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.