Friday, 14 September 2018

Health bulletin - the good news and the bad news

Recap: I'd been feeling ill since the 20th July, with stomach pains, exhaustion, weird-coloured, dayglo wee the consistency of treacle, weight loss, itchiness, fever etc. Around the start of August I began turning yellow. After a week or so, when the colour intensified and it became obvious I had more than "a touch of jaundice" my wife booked a same-day appointment for me with my GP, who wasn't entirely convinced, but ordered blood tests to check out my liver functions and, in particular, the level of billirubin in my system. (Billy Rubin sounds like a Western gunslinger, but is in fact an orange-yellow waste product of haemoglobin which the liver is supposed to process and which causes jaundice if unprocessed.) A phlebotomist took blood samples a week later, and I got a call from the surgery the next day asking me to come in as a matter of urgency - my liver functions were all over the place, and my billirubin levels were so high they hadn't been able to register a reliable reading. Go to hospital at once...

...which I did.

Charing Cross A&E was bedlam (mad gay black chap conducting imaginary conversations with a number of "friends" at the top of his voice, a black criminal (or victim) in a bed surrounded by four unformed policemen, an old guy bellowing in pain in the next cubicle, but I was eventually examined and admitted. After two nights in a an assessment ward (a young chap with a severe headache was given a lumbar puncture in the bed next to mine in the middle of the night - it sounded like fun!), I was offered a bed at in the Hammersmith Hospital Gastro-Enterology ward, but had to spend another three nights in a gastro ward at Charing Cross - a truly horrible experience (a suicide risk in the next bed, an ancient chap who gave every impression of being dead in another bed, a thoroughly nasty, disruptive dementia patient across from me who'd wait for someone else to call a nurse before bellowing "NURSE! NURSE! NURSE!" at the top of his voice for what felt like an hour on end, etc.) On Sunday 20th August, I was transferred to Hammersmith, which, after Charing Cross, was so clean, peaceful and efficient, it felt like a Swiss sanatorium (in time, refugees from Ealing Hospital and St. Mary's, Paddington would make similar comments - something to do with whether a hospital has an A&E department or not, apparently - Hammersmith doesn't).

Long story short - the good new is that nineteen days later, I was well enough to be discharged. My startling colour (one nurse called me her "big glow-worm") had almost returned to normal, my billirubin levels were also almost back to normal and still dropping, I could eat without pain, my appetite had returned. True, my weight had dropped to under 15 stone for the first time in nearly half a century, and I was as weak as a kitten - but I was longing to sleep in my own bed under my own roof in the company of my own wife.

I underwent a total of five "procedures" during my stay at Hammersmith (plus a few scans at Charing Cross). These consisted of an endoscopy under general anaesthetic, which turned out to be a waste of time - my bile duct was so distended it couldn't be entered in order to be drained. So I paid five visits to radiology, where, while I remained conscious, a doctor made a tiny incision in my side and, with some difficulty, found the exit from my bile duct, drained off a litre of liquid, and fitted me with a bag into which copious quantities of crud were expelled over the next week. The liquid started off green, but ended up the colour of crude oil - a good thing, apparently. Two days later, the same doctor (evidently a bit of a legend, given the generally awed reaction to any mention of his name) eventually - after a lot of vigorous effort - found the channel which allows the contents of the bile duct, including billirubin, to drain back into the body, as they're supposed to.

Following these remarkably interesting interventions, I spent the next six days pretty much confined to bed and utterly convinced that I was dying - I have never felt worse in my life. During this period I entirely lost my appetite and had to receive nourishment via drip-feeds. I also learned that pancreatic cancer cells had been found during a biopsy. I managed to faint returning from a trip to the loo, scaring the whatsit out of everyone by jack-knifing over the end of my bed before slithering gently onto the floor (my fault for not telling anyone I was going to the loo). Finally - and readers of a squeamish nature are advised to skip this next bit - I spent half an hour one night, surrounded by nurses, vomiting up a mixture of blood and what is known as "coffee-ground vomit" - the latter a sign that the body has been retaining food for too long. (During a particularly noisy bit of upchucking, one nurse asked me to confirm my date of birth - I'll leave you to imagine my response - while another suddenly shouted "You mustn't eat anything!", to which I growled "Do I look like I want to fucking eat anything?" People do and say the oddest things when stressed.)

After that episode, my appetite roared back to life, and I began to feel vaguely human again.

As for the cancer, I'm awaiting an appointment with the oncology department at Charing Cross to see what, if anything, is to be done. I've already been told I can't be operated on - which I'm not too disappointed about, since it would have involved having about half my insides removed. I expect there will be chemotherapy to attempt to keep things on an even keel, and to allow the stent which has been placed in my bile duct to bed in. After that, who knows? A near-neighbour around my age is going through exactly the same thing - out-patient chemotherapy at Charing Cross for inoperable pancreatic cancer, so I'm looking forward to chatting to him. After five years of Chronic Fatigue Syndrome, I know I don't have the energy/determination/vim/vigour/motivation to "fight" the unwelcome intruder - in any case, pancreatic cancer has a lousy survival rate. If I were younger, or the parent of young children, or my family's financial security depended on my staying alive, or if there was something I desperately wanted to achieve before shuffling off this mortal coil, my attitude would no doubt be very different. As it is, I begrudge the years I won't have to enjoy my wife's company and the opportunity to watch my son make his way in the world (at which he seems to be making a damned good fist in any case). Anyhow, mustn't get ahead of myself.

Many, many thanks to those of you who sent cards, emails - even a nostalgic experience-map (hard to explain, but most enjoyable) - messages of support and offers to visit or phone. As and when energy allows, I will respond personally to all of you. Sadly, I'm in no fit state to receive visitors right now, especially as I'm girding my loins to face the oncologists and get some sense as to what happens next - but I'll no doubt be begging you to pop over within a couple of week, so don't imagine you've got away with it!

I'm not sure what I'm going to do with this blog in the meantime. I have absolutely no intention of turning it into an endless account of my health battles - I can't stand reading those, let alone writing one - but I'll use it as a bulletin board until I'm able to respond to you individually.

A few items:

Hugh Wilson, the elder of my wife's two brothers, died last week, aged 82, at home, surrounded by family. His health had been poor for a while, but he actually died of pancreatic cancer. He was an extraordinarily amiable chap - ex-Army, Tory councillor, widely-read (mainly travel books, history and science fiction), dog-lover, and an all-round good egg. My wife, who asked him to give her away at our wedding (if that's the right phrase), was always immensely fond of him. Farewell, old man - safe journey.

Twentieth Century (1934), a screwball comedy starring Carole Lombard as an actress and John Barrymore as the washed-up theatre director who "created" her and is desperately trying to lure her back is one of the funniest films I've ever seen - Barrymore's performance is a rip-roaring comic tour de force.

My wife bought me Citizens of London: the Americans Who Stood with Britain in its Darkest, Finest Hour by Lynne Olson - which she had read for a book group - when I went into hospital. It's the story of three Americans who lived in London during WWII and did all they could to alert their countrymen to what the Brits were going through, and relentlessly pressured the US government to come in on Britain's side. The account of CBS radio broadcaster Ed Murrow (whose whole body, a witness reported, shook with rage during one his broadcasts during the Blitz), the truly saintly American Ambassador to the UK, John Gilbert Winant (a Republican Roosevelt supporter who Londoners readily took to their hearts - little wonder: the aftermath of each German bombing raid would see him out on the streets, doing all he could to help, and he even stuck to British wartime rations) and Averell Harriman, who was in charge of the Lend-Lease programme, constantly reduced me to tears. I can't recommend it highly enough: truly humbling.

Finally, if you're looking for some high-class comedy writing, let me recommend Colin Watson's Flaxborough Chronicles, thirteen British detective novels published between 1958 and 1962. Beautifully written, and laugh-out-loud funny. 

2 comments:

  1. Sounds like a cross between 'Creatures of the Abyss' and Dr.Kildare with bells on.
    What a torrid time you had of it. My endoscopy some time ago involved simply gazing up at the TV screen marvelling at modern medicine.
    Really good to hear you're back with your family.
    Let's hope your course of further treatment is satisfactory.
    When you say you don't wish to "fight" the intruder do you mean visualization techniques: good white knights attacking bad (cancerous) red knights, that sort of thing?
    Please rest as far as possible and recover your strength.

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    1. Thanks, southern man. It's great to be home! To be fair, Hammersmith Hospital was a pleasant surprise, and that's where I spent most of my stay - could have been a lot worse.

      That's indeed the sort of thing I mean when I talk about "fighting" the cancer. I don't wish to sound wet, but I just don't have the reserves of strength - the vigour - required for a life-or-death struggle. Anyway, I hope to find out more about what I'm actually facing next week, when my first appointment with Oncology is scheduled to take place. (I suspect it's too much to hope that they've got me mixed up with another Scott Grønmark?)

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