Yuletide

I hope you all have had a lovely Christmas. And if it hasn't been lovely, I hope it hasn't been too difficult. I know exactly how it feels not to have a happy Christmas. Indeed, last year I was in hospital after major abdominal surgery.

This year T and I have had a very happy and relaxed time at home. We ate duck, turkey and gammon with chestnut stuffing. We drank mulled wine and champagne. We scoffed mince pies, Christmas cake, Baklava, dates, chocolate and nuts. We sat around our large tree and enjoyed plenty of good presents from family, friends and neighbours. And we slept in, often not rising until noon.

It has been a time of indulgence and celebration: giving thanks that I am not where I was a year ago; giving thanks that I have come through two recurrences of my cancer.

In-between all the sleeping, eating and relaxing we managed a few local walks, giving Rex, the farm dog, a present of extra biscuits. He was happy to see us, as usual, and rolled over in the farmyard to get his throat, ears and belly rubbed.

We got so relaxed that we almost forgot that we were going away for Hogmanay. So we have been frantically packing.

Wishing you and yours a healthy and fruitful New Year.

I'm wishing for a cancer free 2017.

Paul xxx

Dear Friends,

Thank you for following my blog. Your support and encouragement has made a real difference to what has been a very difficult year for me.

As you may recall, after four years of being all clear I had a recurrence of my cancer and this time last year I was admitted for major abdominal surgery. Due to some complications I ended up staying in hospital until Boxing Day. T decorated my bed with Xmas lights and tinsel, the nurses called it Santa’s Grotto!

Unfortunately, they didn’t remove all of the bad cells and six months later the tumour had regrown in the same place. In early September I went back into hospital for more surgery and have been recovering well since. I had a scan a month ago and that was all clear, but you need a series of them to be sure.

T and I have exchanged rings and have set up home together. She has been great throughout these hard times. I don’t know what I would do without her.

While recuperating from the two periods in hospital, I’ve continued to write poetry and my weekly blog. I’ve also managed to become active again, walking and cycling regularly. And I’ve rejoined the Sing for Life choir.

I very much hope your troubles have been few.

Wishing you and yours all the very best for Xmas and the New Year.

Paul xxx

Speed Dating

T and I have never been car enthusiasts. We can’t stand Jeremy Clarkson or Top Gear. All we really want from a car is for it to start reliably, drive well and not cost us too much to get through the MOT. Due to a series of unfortunate events, T has become the owner of two cars. But neither of them works. And we have been forced to enter the murky world of automobiles in more depth than we ever wanted.

For years T had driven a German car with a reputation for its engineering. She never really liked the car that much. The seats weren’t comfortable and it drove badly in winter, needing two sacks of sand in the boot to keep it on the road. But it was very reliable, until one day a couple of weeks back when the engine failed and it rolled to stop on the motorway. The car was dragged away at some expense and then taken back to her garage. After some delay we were told the timing chain had broken and had seized the engine. The options were to fit a new engine for £3000 or sell it to a breaker for £500. As the car was nearly seven years old, the latter was the only realistic option.

Fearing the worst, we had already started looking for another car. I sought the weekly magazine called Auto Trader, but was told that it was now all online. Checking through the site we realised it was a little like computer dating. You surf the possibilities, look at their shining photos, read the description of their best qualities and make a short-list. Then you arrange to see them. But this often leads to disappointment, as you find they weren’t quite what you expected. And when you test them you can encounter some unsavoury features.

Car salesmen are also very much of a type, whether at a main dealer or on a small lot somewhere on a country road. They are full of blather and would say almost anything to get you hooked. Despite wearing sharp suits, they would be fully at home at a country fair selling horses with nods and winks. You can well imagine them spitting in their palms to seal the deal.

In the end, we bought a Fiesta from a main Ford dealer; it was three years old with a Powershift automatic gearbox and low mileage. The car cost £7500 with a year’s warranty. We picked it up on Saturday lunchtime, just before they closed. On the way home the car began to judder and rattle alarmingly, this got worse on hills.

We rang Ford and complained. They asked us to bring the car back in for a check. We did so the next day. They confirmed a fault with the automatic transmission. We asked for our money back.

A manager came over and spoke to us gushingly. He offered us our money back, but pleaded for an opportunity to fix the fault at no expense to us. As T liked the car in every other respect, we agreed. He also promised that if the fault was not fixed then we could have our money back. I asked him to put this agreement in writing and gave him my email. He looked at me uneasily and gave me a half nod, then shrugged.

I drove T home and waited for the email. When it didn’t come, I summarised the agreement in an email to him. The next day, I had to take T to her local appointments in my car. At the end of the day I got a call from the manager, he said he agreed with my email. I again asked him to put this in writing, he replied to my email but carefully avoided confirming the agreement. The day after I took T to the Belfast bus and picked her up on her return. Then we had a call to say her car was fixed.

Again we picked it up on Saturday lunchtime. For a wee while it seemed to be going better, then the juddering and rattling began again. Exasperated and unhappy, we returned the car to them. They said that they would fix it for good this time and offered T a hire car for the week. As T still liked the Fiesta, we decided to give them a second chance.

This car problem really bothered me. It was the same week that I was waiting for my scan results. I didn't need another significant stress. I was afraid that we had bought a lemon and that Ford would do their best to avoid refunding us. Might we end up being stuck with it? 

The following Saturday we again collected the car, hoping against hope that the fault might be fixed. But the car juddered and rattled, just like before. We raged and railed. It was over. We had reached the end of an unhappy road with this car. With regret at all the time we had wasted, we returned the car to Ford and asked for our money back.  

Several managers gathered around us with serious expressions. At first they told us that the juddering was a characteristic of the automatic transmission. We refused to believe them, shaking our heads with disbelief. Then they offered to take the Fiesta back, but only if we traded it for another automatic from the lot. We flatly refused to have another Powershift car. Eventually they agreed to take the car and give us our money back.

We shook hands on the deal. It would take some days to process the documents and our refund. We walked away from Ford with deep relief. We were back on the dating scene again.

The Scans

I’ve had three scans over the past two months. The first two took place during my second stay in hospital in early September. The third was last week. My first CT scan was routine, on my admission as a new patient. It identified a suspicious spot on my tenth rib, which could be an early indication of a bone tumour. This scared me very much. My tenth rib was near where I’d just had a tumour removed.

The radiologist said I needed a bone scan to check this out. Three worrying days later, a radiographer appeared at my bedside with a small metal container with radioactive materials in it. This was injected into my bloodstream. She seemed very casual in handling the wee container, so I asked her how much radioactivity had just been pumped into me. Put it this way, she said, you’re exposed to more radioactivity than this when you have a CT scan.

In the scanning room I lay down on a raised bed. I had to be very still for half an hour as a large camera on a metal arm followed the contours of my body very slowly. The radioactive materials highlighted spots where your body was making new bone and the special camera recorded them. These hot-spots could be places where you had a new fracture or a tumour.

I spent a terrible night on the ward, waiting for the results. And when I got them I wasn’t put out of my misery. ‘It’s not positive,’ said the doctor, ‘and it’s not negative’. I looked at him perplexed. ‘There’s no evidence of bone-making going on in your tenth rib,’ he said, ‘but the type of cancer you have can be present without any bone-making going on’. I shook my head in disbelief. ‘We’re discharging you,’ he said, ‘and sending these results to your Oncologist.’

This mental distress was on top of my recent surgery. I was in a lot of pain and still disorientated from the anaesthetic. Three very difficult and fraught weeks later I got to see the Oncologist; or rather the Oncologist’s ‘Reg’ (Registrar), the most senior of the junior doctors, who seemed to end up doing a heavy workload.

‘I’ll be frank with you,’ he said, ‘we don’t know what the spot on your tenth rib is.’

‘Oh,’ I said, ‘but what might it be?’  

‘It could be nothing, a false reading, or it could be some damage connected to the surgery you recently had,' he paused, ‘or it could be a new tumour.’

‘Oh dear,’ I said, ‘so what are you going to do about it?’

‘Wait and see,’ he said. ‘We’ll scan you again in six weeks and see if anything has developed.’

‘Six weeks,’ I gasped, ‘aren’t you going to test it now?’

‘Not at this stage,’ he said, ’a biopsy would have to be done under general anaesthetic, almost the same procedure as to remove the rib itself.’

‘And what would you do if it was a bone tumour?’ I asked.

‘I couldn’t speculate,’ he said, ‘but when we see a tumour in the bone, that’s usually a sign of more widespread recurrences’.

I went home with a dense black cloud hanging over me. I was still recovering from surgery. My body was sore and complaining. My head was full of dread. I hoped against hope that the spot was caused by some damage from the surgery. The surgical table in an operating theatre is narrow and your body must be pulled and pushed around when you are anaesthetised. However, the suspicious spot was on the inside of the rib. I imagined the surgeon cutting away at my rear abdominal muscles with heavy pressure and tearing the attachment to the rib, like when I was carving up a chicken for Sunday dinner. Equally well, I could imagine the tumour cells, that had been just a few inches away from the rib for the best part of eighteen months, spreading there and then throughout my body.

The wait was interminable. I was irritable, moody and couldn’t concentrate. I went for walks, watched TV, surfed the internet. Friends called. Nothing seemed to distract me from the black cloud for very long. Not even the always patient and considerate T, who did her very best to help me.

I returned to the dilemma again and again. Night was always the worst. In sleepless hours I weighed the scant evidence repeatedly. I became my own jury. And often I was my own hanging judge.

The day of the CT scan came. I headed to the Cancer Centre, like I had done so many times before, and went through the machine.

Back home, I waited for days for the call. It normally came from my GP, who would access the scan report online.

The mobile rang. My heart leapt. It was the GP. The hospital intranet was under repair, so he couldn’t get the report. I begged him to try again. I just couldn’t wait the two weeks until my next hospital appointment.

Two terrible days later, another call. Breathless, I listened. The scan was clear.

I gasped. Relief flooded through me, then deep exhaustion.

The Surgeon

I returned to the Mater Hospital for a review appointment with the surgeon who did my operation. He examined my wound and said it was healing well. I told him about the pain I was experiencing in the lower part of the wound. I pointed to a raised patch of skin that became irritated when I slept on my side and by the waistband of my trousers. So much so, that I normally went around with my waistband undone, my zip at three-quarters height and my trousers only held up by a loosely fastened belt. I’m sure if I bent over, which I don’t do because of the wound, there might be an episode of workman’s bum.

He explained that this surface pain was from a fold of skin that protruded because of some of the stitches underneath. He described this as a corrugation and told me the surface layer of skin would soften soon because the stitches underneath would break down and become fully absorbed. I also asked him about the deeper pain I experienced in my lower abdomen. He said that this came from my rear abdominal muscles and nerves that he had to cut into to remove the roots of the tumour. He felt it ought to settle in time. He described this part of the operation as tough work, for he had to ‘hack away’ at the muscle and then ‘haul out’ the tumour which was very reluctant to be dislodged. As he spoke I imagined some nineteenth century surgeon on the battlefield, removing a wounded soldier’s leg. Thankfully, I hadn’t been given a piece of wood to bite on.

He then talked me through the pathology report on the tumour. The good news was that the tumour was fully encapsulated by healthy cells, although in places the clear margin was rather fine, at 1mm. Further good news was that the tumour had abutted onto, but had not invaded, any of the structures of my liver or my small bowel. It seems that it had just been caught in time.

I was extremely relieved and thanked him for his great skill and judgement. He smiled but advised caution. I would have a CT scan shortly and this would be the first real test of whether there was any evidence of spread. After all, cancer cells had been active inside my body for the eighteen months prior to this surgery. I needed to be vigilant.

T and I held hands and walked out of the consulting room with a much lighter step than we had entered. We called in to Ward F; where I had been for a week, two long months ago. I thanked the nurses and gave them presents of chocolates and biscuits. Then I noticed that the young man who had been in the bed next to me was still there. I went over and commiserated with him. He had been discharged but had then relapsed and had been back in hospital for the past month. He had no idea when he might get home. I wished him well with his treatment and left the ward thankful that I had come so far on my journey of recovery.

The Corner

I feel as if I am turning a corner. It is now seven weeks since my surgery and five weeks since I left hospital. The pain of my wound is diminishing and my digestion is improving. I’m putting on weight and I’m able to walk further. There is still some way to go, but I feel that I’m approaching a more normal life; that strange mix of fears and reliefs that punctuate the life of a cancer patient.

My good friend Philip, who I have known since I was eleven, came from England to visit this week. We went to Murlough and did some birdspotting in Dundrum inner bay. But the most unusual bird we saw was actually on the way there, a Merlin flying ahead of us, scouting the hedgerow along a country lane. On another day we went to Castlewellan and walked around the lake. The autumn colours of the beech trees were just turning, and should be at their best in a week or so. Later we went to the Norman castle at Dundrum and surveyed the coast from the top of the keep. Climbing up the narrow spiral staircase was okay, going down was much harder and I was glad of the handrail as my legs got a bit tired and wobbly. We then had a good meal at Maud’s Cafe in Newcastle, finished off by Graham’s excellent ice cream.

I’ve been able to reduce the painkillers I take each day, from four to three grams. But night is still the worst and I often wake up with a throbbing pain in my right side after I have been lying on it awkwardly. I’ve been able to eat more at each meal and to take a more normal range of foods. I tend to try only one new thing at a time, as I can then gauge if there is a reaction in my digestion. Unfortunately both chocolate and marzipan have led to bad reactions, so I have to make do with cake.

T and I are involved in a competition. She is trying to lose weight and I am trying to gain it. The competition began a month ago. She was in the lead at first, but this week I’ve gone ahead by three pounds. I’m sure she will win in the end. The prize is a celebratory Mars Bar.

Next week, I have a review appointment with the surgeon who did my operation. I’ve been noting down questions to ask him, as and when I think of them. I always prepare a list of notes to take in with me, as it is hard to remember what you want to ask when you are in the room with the consultant. And you only get one chance to cover all the issues that you are concerned about. I know some of them don’t like being quizzed in this way, but it is my right as a patient to have my questions answered. It is far worse to be on the way home and then to remember a question that you should have asked.

I’ve not yet restarted any of my normal weekly groups. I do miss going to the Sing for Life Choir and the Queen’s Writers Group. I am becoming more robust, week by week, but I don’t quite feel ready to return yet.

David Hockney and the Flu Jab

I needed to go to Belfast to get the annual flu jab. I wasn’t looking forward to it. ‘You should add in a treat’, suggested T. After some pondering, I decided on the Hockney exhibition at the MAC. It had been recommended by a friend of mine. In the end, I was very glad that I went.

One of the advantages of being a cancer patient, indeed, it may be the only one, is that you are given the annual flu jab free of charge. Despite feeling under the weather, T drove me to Belfast for the jab. And a jab it certainly is; the vaccine is delivered by a broadish needle that the doctor forcefully inserts into the deltoid muscle of your upper arm. Thankfully, it was all over quickly and I was soon on my way to the MAC.

The exhibition space was on the third floor. It was free, but you still needed a ticket. So like many others, I went up to level three, down to the box-office in the foyer and back up again in the lift. The exhibition was billed as the first major show of Hockney’s work on the island of Ireland, surprising given his worldwide recognition. I thought back to the last time I had seen an exhibition of his work. It would have been twenty years before in Salt’s Mill in Bradford, Hockney’s home town. Salt’s Mill had been built by the Victorian social entrepreneur Titus Salt at the centre of his industrial village of Saltaire (like the Richardsons and Bessbrook). At that time I was living in a village in the Yorkshire Wolds, an area that Hockney had recently begun to paint in landscape.

Drawings and canvasses from throughout Hockney’s long career as an artist were crammed into a space that was subdivided into several smallish rooms. My initial thought was that the exhibition would all have been so much better shown in the Ormeau Baths Gallery, but, hey-ho, that was closed down in a political row over the opening of the MAC. But then I began to concentrate on the work.

Hockney is a very skilled draughtsman and drawing has been at the centre of his art since he studied in Bradford during the 1950’s. There were some early streetscapes from Bradford, then a roomful of portraits. Hockney is particularly good at capturing facial expression and bodily aspect. The portrait I liked best was of two men in bathrobes on easy chairs; the older man was looking at the viewer and the younger man was looking at the older.

The next room was dominated by two large pieces. The first was one of his large Californian pool paintings: sunlight, dappled water, a splash, a wobbly pink torso. On closer inspection it was made of coloured papier-mâché, which powerfully augmented the dappled effect. The second, was a series of 16 lithographs called The Rake’s Progress. These were inspired by Hockney’s first trip to the USA and were a reflection on Hogarth’s originals. Although witty and well made, they seemed a little dated in their critique: Bedlam was a row of identikit young men in jeans and T shirts with Sony Walkmans in their back pockets.

The final room was an assemblage of pieces from across his career. There were several of his recent Yorkshire Wolds' landscapes, drawn on Ipad and colour printed. The outcome was more like painting than drawing. I liked a large treescape the best. On the other walls were two very interesting series of lithographs inspired by Surrealism and Expressionism. The first series provided some witty pastiches of Picasso. The second series, called ‘The Boy who Left Home to find Fear,’ was largely expressionist in style. The series was inspired by Grimms’ Fairy Tales. I looked at the dozen or so plates again and again. This series, drawn 1969-70, was, I felt, the best piece in the exhibition.

In the car on the way home, I began to feel groggy. My body started to ache and my throat became sore. The side effects of the flu jab were kicking in. I went to bed and slept for thirteen hours. The next day I was little better, but I still felt groggy, weak and feverish.

The Hockney exhibition is on at the MAC until 16 October. It is well worth a trip. The flu jab is unpleasant in the short term, but hopefully worth it in the long run.