Tiny Aeroplanes

"Do you want to know how long?" my oncologist Dr Ahmad asked me back in early March.

Of course I bloody well did. I'd been trying to get a straight answer to that very question for weeks and the answer ranged from flat out denial along the lines of "we don't know everyone is different" to vague wishy-washy phrases like "medium term" and at last someone was going to give me a number.

I was studying mathematics at the time, I like numbers.

"Six months if the chemotherapy doesn't work, Eighteen or so if it does."

Numbers like pi and e I like. I didn't like six so much. Hell it isn't even a prime.

I could well believe him, we were about a month on from the diagnosis of the liver metastases and things were not going well; I'd been to the doctor to see about getting something with a bit more grunt than paracetemol as the over the counter stuff wasn't touching the pain any more and the neighbours, who we hadn't told, were asking if I was OK as I'd lost so much weight and was starting to get that grey pallor pinched face cancer look.

But six months. "Bugger" I think I said.

Probably followed by "Well, sod that!"

Anyway I made a promise to a very upset Mrs Dracunculus that I would be about to hang something on the Christmas tree that year. A little aeroplane decoration that she'd bought me when I was tooling around the skies in a PA28 (did I mention I'm one of the few dragons that's got a flying licence?)

So having spent the rest of the year being injected with radioactive Yttrium, poisoned by drugs developed from first world war mustard gas, simultaneous projectile vomiting and diarrhoea and not forgetting the man in bed 7 here I am. And here is the tiny aeroplane.

Going to put it up next year too. Sod off cancer.

Ups and downs

Thought I'd better do a blog post as I haven't done one for a while. As you know from the earlier post they've given me a couple of months off from the chemo now and I was due back in the donut of doom for another scan last week and, well the news was good. If anything there's been more shrinking of the liver metastases, enough for them to refer it back to the surgeons.

And duly the surgeons took a look but, as they said at the beginning, there was always a very slim chance it would be operable and so it remains.

I did ask but there's nothing more that they can do to shrink them further at this stage. Chemotherapy drugs are only effective because they attack rapidly dividing cells (which is why incidentally your hair falls out) so if the cancer isn't actively growing the don't work.

So what happens now, well now there's nothing to do but wait. But I'm not entirely sure for what.

Waiting

I'm getting on with life as best I can and despite not having a bucket list I'm cramming a few things in that I fancied doing, last Thursday for instance I attended a wonderful performance of Faure and Debussy at the Concertgebow in Amsterdam. Best tickets in the house of course.

You can't take it with you.

Close, but no cigar

Well the results are in and, to be fair, they're good. Another 50% reduction on the big liver mets and the primary tumour in the sigmoid has also shrunk. However given the number and spread of all the liver mets getting it clear enough to allow the liver resection was always a very long shot and so it has proved. They've shrunk a lot but there's just too many of them still to be able to remove enough liver to give clear margins and leave enough liver to cope with the vast quantities of alcohol* needed to fuel a dragon.

So the bad news is that I'm still palliative rather than curable but the good news is that with the amout of shrinkage they've probably bought me a fair amount of time before I get unwell again, hopefully somewhere towards the upper estimate of how long I have left. It's still there and it'll come back but with any luck that shouldn't be for a while and we have options when it does.

I'm back in two months for a ride in the donut of doom and we'll take a look then.



* A small glass of port and lemon at bedtime

Exams

I've always been quite good at tests and exams, in fact I don't think I've ever actually failed one or had to do a retake. All the way through O and A levels at school, my univerity degree, pilot's licence Navigation and Flight Tests (although I do recall giving ATC at Lydd a minor heart attack by turning left instead of right - I'd put my socks on the wrng feet that day) and I even managed to get my driving licence on the first go.

But you can always revise for tests, read the books, study the set text and student notes, practice with old exam papers, give yourself the best chance at passing.

Last Monday evening I had probably the most important test of my life, the one that says if the chemotherapy I've been having for the last six months has worked. It's a pretty simple test, someone sticks a tube in your arm and you get shoved through a CT scanner a few times. All you need to do is hold your breath for a few seconds when the computerised voice tells you to.  It's not a test you can revise for, there's no book to read, and every test is different. All you can do is lie there and let it happen in the knowledge that if you fail this test there's no exam body you can appeal to and you can't do a resit. If you pass you get to move onto the "curative" pathway, fail and you stay in the "palliative" stream which is the cancer equivalent of being held back a year, forever.

My paper gets marked tomorrow and I get the results on Monday.

I have booked the Daily Mail photographer so we can get a picture of me leaping in the air. I've not failed an exam yet and I don't intend to start now.

And it's over, for now.

So yesterday I finished cycle 12 of my FOLFOX chemotherapy and a nice nurse pulled my PICC line out. It's done, over, and I can have a shower without having to wear a blue plastic bag on my arm.

I haven't been blogging much as everything becare rather routine, a cycle of clinic - chemo - pump off - flush line and back to clinic again on a 2 week merry-go-round. The last couple of cycles have been, to be honest, really rough. The neuropathy is now constant and rather than a sharp cold feeling has become a dull numbness in the fingers and hands and a general soreness in the feet; I'm perpertually exhausted and can barely concentrate. Even watching the Great British Bake-Off is becoming a challenge and I can't work out whose sponge cake belongs to who*

But anyway the chemotherapy is over and that's a good thing. Yes? Well kinda, because apparently I found out this week that despite this bloody stuff poisoning you you also get withdrawal symptoms when you stop taking it and the neuropathy can get worse. Must have missed that part of the blurb when I signed the consent forms.

Of course the big question is "did it work". Well as you may have read earlier it was at least working on the liver metastices so the doctors were hopeful that it'll have carried on working. We find out in the next few days because on Monday I'm back in the donut of doom for a scan, the "multidisciplinary team"** meet on Thursday to read the runes and the goat entrails and the following Monday I get to hear if the man from hepatic surgery, he say yes, or no.

Stay tuned.




* apart from our hairy Irish proto-Gandalf of course - his is the one in the bin.
** one of them has a qualification in Uighur throat-singing, now that's multidisciplinary

Life During Wartime

I follow a journalist on Twitter (@johnelworthy  if you want to give him a follow) and he mentioned in a tweet that he was going to stop using the phrase "x died after a battle with cancer". I was most pleased with this and told him so as sometimes I wonder if I have accidentally joined the army since getting my diagnosis.

Cancer is surrounded by war metaphors. Cancer is an "enemy" to be engaged in "battle" that you "fight" using the "weapons" of chemotherapy and radiotherapy. I really don't know where it comes from but its lazy, innacurate and really tweaks my tail. Its a disease and I'm being treated for it; I'm not fighting the second battle of Ypres for crying out loud.

And of course the soldiers in this battle, that would be me, are always "brave" and "heroic". No we aren't. Bravery is rescuing a wounded comrade under fire. Heroism is running into a burning building to save the life of a child. You have a choice to be brave or heroic, having cancer isn't a choice it's just something that happens to you. Sure as a cancer patient you can be stoical and I think I am* but brave, not a chance.

Anyway the enemy will be engaged once more at Addenbrookes at 1300 hours this wednesday. Synchronise watches men! This is life during wartime



(Any excuse to post a Talking Heads video)

* Mrs Dracunculus may disagree as she has to put up with my grumpyness

Its working, but at a price.

Every couple of weeks the nice folk at the hospital extract a bit of blood from me. As time has gone on the PICC line has become increasingly uncooperative to this endeavor and today in order to get a dribble out if  it involved me coughing, standing up and taking deep breaths. I was beginning to wonder if jumping up and down on a hospital bed like in the Olympic games opening ceremony would be required.

The reason they need the blood is mainly to check that you're well enough for the next round of chemotherapy so they're looking at platelet counts and white blood cells. The other thing they do though is check for certain cancer markers in the blood, one of which is called CEA (which Professor Goole informs me is short for Carcinoembryonic Antigen). In healthy people the level is around 2.5 ng/ml and in your dragon at the start of treatment it was somewhere around the 300 mark indicating one seriously busy set of carcinomas.

Apparently according to my latest leakage into a test tube, I'm now down at 2, indicating that the bastard things aren't growing and we've put them to sleep.

Of course this being cancer it's swings and roundabouts and the wobbly-sit-on-horsey-mounted-on-a-spring in my playground is the fatigue. It's now pretty much constant throughout the 2 week treatment cycle whereas before it limited itself to when the 5FU pump was running and a day or two afterwards. Fatigue isn't like just being tired; sleep doesn't cure it and it messes with your head making concentration difficult and your thoughts as slow as wading through treacle.

"...It is by the juice of sapho that thoughts acquire speed..." I could do with some of that

So anyway because of that I've stopped driving and I'm relying on the Mrs Dragon chauffeuring services.  I should probably get her one of those hats.

Half Time Match Analysis

"Well Brian, football's a funny old game of two halves, both teams are giving it 110% out there and if that had gone into the net it would have been a goal"

So enough with the football, here's my chemo half-time report. They give you a scan after six sessions to see if it's working and I was pretty sure that something was working as I'm feeling much better than I did before the treatment started. And indeed something is, the liver metastices have shrunk by over 50%, the biggest ones are now 17 and 13 mm respectively so that's good. Not good enough for resection mind you but then the oncologist did say the chances were "very remote" they could ever operate on the liver.

So that's the good news. The not so great news is the cancer in the bowel is unchanged, which means at least it isn't getting bigger but it isn't getting smaller either. Also the couldn't find the stent which means, assuming I don't have a tumor that can dissolve metal, that it's come loose and is now probably somewhere in my septic tank at home.  Fortunately as the colon tumour isn't growing it's no big deal and they can always replace it if it becomes necessary.

I'm convinced what's done for the liver mets is the SIRT procedure and I'm now even more pleased that I lucked out by getting onto the treatment arm of the trial. However we don't actually know if that's the case so the reccomendation is to carry on with the rest of the chemo and so here I am, back in chair 10 at the day unit being infused by nasty chemicals.

It's making my nose go funny.

Cumulative

One of the not so nice things about chemotherapy is that it never quite goes away. They give you a break of a few days between sessions but it's not quite long enough for the nasties to clear out of your body. So what happens is the side effects of treatment get worse the further in you go.

Last session, number five of twelve, was where my body decided it had quite enough platinum* and decided that it wanted rid of it and no amount of anti-emetics was going to stop it honking up until it was all gone. Unfortunately that doesn't really work with IV medication but my body doesn't know that. The other fun side effect which I've mentioned before is the peripheral neuropathy, the main part of which is hypersensitivity to cold. This used to just last a couple of days but it's now sticking around for the whole cycle.

So it's a bit of a balancing act the oncologist has; give you enough medicine to work against the cancer but not enough so the treatment makes you feel worse than the disease.

He's tweaked the drugs down by 20% in today's clinic session. I'll know by the end of the week if that worked or if I need to redecorate the bathroom.




*one of the drugs they give you, oxaliplatin, has platinum in it

None of my clothes fit

One of the first clues something was amiss at the back end of last year was the diet that never stopped. Me and the mrs had put on a few pounds over the summer so we decided to have a couple of months of watching what we eat and we duly started to shed the weight and got back to where we wanted to be. However my weight kept falling, and falling...

I'm looking at my weight records and on the 13th of September when I stopped dieting I was 84kg; as of last week I was down to 72kg*.  My cancer is hungry and keeps nicking my food, the little bastard.

Anyway one of the side effects is that none of my clothes fit. It's not just the waistline either which has dropped from a 36/38 to a 32 but it's the everything above the waist as well; t-shirts that were comfortably baggy now feel like you're wearing a tent, jackets don't close in the middle and to work would have to have internal fastenings where your nipples are. I put on some summer trousers the other week, took two steps and they fell down by ankles - which maybe a good look if you're a gangster rapper but you look a twerp if you're a late 40's white computer programmer.  Likewise I put one of my favourite jackets on and Mrs D said "you look just like a kid who's trying on his dad's clothes"; she was right, it actually made me look unwell and I may as well have had a big neon sign pointing at me saying "Cancer Weight Loss Dude"

So I went shopping. I don't like shopping, I like clothes shopping even less.

Mind you with a way smaller frame I found all those fashionable clothes they didn't make in lard-arse dragon sizes will now fit so we had a go at 32 waist skinny fit jeans and blue and white stripy french onion-seller shirts... no Dragon, you looked like a prat when you tried those in your 20's and you still look like a prat in them now.

I went with what I usually go for, outdoorsy active hiking up mountains with a touch of Our Man in Havana travel wear for the more formal side. Mountain Warehouse and Rohan absolutely love me**.

Of course this all costs money, they don't tell you how much this cancer lark costs when you get it but it's a not inconsiderable amount of baubles from this dragon's hoard but at least I have a hoard. I hate to think how others must struggle with these unexpected costs when Mr C comes knocking at the door.

I'm doing a bit of offsetting by flogging my old stuff on eBay. Anyone want to buy a hardly worn dinner jacket? I'm throwing in a free cummerbund.




*That's 13st 3lb to 11st 4lb in old money

**Actually they love my credit card; to them I'm just the means to move it from my wallet to their tills.

Adjustments

A rather sad week as the first real bastardness of the consequences of cancer came to pass. Nothing physical you understand but I sold my horses and now there's a silent set of stables and a paddock I need to get my ride on mower to keep the grass short.

I'd had lots of plans, was going to train Leo to harness as he'd just turned three and was ready to start working and I was going to get a horsebox and take Meadow to shows...

Fig 73: If you're gorgeous and you know it, clap your hooves

... but that's not going to happen. I'm flat on my back or in a hospital five days out of every two weeks and I get tired really easily so I couldn't give them the attention they need and they need to be doing some work rather than just standing in a field being ambulatory lawn ornaments. Fortunately they've both gone to good local homes and are right now being fussed, ridden, cuddled and generally pestered by little girls and probably wishing they were back in my quiet field being ambulatory lawn ornaments.

Going to miss them though, must go and plonk myself on the backs of other peoples horses so I can get my equine fix more often.

On the admin side we have had a step forward and one back. Going forward I'm now going to the little local hospital about 15 miles away to have my pump removed and the PICC line flushed and dressed; this is way better than having the schlep all the way down to Addenbrookes for what is a 5 minute procedure and is saving me a whole load of time, grief and petrol money. Going backwards the oncology day unit have been kicking up a fuss because they originally had me doing my clinic appointment and bloods taken and the chemo treatment on the same day. Now this confuses the poor little darlings at the NHS as its currently taking a life-age of men to get the blood work back that says if I can have the treatment or not* and so I have to have the clinic/bloods on one day and the chemo the next so it's two days of dicking about instead of one.

Bet that doesn't happen if you go private.




* Apparently there's a magic number of white blood cells and platelets you need

Normal

It was three months ago this week that I got the cancer diagnosis and in that time a rather ordinary word has taken on a new meaning. That word is "normal".

In the days "BC" normal was getting the train to work, picking up a bottle of milk from Sainsburys, walking the dogs. Now "normal" in cancer-speak seems to be the most un-normal things you could come up with, for example.

"Now take these poisonous chemicals, they will make you feel really sick, that's normal. We'll give you some slightly less poisonous chemicals to make you feel normal again."

Another one was during chemo last week, bear in mind this is cycle three, I have another 9 to go. I'm getting used to the chemo sessions, trekking back and forth to the hospital is of course rapidly becoming the new normal. Everything is going fine up until they run in the second set of magnesium and calcium salts (another side-effect preventer) and the nurse asks me if I'd like a drink, what came out of my mouth sounded like Ph'nglui mglw'nafh Cthulhu R'lyeh wgah'nagl fhtagn as my mouth and tongue decided they had forgotten how to make words.


Now this only lasted a matter of seconds but caused a bit of a stir and the summoning of a man in a white coat bearing a stethoscope who, after a few questions, established that this can happen on quickly delivered high doses of calcium and that it was, of course, normal.

I'm sorry but accidentally summoning the Elder Gods when asking for a cup of tea and shortbread biscuit is never going to be bastard normal.

But as I'm discovering three months in, as soon as someone hands down the dread diagnosis, nothing will be normal ever again.

Radioactivity

I now make Geiger counters crackle

Fig 27: Yes Ralf, but it might just keep me alive too

So this week had me back in the hospital, this time for the big enchilada, the SIRT procedure.Just to remind you this is the bit where they put these tiny spheres dosed with Yttrium-90 directly into the liver where they should lodge up close to the nasty tumours and zap them with beta radiation and killing them, or at the very least giving them several hard kicks in the nadgers.

Now this is incredibly time critical becuase Y-90 only has a 3 day half life so the treatment needs to be administered whilst its still effective. These spheres are custom ordered from a company called Sirtex in Australia and they are then flown to a nuclear lab in Sweden where they get made radioactive - most likely a process involving nuclear reactors and a moose - then they come to the UK in, I am suspecting, a big lead box with "DO NOT OPEN THIS BASTARD!" written on it in big red letters.  I mention this because as at 4pm on my date of admission the hospital were still waiting on a bed for me.

I made a phone call to the senior consultant oncolgist running the trial.  I had my bed fifteen minutes later.  And as an extra bonus I found when I got in they'd put me in a single side room. Result!

So a good, or at least reasonable, night followed and in the morning after the ritual 6am poking I toddle off for a brew in the day room. On my way back what do I hear drifting down the corridor...

"Nurse! Nuuuuurse! I'm going home now! Nurse!" Yep, it was the man from bed 7. He was still there, still shouting and still giving master-classes in Extreme Gittery. I went back to my room and closed the door.

So let's fast forward to the procedure. Essentially its the same as last week, they thread a wire up through an artery in my groin to the liver but this time squirt in the nasty stuff. I sign the forms and off we go only this time there's a problem as the access artery in my leg didn't like being poked last week and is trying to hide so there is lots of kerfuffle and multiple attempts at wielding scalpel blades, false starts they had to back out of and so on trying to get access.

This hurt. A lot. At one point they must have hit a major nerve as it felt like a flash fire was spreading down my leg. I may have screamed a bit.

However after a few minutes we are awash with local anathetics and the tubes are in position so out come the two boxes of Y-90 spheres. I was rather hoping they would play the incidental music from the Bond movies where the baddie's world destroying death machine is first show but no, NHS cutbacks I guess. The boxes themselves were perspex ones with a couple of knobs on the outside and two small glass bottles inside and from here on it it got all endearingly lo-tech. A couple of needles with tubes attached are poked in connected to me and there's some sort of flush mechanism attached and in the spheres go, helped along by one of the doctors gingerly gripping the output tube with forceps and giving it a gentle shake to make sure it flows smoothly.  One bottle, a third of the total, goes to the left lobe and the rest after a wire reposition goes into the right. The whole thing takes about half an hour and we're done. The doctors are happy, Nuclear Medicine are happy we haven't contaminated the hospital and after half an hour pressing on my groin I'm allowed back up to the ward.

The following day I have a couple of scans to make sure the spheres aren't anywhere they shouldn't be and I'm allowed home. "You may feel a bit flu like" they warn me but actually I feel fine.

Well I did until that evening when I felt I'd been hit by a train. I've been in bed pretty much since then until today with what felt like flu without the fever, that bone-aching tiredness that makes you just want to sleep.

Still I'm here, nothing has exploded and apart from turning into SlumberMan I didn't get any super hero powers.

They do a CT scan in a month from now. Let's hope its done some good.

Anyway here's some more Kraftwerk, because you can never have enough Kraftwerk. Sing along now.

Fig 42: Reisen, Zeit, Medizin, Unterhaltung

Of Angiograms and The Man in Bed 7

Bit of a gap since the last post but my excuse was that I've been in hospital; properly, with a bed and nurses and everything.  I've actually done pretty well as I'm knocking on the door of 50 years old and this was the first time I've had to stay overnight in a hospital.

The reason I was there was they need to fiddle around with my liver a bit before they shove the radioactive spheres into it. Now the idea behind these spheres is that if they squirt them into the correct artery that supplies the cancerous bits with blood these spheres are just the right size to stick in the artery where it narrows thus allowing them to offload beta radiation directly into the tumor. Neat! The downside is that this "correct" artery has a couple of branches off to the stomach and elsewhere and these need to be blocked off first so the spheres don't do to the healthy bits. This procedure is all done under a very clever (and expensive) X-ray angiogram machine and through a wire and tube that's been inserted into the groin and threaded up to the liver.

So on the day of the procedure I'm wheeled off the ward to the lift, then back to the ward as they've forgotten to take bloods to check my platelet count* and then off we go again. Everything is all explained to me and yet more consent forms are signed and then my role appears to be lie under the machine, don't move and hold your breath when we tell you to. In the meantime you get to listen to the two registrars and the senior consultant (the nice and amiable Dr See who came in and advised on the tricky bits) going about their work which, at times, sounded like you were in a machine shop and they were trying to work out which size screws and bolts would fit...

"... well that's a good sized gastric artery so we'll try with two ten-by-fives and the see if we can get a three-eighteenths Armstrong-Whitworth countersunk to close it ..."

Right at the end when all the stray blood vessels are closed in came the guy from Nuclear Medicine with a lead lined box. Now this isn't the treatment but it mimics it and is a very low dose of Technitium-99m which is used as a radioactive tracer. They inject this where they would put the spheres and if it only goes to the liver we're onto a winner.

So I'm injected with this stuff and I aquire my first superpower which is "lie completely flat for the next two hours and firmly press this cotton pad into your groin to stop the bleeding" which, as superpowers go, is a pretty crap one.

The wait isn't too bad mind as I spend most of it underneath a rotating gamma detecting camera which builds up a pretty 3D image of my insides. When it was done the technician showed me the image of my liver rotating round and round in pink and orange hues; it looked absolutely normal, just like in the text books and it's hard to believe there's something wrong with it.

So there we all are and its back to the ward.

Fig 62: An NHS ward, last week .

To be fair I was expecting worse. It was clean but too hot** (enough to raise my body temperature to a nurse-worrying 37.9 at one point) and the staff were great - friendly, courteous and attentive. Even the food wasn't bad.  The big problem was the noise and constant disturbance; the day kicks off at six and they didn't turn the lights down until midnight, everyone including me was on 4 hour observations so even if you do get to sleep they wake you up at 2am for blood pressure and general pokage and this being the oncology ward half the people in my bay of 7 beds are on machines that go "beep" so as they roll over in their sleep they block the flow and "BEEEP BEEEP FECKING ATTEND TO ME BEEEEEP!" happens.

And of course there are always the other patients. Now most were fine, nice people whom I exchanged pleasantries and a little conversation with. And then there was the man in bed 7.  At first I was being charitable and thinking maybe being elderly he was a bit confused, frightened and in pain. Then I thought he was a bit of a git. Then a fully paid up git. Finally I settled on the fact he has a PhD in gittishness from the University of Gittingen and was currently Emeritus Chair of Obnoxiousness and Git Studies at Trinity College.

His constant background routine was like the old priest in the Father Ted comedy series except his yelled phrases were "Nurse!", "Bottle!" and "Tablets!". This went on all night. In the early morning he decided he was going home, whilst connected to two drip lines. The nurses, under lots of provocation including racial and extreme sexual harrasement (he offered a nurse "more than the NHS paid for an hour" at one point) managed to get him back into bed several times until he decided quite calmly to disconnect his drips - fortunately he was just on fluids rather that chemo - and stand up. And promptly fall down.  At this point he got moved to a smaller side ward. Which was probably just as well as a queue was starting to form to kill him just like in Murder on the Orient Express.

They let me go home after two days in which, despite taking earplugs and eyemasks, I probably slept a total of four hours.  That was Thursday. Now you know why I haven't blogged until today. I've been asleep.

A hospital is a treatment machine. It's there to do stuff to to you. It most certainly is not somewhere you go to get better.

And I get to do the whole thing again next week.




* That's important because if its too low I bleed out all over the angioscopy suite and that blows the NHS cleaning up budget for the month.

** But the hospital as a whole has the heating cranked up to the max

Rough as a...

Oh just mild tingly fingers, hadly any side effects at all...

... yeah right, last two days I've felt as rough as one of these.

Fig 12: A Badger's Arse

Don't get me wrong, they dosed me up on loads of stuff to stop the chemotherapy induced vomiting and to be fair that all worked. My stomach did a few backflips but no nausea or vomiting, whoopee. But then the hiccups started.

Hiccups? You're complaining about hiccups? What sort of a wussy dragon are you?

OK now you have hiccups for 12 hours straight, hiccups that even when you can stop them start again and wake you up, hiccups so violent I've wrenched most of the muscles in my ribcage and put my right shoulder out. Oh and the fatigue too. Basically not a whole heap of fun which is why rather than being a busy bee I'm sat here on a Saturday afternoon just soaking up some sunshine.

Now like me you're probably thinking this is some wierd chemotherapy side effect. Well it seems not; it's a side effect of the drugs they give you to counteract the chemo, in this case dexamethazone, and this isn't from one of those "nasty big pharma just want to poison you and take your money" tinfoil hat websites but a peer reviewed medical journal: http://www.ncbi.nlm.nih.gov/pubmed/19276142

Seemed to work too as I skipped the final dex pill and 12 hours later, no more hiccups. Yay!

Hopefully I can just forego the dexamethazone next time with no ill effects but there is a alternative (hooray for Google, we're all clinical physicancs now!) called Aprepitant but it's not normally prescribed as it's more expensive.

They will be prescribing it to me, I assure you <hard dragon stare>

Seconds away. Round one

And so it begins, cycle one (of twelve) chemo sessions are now under way. Yesterday basically involved sitting on my tail for five hours whilst various bags of alternating normal and noxious chemicals were attached to my shiny new PICC line via the machine that goes "beep"

Fig 32b: The Machine that goes "beep"

Said machine is there to control the speed of administration of the chemicals but it does still require a bit of human intervention as when the bags of fluid run down the machine that goes "beep" beeps its low flow alarm and the drip bag needs a jiggle. After about eight or nine times of observing low flow bleeps I did ask the nurse if she wanted me to override the machine that goes "beep"s screen lockout*, stop the flow, jiggle the bag and press "resume" when it happened next time..

Apparently dragons are not allowed to touch the machine that goes "beep". Ever.

Mrs Dragon came down to the hospital to pick me up (because you're not allowed to drive straight after this stuff as it can have nasty side effects) and we both got the detailed burble on possible problems and a nice emergency card for my wallet that says "you have an hour to save this dragon's life - fill him full of IV antibiotics".  After that they connected me up to my Flourouracil pump.That's my slow release chemotherapy drug that rather being pumped in at 125ml per hour like the rest ges in over 46 hours at a sedate 2.5ml per hour and rather cleverly uses a tiny little mechanical pump attached to my PICC line that works off body heat which I thought was ever so clever. The drug itself sits in some sort of medical balloon inside a sealed plastic container that I wear in a bum bag for the next couple of days. It's protected in this way as this stuff is officially labelled as "bad"

It's so bad that we got issued with a cleaning up kit that you'd normally expect to see when cleaning up Chernobil. There's some sterile stuff for sealing up the PICC line but then two double thick bags for putting the drug reservoir in plus any clothes that it got spilled on. You then put all this in the issued bucket, seal it and take to the hospital where it gets thrown in the incinerator alongside all those terminated fetuses the anti-abortion brigade were getting their panties in a bunch over this week.

Anyway that all done it's now 7pm (these are long days!) and I get to go home. It had got chilly in Cambridge by this time so on the walk from the hospital to the car park I got my first side effect symptom, my ears, nose and fingers all went tingly, like snow was falling on them; it was quite nice actually for a couple of minutes.

Mrs Dragon says its called "peripheral neuropathy" and I'm not allowed out in the cold for the next couple of days.




* using a highly sophisticated hacker's method of pressing the "screen lock" button on the back of the unit.

PICC that up.

Things are definitely moving forward now, I'd like you all to meet my new friend, Mr Groshong

Fig 12: Medical stuff

 

In case you're wondering that's a PICC, a peripherally inserted central catheter; the red and white thing is the end of a small tube that goes up a vein in my arm to a tiny valve that's positioned just above my heart. The purpose of this is to make getting all those nasty chemotherapy drugs into me just that bit easier as it stays there until the end of treatment and means every time I go in I don't have the YTS trainee searching for a place to stick a needle. 

I did get a book of instructions with it but they're mainly for the professionals. The patient care bit basically has the same instructions as the mogwai from "Gremlins". Don't get it wet.

Not sure what happens if I feed it after midnight though.

FOXFIRE update

As the machinery grinds ever closer to actually giving me some treatment for this bastard disease I had to go and have another bunch of tests this week including the inevitable blood tests, measuring my height (why do they do that, does cancer make you shrink or something?) and another spin in the donut of doom. This second spin was so they can get a close up look at where the pesky little liver mets are and also to do a "how cancerous is your liver" test because, according to the consultant, if you've more cancer than liver they can't let you on the trial.

Whilst I was there said consultant went through the gory details of what, if I were allocated the treatment group, I could expect and what could go wrong. It seems at best after each dose of the radioactive spheres patients feel like "they have the flu for a few days" and a few other symptoms too all of which I kind of recognised being a child of the 70's and 80's and growing up with that cold war "Protect and Survive" leaflet.

Basically every month they give you radiation sickness. Whoopee!

And that's just the normal stuff, the "well if it goes wrong / you react badly" bits are even more fun ranging from pancreatitis right through to this irradiating your entire liver which, with classic doctor understatement, was described as "life threatening". You don't say.

Ah what the hell, if I don't do this I'm not going to see my next birthday so I signed all the consent forms and went into the randomisation process. And just my luck... I got allocated the treatment group!

Unfortunately this is a bit more delay as they need to co-ordinate chemo and radiation and to do that they need the specialist radiologist who has to guide the tube delivering the stuff to my liver using an angiogram so he needs to be scheduled. Long story short I'm pencilled in to kick of cycle 1 of chemo on the 31st of March.

Here's to glowing in the dark.

UPDATE
Due to some admin juggling by the wonderful trial secretary Amy things have moved earlier so I'm in for PICC line insertion this coming monday, first cycle of chemo on Tuesday (expect projectile vomiting and curses in Ancient Draconian), a week later I'm back in for angiograms to check the hepatic portal vein doesn't have any strange offshoots (and to close them off if it does) and then on the 10th I get radioactive balls.  What larks!

Buckets

One of my friends and commentator on the blog (hi Dragonboy!) mentioned bucket lists a little while back and a couple of people offline have also brought the subject up.

No Lolrus, not that bucket

So what's a bucket list? Well simply it's a list of all the things you should do before you kick the aforementioned recepticle. A bit like those lists you see in the sunday papers when they're desperate to fill a few more column inches before going to press like "25 pretentious hip bistros you must eat in before you're 40" and "50 exotic locations you must visit and catch dysentry in before you retire"

So do I have a bucket list? No, I don't.  I could have one I guess. I've never been to Thailand. I've never been skydiving. I've never made love to a moose. I've never made love to a moose whilst skydiving in Thailand.  The thing is I've already done pretty much everything I can think of that I wanted to do. I've owned horses and my own equestrian property in the country* (and still do), fast sports cars and I even had an aeroplane once**

Piper Turbo Arrow (PA28 201-T) Mine was one of these

Add on top of that the travelling the world and staying in 5 star hotels (added bonus, my employer at the time was paying), hell I was even the keyboard player in a rock band at one time (we weren't very good but it was great fun).  So if I've wanted to do something I've always just gone out and done it and I was kind of looking forward to, well, throttling back a bit and maybe growing tomatoes and showing Meadow at the odd horse show

I am not an ornament. I am a free horse!

(and take this bloody Katie Price headcollar off me)

As a consequence then I don't have a bucket list, nor do I feel the need for one. However if anyone has a reservation at Heston's restaurant The Fat Duck they don't want I might be interested.

You can keep the moose though.




*Don't get too excited, it's 2 acres of reclaimed swamp down a crappy, potholed farm track. We're not talking Downton Abbey here.

** I'm the only dragon I know who actually has a pilot's licence.

Foxfire

It turns out that when you get a diagnosis like mine all this machinery you never hear about kicks into action. I feel like I've been twiddling my talons for the last month since the stent was fitted and nothing has been happening but, as I found out on Friday, there's been a whole load of meetings with liver specialists, surgeons, oncologists, firemen* and other professionals to decide how best to patch up your dragon here. This I found out when I met the first doctor who has actually given me a straight answer without resorting to obfuscation and unnecessary cancerspeak.

One of the first things he did was show me my CT scan - this was done about 5 weeks ago but nobody has shown it to me yet. All I could get was the liver mets were "serious" and there were "several", which when I looked at them on the screen is, to be fair, pretty accurate. There they were, dark grey against the light grey liver*, one... after... another. And they were big bastards too, 2 centimetres some of them and all over the shop. OK so even me whose only experience of surgery was playing that "Operation" game that buzzed if you touched the two metal bits together as a kid could see that you're not going to be able to resection that.

So that's the bad news. The good news is that given I'm this messed up but can still flap my wings I'm eligable as a candidate for the super-sexy sounding FOXFIRE trial - and yes it is all in capital letters. Essentially what this is is the kick-ass chemotherapy that they can give you for this (5-Fluorouracil, OXaliplatin and Folinic acid) but the added bit, if you're on the treatment group is "Interventional Radiotherapy Embolisation"

No that's the Russian plane Clint Eastwood stole in the film.

What this involves is them putting a line into an artery near the liver and injecting very small balls doped with Yttrium-90. That sounds radioactive doesn't it. That's because it is! It decays giving off beta radiation and the idea is that it kills the cancer cells in the liver and their blood supplies. It's not a cure but if it works should make things better for longer.

Now this is a clinical trial so there's only a 50% chance I'll get the radiation treatment but I'm cool with that; I'll get the standard treatment anyhow so signing up for the trial was a no brainer. OK so according to the blurb I've been given there's a 1 in 1000 chance this thing will kill me outright but on the other hand there's a chance I'll also get some great mutant superpowers like this:

A Firefox, yesterday.

... probably not.

We'll find out next monday.



* turns out they only need those for me.
* CT scans are in greyscale

Risky Business

So I have two weeks until my oncology appointment and starting any kind of chemo treatment and so, as I'm pretty much symptom free at the moment*, I was considering four or five days away soaking up some rays and getting a bit of heat into the bones. Now at this time of year there's pretty much only one place for that and that's Dubai. Only 7 hours travel, not too expensive, guaranteed sunshine and the local muslims aren't so rabid that you can't get a beer or two when you're thirsty.

So off I go to lastbargaincheapholidaysfordragons.com and there's a couple of decent deals to be had. Click, click, click I go until it gets to the "Add travel insurance" bit - well it's over a grand if I cancel and my E111** card won't work over there so I guess I better had.

Bzzzzt. Computer says no. You don't even need to have cancer, you just need to have been referred for ANY kind of scan or diagnostic test and they won't touch you. If, gods forbid, you actually have a diagnosis the underwriters just point at you and laugh. Well there are these other sites you see advertised, the ones that claim they will insure you even if you're missing a head. Well it turns out that, no, they won't. They'll cover you for a hulking great premium but only after you've been treated, not before.

I did discover one place, probably called www.deadmanwalking.com or something, that would take me on risk but only after filling in reams of paperwork, providing a letter from my oncologist***, getting special dispensation from the Dalai Lama that in my next incarnation I'll be reincarnated as at least a mammal plus, of course, a vast sum of money.

So I decided sod it. I've stocked up on coal, lit the fire and brought the sun-lamp down from the loft.

Someone bring me a Heineken.




* apart from the fascinating new experience of my right pelvis wanting to leap from my body every time I cough. That's a fun one.

** that's the thing that entitles you to free emergency treatment in the EU if you're a UK citizen

*** who I can just about get an appointment with let alone prise any documents from

Mac and cheese

A while back the red-robed cancer angel mentioned the Macmillan Nurses to Mrs Dragon as maybe able to give us some support; apparently I have to ask for the referral which I duly did and after a week our assigned Mac Nurse rocked up to the dragon's lair*

First surprise to me was that I always thought they were some independent charity; seemingly not as mine had an NHS id badge. The rest came as no real surprise, a basic bit of touchy-feely "so how do you feel"? cod psychology and about an hours worth of waffle on matters me and the Mrs has largely figured out ourselves. Well meaing I guess but helpful? Not really.

One god thing that came out of it was at least she gave the oncologist a poke (he'd been off on his hols apparently as I'm probably bottom of his in-tray) and so I now have an appointment in a couple of weeks. Hardly speedy but not too slow that I could kick up a fuss.



* we have lairs, not dens; don't believe everything you see on the tellybox.

A little island of calm

They say that you really shouldn't consult Dr Google. "Everyone is different," they say; "your symptoms won't exactly match," they say. Generally that's true and you can easily google you cold and flu symptoms and go away convinced you have a combination of Ebola, H5N1 and Choleric Humours in the Spleen.

However after checking out some very serious studies from the likes of Johns Hopkins, Oxford University and the Khazakstan Institute of Horse Medicine* what they tend to agree on is that with my diagnosis you humble dragon is, quite frankly, toast. The 5 year survival rate for any kind of liver metastases is around 6% and I've got quite a few of the little bastards. Also Mrs Tiger had a chatette with primary cancer angel who admitted the main reason they are not going to operate on the bowel cancer is "quality of life" - which is cancerspeak for "you've got precious little time left, the last thing you need is three months recovering from major surgery".

So there you are. Most likely I'll be in a box inside of two or three years**.

Now how exactly are you supposed to react to that kind of thing? 

You'd think floods of tears, raging at God / The World / Fate / The Invisible Pink Unicorn (PBUH), rending of clothing in twain and the like wouldn't you? Well it turns out not. I'm just completely calm about the whole thing. I'm not in denial, I know its going to happen but I feel... nothing; no anger, no fear, no frustration, nothing. Maybe a little wistfulness that it might have been nice to be pottering around weeding the brassicas and showing Welsh mountain ponies when I was 64 but that's about it.

It's a bit bastard wierd I can tell you.




* Note sure they were very useful, it said I probably had worms.
** I'm a dragon, you'll need a bastard big box; better get planing that wood now.

Patching up the dragon

As you probably read in the last entry things took a turn for the serious and with the liver issue my guts surgeon Mr C can't take the primary bowel cancer out as it would cause too many problems with the liver, so the liver mets need bringing under control first. This however causes a bit of a problem as the primary cancer will most likely continue to grow and could end up blocking the colon.

Apparently this is "bad" and would involve flashing blue lights, emergency surgery, intensive care units and nurses and doctors looking at each other meaningfully over my bed just like in Holby City. So to avoid that scenario the doctors are going to put something called a "stent" in. Here's what they look like:

Fig 2: Medical chicken wire

As you can see its basically a medical-grade chicken wire tube. Now they don't need to operate to put these in so on tuesday I get a call from the hospital to come on up to the endoscopy department the following day and they fit my new tube and have another crack at the biopsy at the same time. "And you don't need to take the picolax and fast for two days first," they say

Hooray!

"You will need an enema though, two actually"

Boo!

So two weeks after the original diagnosis I'm back in Endoscopy and a very nice nurse is shoving a tube up my bum. "It should take between two and five minutes to work," she says "and the lavatories are just outside on the left and ri..."

"IT WON'T TAKE TWO MINUTES!"

So on Monday the bottom fell out of my world. And on Wednesday the world fell out of my bottom. Twice

Anyway after that I had a quick chat with Dr D who had done the original colonoscopy who gave me the run down on the procedure and asked me to sign the "consent to poke dragons with sticks" form and in I go, they pump me full of pethidine and some sort of sedative and this time I fall right asleep - I have vague memories of waking up and trying to get up only to be told "Here have some gas and air", biting down on some plastic mouthpiece and some pain but it was all a bit woozy to be honest and afterwards Dr D said it had all gone well so I guess I hadn't trashed theatre after all (always a potential hazard when operating on fire breathing irritable reptiles that).

They kept me in for the rest of the day for observations, especially as I was now "the man who had the Entonox" and there was talk of an overnight admission but good progress (and probably a lack of beds) meant I could go home in the early evening.

So here I am four days later. It's not all been plain sailing as I keep getting cramps in my guts and it would be unwise to stray more than a few metres from the bog but it is starting to settle down so with any luck that's that bit sorted.    

They'd better have got this bloody biopsy right this time!

Our Survey Said...

You're probably wondering why I haven't posted for a bit given that I was going in to get my results on Monday. Well that's because if you remember the old game show "Family Fortunes" it went something like this...

"So your answer was 'It's an easy cancer to fix with surgery and a spot of chemo', our survey said..."


This is me we're talking about here. I don't do straightforward.

You know something is amiss when you turn up for your appointment and the nurse says "OK Who's here to see Mr C" and four of you stand up only for you to be swiftly whisked to one side by Angela, my red-uniformed cancer angel, and lead to a seperate consulting room where you come across Lena, another red cancer angel, who is breaking open several boxes of industrial strength Kleenex.

So after a moment Mr C the guts surgeon rocks up and the first thing he says was "well I'm afraid your scan wasn't clear". I thought that meant they'd got a blurry picture and needed to take it again but apparently this is a new piece of cancer jargon and really means "you've got other stuff"

The "other stuff" turns out to be secondary tumors, or "mets" in the jargon* and they're in the liver. Now apparently this isn't too uncommon but in my case there are several of them and they're spread over both lobes of the liver... here's a liver so you can see what it looks like

Fig 1: The Liver (this bit is bolloxed as well)

It seems that the liver is a very clever thing and as well as tasting great with onions and mash it can repair itself even if you hack 70% of it away, and normally that's what happens with liver secondaries if you've only got the one. Unfortunately that isn't an option for me so they're going to have to try and shrink the mets with chemo first and then see if there's enough liver left to save. And they can't do that right now as they need another biopsy as the first one was "inconclusive" - which either means that the cytology guy get my sample mixed up with his lunchtime yoghurt or they can't work out why a cancer that only affects large fire-breathing reptiles is inside a human (damn my disguise, it's just too good)

They say you should take along a list of questions to these meetings and I did have one but it was all about surgery options and stomas. That list went right out the window when he said "I'm sorry, the bowel cancer isn't operable, I can't cure you with surgery right now." What he can do however is fit a stent around the cancer to keep my colon from blocking and they'll do the second biopsy at the same time. So that's the subject of the next post.

Oh yes I did ask the stupid cancer patient question "How long have I got." They don't answer that any more it seems but the strong steer I was getting was "I wouldn't invest in any ISA products if I were you."




* there will be a test on cancer jargon at the end of the month so do pay attention. Especially you at the back of the class.

Buzzword Bingo

Well not a lot of progress this week from my perspective but today is the day that all the clever doctors and consultants get together, drink tea and eat biscuits, and shuffle through the newcomers to the cancer rollercoaster's scans and biopsies and decide just how screwed you are and how best to treat you.

This being the brave new world of management speak these people are "The Multidisciplinary Team" and no doubt they will be "creating holistic care pathways" that will result in "positive patient health outcomes" whilst remaining "true to core clinical values and in keeping with our community health centred ethos; now sit there and we'll play you some whalesong"

I think they're missing a trick. They should call themselves "The Funky Tumor Prodding Squad"

They'd better get me an appointment with them soon as I'm running out of fingernails here.


UPDATE: Abut 10 minutes after posting that the hospital rang, I've got thr first appointment on Monday.

Radioactive metal doughnuts

Sunday, ah we all like sundays. Stroll to the shop, read the paper, roast dinner and an afternoon snooze.

Well you might have but I didn't. Sunday found me back in hospital as for some reason that's when my CT scan was scheduled - rather a surprise as I figured the NHS wouldn't work weekends. The hospital was a bit of a strange place on the weekend, none of the frenzied activity when I was there the previous week for the colonoscopy, just a few people milling about and of course nobody on the reception at the CT suite.

The Radioactive Doughnut of Doom
(your actual NHS model might be a bit older and more tatty)

However after tem minutes or so someone rocked up and I was sat down with a big jug of water and told to drink it slowly over the next hour. They didn't tell me what it was but being of a scientific bent I figured it was some sort of barium solution or something similar. I was rather expecting it to taste foul but it just tasted of water. I was surprised how busy the CT suite actually was with a steady stream of people from the wards and A&E trundling through for scans including one poor old sod who was having a full body scan "so we can see what's making you go all wobbly Mr Smith" - honestly if* I ever get old and they patronise me like that they're going to get both nostrils set to "crispy"**.

Anyway after an hour of glugging my show up on the machine drink and chatting to Mrs Miggins and her sister who'd come in for a look at her dicky bladder it's my turn in the doughnut of doom. Again, as seems to happen these days every time I enter the gravitational field of a medical professional, they stick a needle in my arm but this time it's connected by a long spiral tube to a pointy-nosed drug dispensing robot. This was easy according to the technician working doom doughnut as I have "good veins". Well at least there's something on the dragon that works.

So after that the tech dissapears and the doughnut of doom slides me into itself, whizzes its internal mechanism round for a quick look and then winds itself up into a spinning frenzy like a cross between the Stargate off that show on the Sci-Fi channel and my washing machine on a fast cycle; an american voice tells me to hold my breath and then I'm shot through the machine. This happens a couple of times and then the beast starts to spin down (without having fired me to the far reaches of the galaxy to do battle with the Goa'uld - bit of a dissapointment that) 

So that was that, relatively painless and the scan itself was done in a few minutes.

And now it's back to waiting.

There seems to be a lot of waiting.



* big "if" at the moment I guess
** I can breathe fire you know, proper dragon here, not like those wussy Chinese ones that just make it rain.

Be a Pain in the Arse

One of the folks who follow me on Twitter suggested that I do a post about what made me go to the doctor in the first place as it might help people who stumble on the blog do the same. Good idea I thought so here it is. However if you're eating you might want to stop, this is bowel cancer, "icky" comes with the territory.

I'd been feeling a bit tired and lethargic for some weeks and things I'd previously enjoyed like studying for the Open University (I was doing a mathematics degree) were starting to feel like a chore. I didn't think much of it though as it was getting into winter, the weather was miserable and dark and I don't do dark winter too well so I just put it down to a touch of the winter blues. Then a couple of weeks before Christmas the constipation started. Again nothing to worry about really, guzzle a couple of Senokot before bedtime and that'll be fixed. Only it wasn't, my arse end resorted to doing small and frequent micro-poops, very unpleasant cramps accompanied by what can only be described as clear jelly with blood in it. Hmmm... not good but what the hell, it's Christmas, I'll get past that and then we'll see,

Stupid prat of a dragon that I am I put up with three weeks of that before going "well whatever it is I doubt its piles" and trundled off to see my GP who I'd last seen about 5 years ago when I broke a couple of ribs falling off a horse*.  He pokes and prods a bit, shoves a finger up my bum and goes "well it's not constipation" and when I tell him the rest of the symptoms he goes all serious. "You tick all the cancer boxes," he says to me "but I'm not supposed to refer you until you've had these symptoms for six weeks..." 

Here we go I thought, your wonderful NHS death-machine at work...

... "but I'm going to refer you right now." he said, leaping panther-like to his computer keyboard and typing up the referral then and there.  "I just want to be sure, it's unlikely, at your age less than a 10% chance."

Hey I used to suck at passing my saving throws when I played Dungeons and Dragons too.

I guess what I'm trying to say is I had a good GP who was prepared to push the rules a bit. I know the NHS has to ration care but if you do get a change in bowel habit and it lasts more than a couple of weeks then go and see your doctor and be a bastard nuisance. It's your body and they only let you have one. Kick up a fuss, be a squeaky wheel and get yourself seen. Also if you get one of those test yourself kits, use it. I was reading the take up rate is less than 50%. Yes you need to poke around in your poop for a while but hey, just wash your hand afterwards.

This has been a Dragon public service broadcast. Take heed or I'll set you on fire.




* among my many lacks of talent I'm a very keen but lousy horseman.

Its cancer guys, not leprosy.

I went into work this Monday having taken the previous week off on sick leave so I could get all the tests done. Yes I know I'm "sick" but I can still function and as my job is mainly shuffling ones and zeros into a particular order I'm pretty sure I can do that for now until they start pouring nasty chemicals into me or making holes in me.

To be fair my boss was very understanding and sympathetic when I told him the diagnosis (we've got on well as colleagues for years, even before he became my boss) but he did wonder why I'd come into the office (errrr, because I can?). I told a few other people around the office too when they'd asked where I'd been the previous week and I did get some odd reactions; one in particular started going on about the lead character in the TV series Breaking Bad* but most were "but they caught it early" or "It can be treated can't it?" - I said yes to both questions but in all honesty until I get the scans done and the biopsy results back the honest answer is "I haven't a scooby" - and a general sense of people being uneasy around me, kind of like I was a dead man walking.

Anyway after lunch boss came over and said that I didn't need to be there and he's happy for me to work from home until I get the treatment plan so off I went. Fortunately we don't have much on at work at the moment (lots of reorganisations - won't bore you with the details) so I'll be taking the opportunity to pick up a couple of new skills that might come in useful in the brave new world.

But I can't shake the feeling of there was a sigh of relief when I walked out the door... "Thank God he's gone, he was creeping us out"



* I would not have a clue how to make Meth. I know how to brew beer though, does that help?

The Colonoscopy Diet Plan

Want to lose 3 kilos (six and a half pounds in old money) in two days? Have a colonsocopy!

It's not much of a diet plan I know but last Wednesday, having had a small periscope thing called a sigmoidoscope shoved up my jacksie, they said they needed a proper look with the whizzy camera at the big hospital. No problem there as this camera is a tiny thing at the end of  a fiber-optic line but the kicker is they need you "empty" so they can get some good footage (they probably upload the best bits to YouTube)

So back comes nursie with my invitation to big hospital and a blue box with two sachets of powder in it. "You'll need to take one of these in the morning and one in the afternoon" she says, "stay off work, don't go out and stay near the loo."

Which wasn't quite right, what she should have said was "You might want to run Ethernet to your lav and stream the last two series of Game of Thrones off Netflix because you and your porcelain throne are going to get to be really good friends over the next 24 hours."

Let's jus say last Thursday wasn't the best day in my life although I did get to drink Lucozade like when I was a kid.

Anyway Friday dawns and I weigh myself. 78.5kg, down over three kilos. When you think about it that's an awful lot of stuff working its way through you at any one time. So I'm now allowed to eat again, yay! Trouble is your guts don't seem to like being turned off and on again like your laptop so its rather uncomfortable as everything gets back to normal - plus of course Mr Poo still has to negotiate its way past Mr Tumor and he's still being a bastard so that's uncomfy as well.

However it is giving me a perfect excuse to lounge around on the sofa on a wet Sunday. Might even watch some more Game of Thrones.

"You've Got Cancer"

I'm pretty sure that's what he said, it was quite direct anyway. A few minutes earlier the doctor who just handed down the words nobody ever wants to hear had been fiddling with a camera inside my guts and although I was partly sedated I could see on the screen that they kept returning to this white blob, eventually squirting it with something that made it into a black blob.

I should have figured at the time the gig was up, I blame the happy drugs they gave me as I was away with the unicorns ;)

The Mrs, who we'll call Tiger in this blog* took this news rather worse than I did (in fact I think my only response at the time was to go "On, that sucks" - unicorns you see) and for some reason the doctor giving me the news then seemed to address everything else to her. I almost felt like saying "Hey dude, I'm the one with the disease, remember?" but as I'm currently learning the mere mention of the "The C Word" seems to have the power to make everyone lose their marbles.

So anywhere there you go, that's how this got started.

I'm really not expecting anyone to read this blog, it's really just for me to scribble down thoughts and feelings and get shit off my chest. Hopefully thought it'll be a bit factual if you're going through something similar and maybe I'll squeeze an off-colour joke or two to do with bowel functions that'll make you smile.

But anyway, the colonoscopy is done, the pain killers have worn off and I'm still pretty stoical about the whole thing. I'm not in denial, I know it's there and it's serious its just I seem to have skipped the whole "seven stages of grief" stuff** and gone straight to acceptance (do not pass Go, do not collect £200). I'm just waiting for the next set of tests - that's a CAT scan scheduled for next week - and then all the clever doctors get together to decide a plan of action for treatment.

I'll probably start wibbling around then.





* because its not her name and it gives me the opportunity for very lame "Crouching Tiger, Hidden Dragon" based puns going forward.

** do not take that website seriously, they've used Comic Sans, the typeface of morons.