse the events and reason that I very likely had COVID-19. Now that I know that patients who recover after mild symptoms suffer in the long term days of weakness and debility, I feel totally convinced that COVID-19 was what it was. Whatever the full facts, I am leaving nothing to chance because nobody yet knows about immunity.
My overriding thought now is simply sheer gratitude to be still alive. I think what if I had not felt the sense of urgency that very day to make the first GP appointment and say "I have problems getting up to pee in the night, I think the old prostate might need looking at". I think about when the urologist said "Your urinary obstruction could have caused sudden total kidney failure at any moment". I think about the fact that the COVID-19 crisis hit within a few weeks of my treatment finishing; after which all hospital schedules were disrupted. I think that, had events turned out slightly differently, I would be dead by now; and I am profoundly grateful for each day of life. It's time to blog about something else.
