Preparation – the start of things to come.

I was hoping that someone would ask if I had been in this hospital before and I would answer “Yes” with any luck they then would ask “when?” and I would reply “1954!”  It was 2015. It’s a joke I had rehearsed for a while but no-one asked…!

Well this is it! Meeting the Anaesthetist! The questions are important but not taxing and there was a chance to ask some of your own. I don’t think I asked any questions. It was all clear what was to happen, I signed the forms; then…the parting words from the Anaesthetist.  “I look forward to seeing you later.” As one Anaesthetist pointed out “ when people ask what I do for a living I often say, I spend my day putting people to sleep and then waking them up”…

The next activity was the visit of the Colorectal Nurse who was to site the position of the ileoscopy bag. With my shirt open she asked me to bend and twist into many of the normal positions we encounter in the general run of life. The reason being was to mark a point on my body that would avoid any natural body folds where the small bowel would soon exit my body in order to connect with the ileoscopy bag. I would like to think she needed to consider where the six-pack was! Thankfully she selected the appropriate position and there were very few rolling layers for her to contend with. The small bowel would protrude only a little and only for a short time. (Well, a few months as it actually turned out!!)

Once allocated a bed in one of the small wards, I changed into the “gown” and also into a very tight fitting pair of green socks. Covering the entire length of my lower legs it transformed that part of my body to look like one of Robin Hood’s Merry Men! I had barely finished changing when the porter arrived with a trolley/bed to transport me to the operating theatre. I usually like going to the theatre to see a show, this time however I had a part to play admittedly it’s a non-speaking part, but I am central to the plot.

On arrival in the preparation room the Anaesthetist and several other nurses greeted me. I went through several questions to confirm who I was and whether I understood what was about to happen, I remember this being a pleasant time chatting with the medical staff. I am not sure who brought up the subject but we all seemed to join in on the subject of cycling. A cannula was fitted in my hand (a devise to enable drugs and solutions to be delivered to my body when needed.) and I was asked to sit on the side of the trolley. The gown was loosened at the back and I was told to expect a cold sensation. Oooh! I took a sharp intake of breath as some form of spray landed on my back. Oooh! it did feel cold but only for a few seconds. An epidural was then administered. From what I can understand this is an injection to provide pain management but at the time I thought it was a small tube of some kind. When told to lie back on the bed I inquired if it was safe to do so just in case I crushed the tube or whatever. Smiling they told me there was nothing there I had simply had the sensation of what had happened.

Whilst I had been in the sitting position I faced what looked like some form of ‘hostess’ trolley but instead of lunch it contained a number of medical appliances. I noticed there was one gauge that had the word Oxygen upon it – the needle being in the red zone and the word ‘empty’ adjacent to it, Thinking of the newspaper headlines… “Patient left in Vegetated state due to lack of Oxygen”(Yes, some people would notice the difference!)  I thought that I should mention it. Even bigger smiles from the staff “No, we wont be using that equipment, no need to worry!”

At some point the Consultant entered. “Nice to see you again.”  My hand was injected and within seconds I was sleeping. At this point the real work began for both the Surgical Team and the Anaesthetist. I wonder if, like my mum when I was younger, they were happy when I went to sleep?

Tractor Man

GBNHS

 

 

Bowel School

The idea of being invited to attend Bowel School seemed strange at first but, always wanting to support any offers that would aid my recovery, I accepted. I remembered   a sporting representation of the letters PPPPP, which translates to ‘Proper Preparation Prevents Poor Performance’. I did not want to be a poor performer.

My dear wife was going to accompany me to this class. I thought I would play a joke and pretending I was a little boy. I came into the room with my hands cupped holding a number of mini Mars Bars and said “look at what I made in Bowel School today Mummy.” You can now arrange the following disparaging words in any order. “Grow up!”  “Disgusting!”  “Have you nothing better to think about?”  “Is that necessary?”

There were a number of other patients present at the class with their respective partners. The session was led by the ward sister who had also invited a number of nurses. These professionals would guide us through a number of topics, which were to be considered in light of the forth-coming procedures.

The dietician offered many interesting aspects of nutrition and provided suggestions for meals and ways to adjust our present diet. My wife being very experienced in this area made a good contribution by way of questions, the answers were, I think, useful to everybody there. When we were given the opportunity to taste one of the high calorie energy drinks many of the partners seemed reluctant and sampled with a small sip. I do admit that, nice as it was, it wouldn’t become a best seller in the supermarkets.

Nurses from the physiotherapy department guided us through our recovery program.

Apparently deep breathing exercises can prevent lung infections when you are restricted in your movements. We all joined in, trying out the different methods of breathing. “Deep breath” was the command and as we all drew in and sucked most of the air from the room I am sure the curtains on the window moved away from the windows, though perhaps it could have been a slight breeze as it was a pleasant day outside… We then practiced a few stretching movements, followed by some recommended leg movements and as we performed this sitting down it looked like an armchair version of Riverdance! These exercises were to be performed at regular intervals along with the deep breathing when we were in the ward post op.

Any one expecting a few days in bed may have been shocked to hear that this is no longer the case. It is thought to be medically beneficial to be active the day after surgery even if that activity is simply by getting out of bed and into a chair – mmm at this rate I think I will be back on my bike by June!

Accompanied by one of the nurses we were taken on a tour of the ward. The design of the hospital is such that the wards are grouped around a hexagonal, which is an administrative area. This means you can start to walk from the entrance of your ward, around the hexagon and then find yourself back where you started  – the entrance to your own ward! It may not seem inspiring to visit a hospital ward but I thought it was. The sight of men and women in their hospital attire walking around the ward, gradually building the number of laps day by day and getting fitter and fitter was encouraging. Feeling sporty I wondered whether there was a lap record I could attempt to claim after my surgery?

Tractor Man

GBNHS

 

The Pre-Op

Knowing that there is a procedure that will remove cancerous cells and tissue is wonderful. The hospital now needs to know I am well enough to have that procedure.

As is normal for me, I arrived early and sat reading waiting to be called. I had no worries about this appointment and felt confident that I would be well enough to have the procedure. I had, by now, developed an automatic response to “can you confirm your name?” Trying to help I simply continued, without being asked, to give my date of birth and home address. I did however resist the temptation to carry it on to shoe size, shirt collar size and that I hold the rank of Queen Scout (once awarded its yours for life.)

During this appointment there were several people to see and a few tests to complete.

• Height and weight – not so much a test to pass! More, I believe, a case of collecting data as an indication of general health.
• As I sit, the nurse asks if I have ever had MRSA or been in a hospital where it had been recorded as being present. I answered “no” and she politely informed me that she needed to take a swab sample from the inside of my nose. At that point she produced what looked like a cotton bud however it was quite long and could possibly have penetrated the length of my nose and taken a sample from my ears at the same time! However, as it happened, she only swabbed just inside my nose. I suppose though it needed to be long as there well may be some large hooters among the population…
• EGC – very quick and efficiently done. The little pads were fitted; wires connected and print out provided. From what I could see the peaks on the print out appeared to be regular so I assumed that all was normal.
• I had one more nurse to meet. He went through general health questions and asked if I understood the procedure that was to happen. We seemed to get on well, so it was an enjoyable and relaxing discussion.  Then… his perfect analogy. “ Don’t take it personally that you have cancer, it can happen to any one. No matter how fit you keep your self, no matter how well you look after your self by eating the correct foods and in your case not smoking, its just like a stray bullet flying through the air and it hits you…mind you it can kill you, but it’s not personal!” I did laugh, it was a comfort really as it was a good way of thinking and made me feel that my efforts to live a healthy life had not in vain.
• Then, on to see the doctor and an examination with a stethoscope, and the good news that all was well and the procedure could take place.
• Final act of the day was to have a blood sample taken. “You may feel a little scratch,” the nurse said. I expected to feel a painful scratch similar to a bramble or a scratch, which, I never seem to avoid when pruning the rose trees, but no, I hardly felt a thing. It was late afternoon and these nurses had been working so hard all day yet I felt that the excellent treatment I had received was equal to that which the first patient that morning would have experienced. Quite remarkable.                                                                                                                                                        So now I had a date. I had been found fit and able to proceed. It was simply just a case of waiting and being prepared. Time to invest in new Pj’s, slippers, books and magazines. Oh yes and to record all my favorite music on to my i pod.

Tractor man

GBNHS

 

The Cycle Group.

There is evidence to suggest that people who belong to social groups tend to have happier, longer lives. If you add exercise to that, well naturally it becomes even more beneficial.

If you were a young person, possibly a mid twenty/thirty year old, on seeing up to twenty-four men and woman who are senior members of society (I refuse to use the term old) cycling together, what would your thoughts be? Hopefully the words astonishing, amazing and inspirational would spring to mind.

You may be amazed as they ride by at a decent pace. Possibly you are bemused by the fact that most of the group are dressed in the appropriate cycle kit, perhaps also noticing a fine a collection of MAMIL’S (Middle Age Men In Lycra.) within the group – there is currently no acronym for senior men and woman wearing Lycra but give it time ….as numbers grow…

You could mistakenly have thought it’s a charity ride, a one off perhaps. If you live in Knowsley it is more likely to be a group from Pedal Away. *

As a group they cycle on some of Sustrans well maintained cycle tracks and also along quiet lanes within the borough. Pedal Away have been featured on BBC News at Ten as a good example of how one group of seniors are making efforts to improve or maintain their health and well being. They have also won local awards for promoting the same health and well being ideals. One also needs to consider the social benefits of such a group meeting weekly or for some members three times a week.

They say that “you don’t find things, things find you.” Well it seems true when it comes to bills, junk mail and litter in your front garden. However, I do understand the thought behind the phrase. So did I find the cycle group or did they find me?

If I hadn’t run for the train and missed it like the other person from the opposite direction who also missed it (well, technically we did not miss our train but tried to catch an earlier one that was late!) We may never have chatted and I may never of heard of the Pedal Away Cycle group. Thanks “T” for being a man who likes to be early.

I first rode with the group in June 2014 and continued to do so until the week before going in hospital for my first procedure (May 2015.) They, as you will see later, play an important role in my story. My daughter refers to my cycle group as the Aldi Cycle Club, its true we do all look similar and some of us do take advantage of the sale of cycle clothing at the store.

Remember the words of my consultant “You are so fit and well you can handle any anything we need to do to get you well.” Riding with Pedal Away should be seen as part of my fitness regime.

*Knowsley Pedal Away. Is a cycling initiative set up by the charity Cycle Projects.

It began in the Metropolitan Borough of Knowsley Merseyside in 2008 and since then has grown to have cycle hubs across the borough. The rides are supported by a strong group of volunteers and ride leaders. Their friendly approach has seen many people go from cycling novice to regular weekly cyclists.

www.Austrians.org.uk

www.cycling.org.uk

Tractor Man

GBNHS & KPA!

Time for an adventure. A trip to the Northeast.

So there it was, all activity had come to a halt. Nothing further could be done until I entered the next phase, which would be the treatment.

I had a week’s walking holiday pre booked. I was to walk the Northeast Coastal Path. It would not be possible to complete the walk as I had an appointment at the hospital for my Pre-op towards the end of the week however; cancelling it was never in my mind. Adapting the holiday to provide some walking on the costal path was the option I chose. I understood that the fitter you are, the quicker the recovery. So mentally it seemed to make sense to keep as active as I could.

The normal walking routine changed from what it had been on previous expeditions

This time, as I was walking and enjoying the beauty of the coast, my mind would wander and think of the next stopping point. For the first time in my life toilet stops were vital. There were two of us on the walk. At the approach to a café my focus would be on finding the facilities, theirs would be solely on the selection of cakes. Sometimes they would be lured into a quicker pace by the smell of cooking bacon drifting on the breeze. The quicker pace suited me!

On arrival, my rucksack quickly dumped, I hastened to the facilities returning moments later to a hot mug of tea and whatever had been selected. I know that you’re thinking that it was a good way to avoid paying! I am not sure who suggested we had a “kitty” – I think it was me! I would imagine, as we stopped several times in the day, the calorie intake exceeded the calories expended by the walking. It may well have been that we went home heavier than when we arrived!

The accommodation had been booked for a while. There were seven overnights stops in B&Bs along the route. Each accommodation provided a room with en suite bathroom, which was pleasing as other guests would never need to be disturbed and in the case of a “sudden urge” private facilities would be available.

I am not sure if it’s just me or others are the same but when I first enter my room I immediately look out of the window and admire the view before beginning my ritual of entertaining myself with the light switches to see what operates what and how the shower works. After a hard days walk I normally go for what I call the ‘Golden Hour’. Within that hour, I like to have a cup of tea, unpack what I need for the stay and also shower; it is a constant stream of activity. Having completed everything within this time means that I can then relax. My walking partner operates the ‘Drop and Flop’ routine in which the rucksack is dropped, they flop on the bed and enjoy a cup of tea, which I must point out was prepared by me; they are then entertained by my continuous hullabaloo.

One of the B&B’s was called the Old Vicarage and when looking out of the window all that was on view was a cemetery… The graveyard on that dull dark evening was not the view that I had expected. I had thought that I might have had my sprits lifted by observing a beautiful vista over the surrounding hillsides and valleys. However my eyes could only focus on that limited view below my window as trees and bushes surrounded the entire burial ground. There was no distraction to be had from the stark, cold headstones of others who had departed this life some time hence… Sorry, I have been reading far too many books by the Bronte sisters.

The week was very enjoyable and at times made me think of my imminent procedure, the recovery and then… returning to some great adventures soon after.

Always positive, always looking on the bright side.    

Tractor Man

GBNHS

 

 

Lets start spreading the news,,,

I think it’s a little easier telling friends than family. I met with some the evening after the colonoscopy, I told them what had been discovered and left it at that. They may well have drawn some conclusions but said little, their support came later when the full details were known.

I did not have an order of which friends to tell but wanted them to hear from me and not from each other. My choice of using an email may not have been the best but a phone call would have been even more difficult for the person at the receiving end. I felt that they would have listened and needed to respond, having had no time to gather their thoughts. Phone calls came from them when they felt ready. No, it was not a ploy by me to save on the cost of phone calls!

However one of the phone calls that I did make could not have turned out any better.

It was to a friend who is a lot younger than myself and one with whom I have had some great travelling adventures. We seem to have a similar outlook on life.

(Me) “Hi. How are you? I just thought I would give a ring, as we have not chatted for ages.”

(Him)  “I’ve been pretty busy, I should have rang. Any adventures planned?”

“I’d planned one big bike ride for 2015, I was thinking that you might enjoy it as well but I think I will have to put that on hold. Have you been training hard?”

“I was and doing well but I had a bad injury so I had to stop for ages. I was just getting back into it but taking it slow and steady when “R” (his girlfriend) had a serious problem with her back and needed urgent surgery.  So both of us have been out of action. Pity, as we had some great plans for this year, some great races to enter. By the time we both recover the year is going to be half over. So what’s the problem with the bike ride?”

“I have bowel cancer, but don’t worry its all sorted, in fact I maybe back to adventures about the same time as you and “R” will be, by the sound of things!!”

“Wow, I am sorry to hear that, not such a great year for us all then. What’s going to happen?”

“Its quite simple I think as I discovered the Cancer early. The surgeon just cuts out the bad bit and sews me up, leaving part of the small bowel outside to which he fits a bag for the collection of ****! This gives the large bowel time to heal. Then he will reverse the operation by reconnecting both ends again. Human plumbing, I guess”

“If it’s that simple I can do it, I have my First Aid Certificate.”

“If its all the same to you mate, I will let the surgeon have a go! There is some good news though. You know the way “A”  (A is a Liverpool FC supporter) says Everton will never win the FA cup as long as I have a hole in my A***. Well, I won’t have for a while so this could be our year for the trophy mate!” 

“Well don’t be in a rush to get sewn back, try to last out for the season. Just a second…”

I could only hear him faintly as he had lowered the phone from his mouth in order to talk with his girl friend

“If you have to go don’t worry I will catch up with you again soon.”

“No, its just “R” asking who is on the phone. She wondered why we were laughing so much. I’ve just told her who it was and that you have Bowel Cancer. She was a little shocked that we were laughing but I’ve promised to explain later.  She passes on her best wishes”

“Say I am sorry to hear about her back and tell her that I’m glad she’s making a full recovery.”

“I’ll tell her, I must say you do sound confident.”

“I am, very confident. The surgeon says that I am fit and should be capable of handling everything that they need to do in order for me to recover. He also says I am intelligent, handsome, and a pleasure to meet. In fact, all round, an extremely good chap.” (I added some lies here for effect.)

“I would ask for another surgeon if I were you as any one who thinks that about you can’t be that clever.”

Then followed another bout of laughter from us both and the conversation continued in this comical way. As you would imagine there were a lot more funny remarks than I’ve included in this post but I’m sure that you have got the idea.

Like me, my friend looks on the bright side of life and always looks for the positive. In fact, thinking about it, most of my friends do.

Tractor Man

GBNHS

 

 

 

 

Telling the family.

When you say to a family member “ I don’t want you to worry”, the first think they do is to worry!

In situations like this people communicate in ways that suit their own character and personality. Some may like to keep the information private and have their own thoughts before telling family and friends. Others may prefer telling close friends and family as soon as they have the information. For me, it seemed important to be honest and open with the family from the start. It may have given them concerns about the future but knowing what was going on hopefully prevented the thought “what’s he not telling us…”

Understanding that they would be upset I wanted to convey that having met with the Consultant, I was very confident that all would be well. I wanted them to have as much of a positive feeling for the future as I had. Not easy! So, how to do it?

When talking I wanted the diagnosis bit to be short then spend more time on the positive outcomes.

What about?…, “Hi Guess what?” or “Remember I told you that I was going to the hospital, well guess what?” Maybe it could be “You would never have guessed that when …” I decided to do away with the guessing game as they had probably been guessing since I told them why, having seen my GP, I was going to the hospital.

What about?… “I saw the consultant/doctor today…” No. I have seen and heard that line in so many films…you know what’s coming…either she is pregnant…. or he is terminally ill.

What about? “I need to tell you….”

I had got to a stage when I was beginning to rehearse this and that’s not my way of doing things! So I decided to say it in a confident and an affirmative manner. This is what the results have shown, this is what going to happen, it’s all very positive from the consultant and I’m aiming to be active again very soon.

As it happened the opening words from everyone when I either met them or telephoned was “How did you get on at the hospital?” so then my response was as I have said above but with the added humour that can only be spontaneous and then is instantly forgotten. I needed to pass on my positive feeling to others. I realised it was harder for them to handle than me. If I showed that I was very confident about what was happening hopefully that emotion would pass on to them. In truth I was very confident.

I was in the action and they were watching from the sidelines, which I think is far more difficult. Ask any sporting coach and they will say the same, that it’s far harder watching than playing. I actually felt much happier if I took the lead and made it my responsibility to look after them emotionally.

It was my birthday a few days before the results which on reflection, I think was very lucky if it had been later I think that my presents would have consisted of a dressing gown, pyjamas, a toiletry bag or even slippers with pom poms on!

I think the children’s game called “Operation” may have more appropriate. This is a game in which you have to lift plastic body parts out of a plastic representation of somebody on an operating table. This is done with tweezers and must be carried out with care in order not to touch a certain part of the body, if you fail an alarm buzzes. I wonder if medical students play this game? More fun after a few beers I would think.

Tractor man

GBNHS

Meeting the man who saved my life.

Well that’s what I thought at the time, he is going to save my life. I now know that he has. I think he is too modest to agree, but I can’t think of it in any other terms.

The day of my appointment arrived and my wife and I sat in the waiting area ready to meet “Mr C” who was to be my consultant. His surgery was running late. I didn’t find that a problem at all.

A nurse escorted us to his consulting room where we received a warm welcome. I sat in the chair next to his desk with my wife sitting further back with the nurse.

He apologised for keeping us waiting and explained that he had needed to spend longer with a few other patients as he had information to tell them that he did not want to rush. “I hope you can understand. I hope the wait was not inconvenient.”

I thought that this was such an excellent approach to give each person the time they needed and not be constrained by the allotted appointment time. I was sure I would like this guy. He had my respect in that one sentence.

“Your results show that the polyp is cancerous” he explained.

BOLT FROM THE BLUE …Or was it? I had thought of the possibility of the polyp being cancerous. If I am honest it was in my mind when I first contemplated going to my GP. However guessing what it could be and actually knowing, is a quite a big difference. My brain worked quickly and I thought Bowel Cancer. That’s the problem! I knew what he polyp looked like as I had seen it on the TV screen during the Colonoscopy. Strange it being inside and I didn’t feel a thing, there was no pain at all.

As this was not a TV drama I didn’t feel the need to say, “ OK Doc, how long have I got?” I did think though “Well, this must be easy to treat, lets just hook it out and all is well!” I was to discover that it’s a lot more technical than that.

I am not sure how long we sat with “Mr C” but from then on it was all positive. We went though what he proposed to do. Having some knowledge of human anatomy I found it fascinating and even more so when he drew some diagrams. I later thought that if I’d have had some coloured pencils with me, I would have added colour to the diagrams just like I did when I was in school.

The outline of the treatment went something like this:

• Remove the polyp, part of the bowel and investigate if other tissues would need removing.
• Redesign the lower part of the bowel to compensate for the area removed.
• Fit a temporary ileostomy bag to give the bowel chance to rest and repair.
• Reverse the ileostomy re- connecting the large and small bowel at some point in the future.

This may sound complicated, and it is, unless you are a top class surgeon.

Then some encouraging words from “Mr C” “If we find you need chemotherapy don’t worry. You are so fit and well you can handle any anything we need to do to get you well. I will put you on the Enhanced Recovery Program.” He gave an explanation of what this meant which I shall relate in later postings. “I will see you in a couple of weeks” he said. The date for the operation was May 15^th it was now late April.

I am so glad my dear wife always made sure we ate well and healthily and I enjoyed keeping fit. My fitness developed through a love of walking in the hills, running the occasional half marathon, orienteering, cycling, ski-ing and many other outdoor adventures. Hard work yes but rewarding. I never found going to the gym attractive.

My wife and I left the room shocked of course but feeling that the future was bright and that all should be well. As my wife drove home I did think that this was something of a milestone in my life and somewhat of a challenge.

Mmmm…..‘Enhanced Recovery Program’ so I may well be on my bike by August!

Tractor Man

GBNHS

 

 

My Own Nurse or so it seems…

“Nurse H” came to into my life like a hurricane then developed into the calmest, warmest and welcoming summer breeze there could be.

Meeting “Nurse H” was the most serious of all the events up to date as it was her that delivered the results of the tests. The news was not good. The results had shown that the polyp that had been discovered would need to be removed. I can’t be certain if she actually said it was cancerous or I just assumed it was….

However, the following information gave me much more of a shock “ It will need to be removed” said “Nurse H” “and most likely also part of your bowel. You will then be fitted with a bag.” She said this in the best way she could but bad news is the same no matter how well it’s put to you. I simply replied, “ this will change my life totally” and added “I’m an active person and some of my greatest joys in life are walking on the hills, sailing, swimming and riding my bike. I guess all that will have to change” I am sorry to say that my thoughts at this point were quite selfish and I thought only of myself and what my life would be like in the future.

Then “Nurse H” said the most important words that she could ever say to me, “The only thing that will limit what you do is yourself. You can carry on with all those activities even the swimming. This procedure will not mean that you can’t live a normal life.”  This statement fitted in entirely with my philosophy of life, which was to “Look on the bright side of life”. Never give up and never give in to negative thoughts.

Like most people my knowledge of medical matters is limited however, I was aware of developments in recent years in the fight against cancer. I knew that it was a cancer that could now be treated with some success and that……. I would beat it.

“Nurse H” explained to me that an appointment with the consultant had already been arranged and that the confirmation would arrive in the post soon. She added, “Before your appointment the consultant will meet with others who have been involved in the diagnosis so far and those who maybe involved in any future procedures. They will discuss the best way forward. I will also attend.” She did add, “In the end the choice is yours, you don’t have to follow the treatment offered.” I could not think that I would ever reject the advice of doctors or consultants, no matter how upsetting the treatment may be. Why should I? This treatment could mean the difference between life and death. It appeared that she had arranged all this before meeting me. I am sure this happens with every patient but at this point I felt that I was being looked after on a personal level.

I should add that throughout the whole of my treatment I did feel that all the people I met in the NHS were looking me after on that same very personal level which is incredible when you think of the number of people that I met on this journey from discovery to recovery. More about these dedicated people later in my blog.

“Nurse H” was the one person who was easily available at the end of a telephone line when I needed help understanding what was happening with my treatment. She monitored my progress throughout, at the highest standard possible and still does. Many times giving me a boost in confidence and reassurance. Thanks should be given to all the nurses who perform this service.

Well so much for trying to make this post as funny as I can. I had some humorous thoughts but as you have read it was a time of receiving information that was extremely hard-hitting and so this post lacks humour in order to explain the gravity of the situation.

Tractor man

GBNHS