Wednesday, 19 July 2017

Our Days Out

We inhabit an island with unpredictable weather. T’s mother says that there is only one rule for living here: when the sun shines drop everything and go out. On our staycation we have been doing our best to follow her advice. Our two long sunny days out were good in the main, but with an unexpected twist. And it is bucketing down as I write this.

Monday promised to be a hot day with unbroken sunshine. T arranged to meet a pal of hers in Belfast for lunch and some shopping. I took the bike down to Castlebellingham in Co Louth and followed the coast road south. My bike computer showed 80 degrees F with a cooling breeze coming off the sea. I stopped at Termonfeckin for lunch. It sounded like a place out of Father Ted, but the cafe brought me a good bowl of soup and bread. When cycling with my herniated diaphragm and restricted stomach, I know I need to eat foods that are easily digested.

I headed on into Drogheda, a pretty undistinguished place apart from one medieval gate. Turning inland I lost the sea breeze, the sun got hotter and the hills began. By the time I got to Mellifont Abbey, the remains of the first Cistercian monastery in Ireland, I was feeling rough. The lunch had disagreed with me, my stomach was inflating with wind and was depressing my left lung. I was overheating. I tried to drink more but it wouldn’t go down.

From there it was a lumpy 15 miles back to the car. I struggled up the hills, very salty sweat running into my eyes. The bike computer showed 92 F, the highest I had seen on this island. As I cycled on, via Monasterboice, I began to have irrational thoughts, almost delusions. I saw myself standing by the side of the road watching me inch my way up the hill in bottom gear. It felt a little like when I was cycling in Sri Lanka around ten years ago and I got a touch of heat stroke.

I managed to keep on going and thankfully reached the car. It was 6pm and still 80F. Despite the bad guts, depressed lung and dehydration, I had just completed my longest ride this year: 46 miles. I rested for a while; then drove home very slowly. T was already home and tended me caringly. I lay on the bed and drank rehydration salts. Enormous farts began and continued all through the night. I didn’t sleep much. Although I am accustomed to the sun, my face, arms and legs felt sore. The next morning I had the runs. My light lunch in Termonfeckin had indeed proved costly.

By midday I was starting to perk up and T was keen to go out into the clear blue afternoon. ‘It’s boiling’, she said. Unlike the day before, I packed a hat. We did a tour of Lecale by car, starting off at the stone circle in Ballynoe, which is the largest in NI and has a lovely holloway down to it. Unfortunately over recent years it has become festooned with hippy tat; ribbons, wool, bits of shiny metal dangle beside your head as you make your way there. Thankfully we were alone at the stones themselves.

We drove on through Killough and Ardglass, which was a major medieval port and a holiday resort for early Victorians, with a ladies’ bathing house in the harbour. At Kilclief Bay we had a picnic, went paddling and spotted small flatfish and a hermit crab in rock pools. After ice cream at Strangford we walked to Audley’s Castle and around the coast to Castle Ward.

Two grand days out in warm sunshine before four days forecast with unseasonable wind and rain. Mammy T had indeed been right.

Thursday, 13 July 2017

The Staycation

The deadline for confirming our hotel break was nigh but the weather forecasted for Mayo was very unstable. T and I had to make a decision about whether we would take the room or not. We talked it through but found it hard to decide. Then I confessed that I had first made the hotel reservation because I thought she wanted to go away. T confessed that she had agreed to this trip because she thought I wanted to go away. We laughed. We were both trying to please the other when each of us would have preferred something else.

O Henry wrote a story that illustrates this type of misunderstanding. A young but very poor couple want to buy each other a special present for Xmas. The woman has long, beautiful hair but sells it to buy her husband a gold chain for the pocket watch that he has inherited from his grandfather. The man sells his grandfather’s watch to buy his wife a jewelled comb for her beautiful hair.

The good thing is that we confessed to each other before any disappointment could occur. Otherwise we might have ended up driving all the way to Mayo, watching the rain beating against the hotel room window and feeling some resentment against the other. So we cancelled the hotel reservation and began to plan days out and days at home.

T wanted time to sort out her clothes, books and other things, having been hard at work and dealing with me in and out of hospital since she moved in a year ago. I wanted time to do a series of good long bike rides before I went back into hospital and became incapacitated for months.

The next day the sun shone and we embarked on both of these plans. T pulled out all of her things that had been stored in boxes and began to sort through them. She put them in piles to keep and piles to give to the charity shop. Then she set about rearranging her books and other possessions. It was a grand summer spring clean.

I got out my maps and planned to redo a bike ride that I had last done before I got cancer. I drove to Ardee in Co Louth and rode through winding back roads to Kells in Co Meath. I had lunch in a second-hand bookshop with a cafe and then returned via a new set of back roads to Ardee. It was a grand day out in warm sunshine, the bike ride was 42 miles and took me the best part of five hours in total. The drive to Ardee down the motorway took less than an hour.

At the end of the day we both felt happy and satisfied. Our staycation had begun well.

Tuesday, 4 July 2017

The Getaway

June elapsed, day by anxious day. I was sleeping fitfully with bad dreams and plenty of wakeful episodes with worrying thoughts. I arose most mornings feeling worn out. My hospital bag was packed and sat on the bed in the spare room. I twitched every time the phone rang and again when the post dropped through the letter box. By not being called in to hospital I had a ‘stay of execution’, but it was an unhappy and stressful escape. After pondering for a while, I decided to face my demons. I would ring the hospital to find out when my surgery, planned for June, would actually take place.

I began with my surgeon’s secretary, but I couldn’t get through. I left a message on her voicemail. The next day she rang me back. I explained that I was waiting for surgery and had been told I would be operated on in June. She gave me the phone number of the person who scheduled cardio-thoracic surgery at the Royal. I got another answerphone and I left another message. The scheduler rang me back several hours later. I told her my story.

‘The soonest you could be admitted for surgery would be September,’ she said.

I gasped.

She went on. ‘His theatre list is already full for the summer with people needing surgery for cancer.’  

‘I understand,’ I said, ‘I’m only ringing because the surgeon himself told me that I would be brought in during June.’

‘That was a little unrealistic,’ she said, ‘he’s only in theatre one day every two weeks.’

I thanked her, put the phone down and sighed with relief. A heavy weight had fallen away from me. I told T. She was delighted.

‘We’ve been given the summer back,’ she said.

I grinned. ‘Let’s book a holiday.’ 

I turned to my computer and found the website of our favourite hotel: The Mulranny Park. It overlooks Clew Bay and Croagh Patrick. They were offering short breaks and we booked one. That evening we went out for a meal at our favourite restaurant: The Mourne Seafood Bar. The food was excellent as usual. Afterwards we walked on the beach at Murlough, fresh sea air blowing into our faces. And that night I slept more soundly than I had for many weeks.

Sunday, 25 June 2017

Long Runs The Fox

The fox walked steadily up the centre of our lawn, nose to the ground. I grabbed my camera and took this picture through the bay window as it passed about fifteen feet away. The fox proceeded to the top of the garden and then came back down following the hedge. It was an adult fox, more brown than red, and the first fox I have ever seen in our garden. Although we live in the country, foxes are infrequently seen hereabouts. But the very next day, I saw a different fox, smaller and redder, coming towards me down the lane from our house. What should I make of this visitation?

The fox appears in mythology and folklore all over the world. It is an animal that is clever and resourceful, able to outwit the efforts of the more powerful to hamper or persecute it. For many cultures the fox is a magical creature, a spirit messenger. The fox can also take human form, most often as a woman. The fox is intelligent and passionate but rarely a malevolent spirit. The fox is most often a helper, offering its qualities of quick thinking and adaptability to those in need.

Meanwhile, I still twitch when the post arrives or jerk when the phone rings. But I have heard nothing from the hospital. My first thought was to phone them and chase up my admission for surgery. But then I thought that no news is also good news. I don’t have to ring and remind them. I have a ‘stay of execution’ in which I can enjoy more of the good weather of the summer and do a few more bike rides in the fresh country air. It also means that I am able to attend the end of year parties of my Writers Group and of the Sing for Life Choir.

I take it one day at a time and do my best not to think about the ordeal to come. However, anxious thoughts about the dangers of the surgery and the pain I will be in afterwards still come to me regularly. Sometimes I also imagine myself as crippled by the procedure and in permanent pain. I do my best to calm myself and dismiss these thoughts, but they still come to me unbidden, most often at night.

I am even starting to bargain with myself about the impending surgery. A little voice keeps saying to me – ‘well you are fine at the moment and can do most of the things you want to, so why do you need to have that terrible surgery at all? Haven’t you suffered enough already?’ I know there are a lot of good reasons why I should have the surgery but it seems so much easier to run away from it at the moment.

My hospital bag remains packed and sits on the bed in the spare room. I wonder if that fox was trying to tell me something?  After all, isn’t the fox an archetypal survivor?

Monday, 12 June 2017

Double, Double, Toil and Trouble

It has been an eventful week, during which my mind has turned to the Scottish play. After a campaign of smears and mud-slinging by the right-wing press, I’m delighted the national electorate swung towards a message of hope. Discredited Theresa May is now said to be on ‘death row’ and there have been street protests in Britain about her new friends, the DUP. Locally, I’m sad that our hard-working constituency MP, Margaret Ritchie, has been beaten by an abstensionist. This effectively silences us on any issue, as our new MP will not turn up to do anything on our behalf at Westminster.

I have my hospital bag packed. But I’ve not had a call from Admissions. So I wait anxiously, try to stay well and don’t make plans. It’s not exactly ‘death row’ but each day I wonder if this will be the last time I am able to go for a bike ride, or mow the lawn, or go out for a meal, before I have the surgery and become incapacitated for a long while. I’m living normal life with a heightened intensity as there is an underlying sense of grief at the losses I will suffer for many months to come after going under the knife again. Allied to this is also the fear that something might go wrong and I could be incapacitated forever.

Being experienced at major surgery (having come through two episodes of it in the last 18 months) means that I also know how tough an ordeal it is. I know my body can recover but I have no illusions about the severity of the pain that has to be endured and the long, hard struggle of recovery.

Our dear ginger cat, Cyril, has been missing for several weeks now. We’ve looked everywhere for him, and have put posters up offering a reward. Next door were feeding him each day in the porch of our house whilst we were away in England for a long weekend. But he has been missing since then, whilst his nemesis the big grey feral cat has been very evident in the garden. We think Cyril was beaten up and chased away so that the big grey cat could take all the food. One day last week the big grey feral cat sat in our back yard all afternoon in heavy rain. He just shook his wet pointy-eared head and glowered at us, green eyes glinting. We have renamed him Grey Malkin after the witches’ cat in the Scottish play.

Perhaps I now need to boil a brew of toad, newt, snake, bat, frog, lizard and owl to help foretell my future. But even then I probably wouldn’t be much better off, as the witches’ spells for Macbeth were highly equivocal. The only way to reliably get to the future is to dig deep and live through whatever ordeal you are presently confronted with. This is as true for me as it is for the UK.

Sunday, 4 June 2017

Surgery Again

I am delighted with the all clear on my latest cancer surveillance scan. But there is a downside. It means I will shortly have to go into hospital for surgery: a thoracotomy to repair a diaphragmatic hernia. Last month I met the surgeon at the Royal Victoria Hospital. He explained the procedure and the risks and I signed the consent form. He told me that the surgery would be scheduled for this month, conditional on my scan being all clear. So now I am waiting for the phone call from the hospital. Frankly, I am dreading it.

This surgery is needed to repair a hole in my left diaphragm that was caused by the first big operation I had in 2011. I then needed open heart surgery to safely remove the tumour that had grown up my vena cava. My chest was opened up and the diaphragm cut as part of this procedure. At the conclusion of this long and complex operation, either the diaphragm was not sewn up properly or some of the stitches did not hold.

Some six months after the big operation I was offered surgery to repair the diaphragmatic hernia. I was still in a lot of pain from the big surgery, so I deferred it. Six months later I was again offered the surgery, I wasn’t mentally ready to go back in for another big operation so I deferred it again. At the next review, as I had learned to adapt to my limitations, the surgeon suggested that I continue to manage the problem conservatively (i.e. without surgery).

I did this for another year or so, but then I developed asthma. The specialist reckoned this was due to my left lung being under stress because my stomach was wedged in the diaphragm. I was living with restricted breathing, particularly after eating. He recommended that I again consider surgery to repair the hernia. I met the surgeon two years ago and was discussing having elective surgery when I got the first of my cancer recurrences, followed by the first of my post-operative lung collapses.

So to cut a long story short, here I am nine months after the surgery to remove the second cancer recurrence and I am now preparing to go back in to have more surgery. It aims to restore my normal anatomy and should prevent further lung collapses. Fingers crossed that this will be the end of it.

Because of the two recent operations I was forced to have, I am now much more experienced and know that I can recover from the ordeal of major surgery. But I realise that this operation is bigger than the two previous ones. And when the surgeon tells you that you will be ‘sore’ for three months afterwards (they normally minimise these cautions), it means you will be in a lot of pain for some considerable time: at least six months and probably longer.

A thoracotomy means that your ribs are split open to gain access to your lung and diaphragm. The muscles between the ribs are cut and they take a long time to repair. Nerves run along the edges of the ribs too and are easily damaged (one of the risks). Anyone who has had bruised ribs will know how painful it is just breathing, let alone coughing and sneezing.

The other issue is that the exact nature of the hernia and the extent of the repair will only be known after I am opened up. So how likely the procedure is to be successful is also unknown in advance.

My stomach has become fused to my diaphragm, so they have to be surgically separated. This means the very delicate cutting away of the tissues of the diaphragm from the stomach, being careful not to injure it (one of the main risks). Then the hole in the diaphragm is repaired with a polypropylene mesh patch that is stitched in place.

I am told I will be in hospital for up to two weeks and incapacitated at home for three months or more. I will also have to be very careful for a good while and not undertake any activity which could pull the stitches in my hernia repair.

I have met the surgeon three times and have asked lots of questions. But when I signed the consent form my heart sank. The rational part of my mind realises that it is sensible to have this surgery, but the rest of me is in a state of fear. I've had enough of hospitals and surgery. I am dreading the call. It could come any day now.

Saturday, 27 May 2017

Two Awards

I’ve just had the results of my cancer surveillance CT scan. Thankfully I continue to be all clear. After the long anxious wait, it feels like an award. It’s a bigger prize than the one I was shortlisted for in England. I’m relieved and delighted. My Oncologist says she is pleased with my progress. She still thinks I’m at medium to high risk of a further recurrence. But she will relax the surveillance regime a little. For the next year I will be scanned every four months (rather than every three).

Going away on a short break was a good strategy for coping with the enormous anxiety of waiting for the scan results. We stayed with my oldest friend Phil, who lives in the New Forest. We first met aged eleven. He lost his wife, Jean, to cancer four years ago.

Phil is a volunteer ranger in the National Park. He took us to some woodland near Lyndhurst which is being looked after by a local woodland management and charcoal-making charity. They take people on guided days out in the forest, show them how they manage the woodland, help them to make garden chairs from coppiced hazel and have a modern charcoal oven. Their guided days out are very popular and they will shortly be featured in a Channel Five documentary.

We walked through dense woodland, ungrazed by deer and ponies (kept out by high fences), and came across some ditches that dated from Saxon times. Wandering amongst the heavy green foliage felt like we had gone back in time to when the country was largely covered by broadleaved trees. It was a great distraction from the worry of waiting.

Phil drove us to the awards ceremony in Berkshire. The prizes for the Stanley Spencer Poetry Competition were presented by Lord Young in the little art gallery in Cookham. My heart raced as the names were read out. Alas, I was not called. My award was to be selected for the shortlist of this major prize.

At the reception afterwards I met the grandson of Stanley Spencer who is compiling his letters for publication in three volumes. Stanley had a very colourful personal life. He became infatuated with his life model and left his wife and children for her. After the divorce, he married the life model only to discover she was a lesbian and just interested in his money. He then sought reconciliation with his first wife and wrote very long letters to her, one of which was over 20,000 words. Understandably, his first wife remained unmoved. Stanley remained unhappily married to the life model, the marriage was never consummated and he kept writing to his first wife, even after her death.

On the way back we visited the Sandham Memorial Chapel near Newbury. It is a wonderful place, entirely covered with murals from Spencer’s experience as a medical orderly in the First World War. The chapel is filled with panels each detailing the everyday life of the soldiers: their work, encampments, relaxation, hospital treatment, death and resurrection. The place has an early Renaissance feel, indeed the chapel is based on one painted by Giotto in Padua. The central mural is the Resurrection of the Soldiers, where men and animals climb from their graves or from where they had fallen, carrying crosses. As a medical orderly, Spencer saw a lot of carnage and had to do all the worst jobs. He said he had buried so many dead bodies that he felt sure there must be something beyond death.

The murals are an immensely powerful work, most people in the chapel gaze at them without speaking. They capture the detail of everyday life and reveal the extraordinary that is within it. This forms the great theme of Spencer’s work, which he realises with such passion and intensity. Indeed, isn’t this exactly what poetry is seeking to achieve?