Day 1: Sunday, 17 May 2015
2.45pm: Arrive at Ward 10, a men-only ward at the Cancer Centre, accompanied by my wife and 2 sons – definitely feeling a tad nervous. Shown by a rather formal male nurse ‘A’ to my allotted bed, next to a window overlooking greenery – very soothing. Another, more chatty, male nurse ‘T’ arrives first to take pulse, blood pressure and temperature, then an ECG check for my heart, and finally hands me a swab for my nose and groin required for MRSA testing – so glad that the NHS has finally woken-up to bed-related contagious viruses! He walks me round the ward of about 24 beds, about half-full with the Sunday keenies, and I discover ‘T’ is an ardent Arsenal fan. A very pleasant junior doctor comes to my bed to give me the "thumbs up" for tomorrow.
6.00pm: Dinner arrives, quite acceptable, but I’m not here for the food. My family departs & I chat to MN in the next bed who tells me that he only discovered his advanced throat cancer a week ago. He has clearly come out of a personal crisis having just had explorative surgery which revealed an advanced tumour that could not be removed surgically. I assume it is at least Stage 3, but one doesn’t ask questions when I hear that he will be in the ward a lot longer than me - for many days of chemotherapy and RT. But his resilience and humour are humbling, and my own symptoms pale into insignificance! He tells me that he sketches black and white portraits, and that he intends to use this skill to raise money for cancer.
8.30pm: The ward’s night nurse ‘J’ (from the Phillipines) appears in the day room in which I am availing myself of the Sky TV channels. After introductions she informs me with a wry smile that she has a present to give me later. I know of course that this is a reference to the ‘dreaded’ enema needed to clear out my bowels before tomorrow’s procedure. We negotiate, and settle on delaying it for as late as possible – to 10pm - while I watch the BBC’s Mr Norrel & Jonathan Strange to divert me!
10.05 pm: Nurse ’ J’ duly arrives with a syringe filled with liquid (looks like water) and tells me to hold the liquid in my bowels for 10 minutes in order to perform a complete evacuation, and to ensure that her reputation doesn’t suffer with theatre staff who discover a half-finished job the next day! In the event I can barely hold the liquid for 4-5 minutes before rushing to the toilet – and just making it! I get a cup of tea as reward – my last bit of nourishment, as the “nil-by-mouth” period starts from now till tomorrow afternoon.
2.00 am: Finally get to sleep as not used to empty bowels and the noises around the ward.
Day 2: Monday, 18 May 2015
6.00am: Rise and shine, joining a small queue for a shower and change into my theatre gown and smart white tights (to prevent blood clots and improve circulation) which come up to my knees, reminding me of Kylie Minogue in her early ‘Neighbours’ role! I look at an overnight text sent at 10.44pm from my son: “Sleep well. We are thinking about you. Love from us all”. My text response says “Had good 4 hours sleep. Feeling fine and ready to rock and roll”.
8.00am: Briefed on the day’s proceedings by an oncologist consultant, who I shall refer to as Professor ‘Beard’, because he sports as fine a beard as that of one of my current cricketing heroes Moeen Ali. He tells me that he is kindly standing-in for my designated oncologist.
8.30am: After he leaves, I send the following email message to my family:
“Just met Professor (Beard) who will be carrying out the procedure and then met the anaesthetist. I am second in the queue, on at about 9.30am, and I will be given a general anaesthetic. The procedure to insert the tiny rods will last no more than 1 hour. Then 1 hour in recovery room. Then back to ward and scans to check rods in place. Then in afternoon to brachytherapy room to have radium injected into rods for about 30 minutes. Apparently this process will stir up all the cancer cells in prostate and will release all excess PSA into bloodstream. So PSA will temporarily rise for several months till eventually settling down to normal levels. This is why no PSA test done for 6 months - a bit frustrating. I have been reassured everything will be pain free today. So I'm relaxed and mentally prepared for this. I guess I'll be pretty hungry by 6pm. No need to worry”.
10.30am: After two hours of waiting Nurse ‘T’, who is now a pal, informs me that I have mysteriously been moved to fourth, the last place in the brachytherapy queue.
11.30am: The porter finally arrives with wheelchair to take me on the 500metre trip to operating theatre at the other end of the Cancer Centre site. It has now started to rain and a nurse with umbrella walks alongside. On my journey I discover that my 2 attendants have 50+ years NHS service between them – and both still seem very chirpy!
12.00pm: I meet the anaesthetist and nurse at the theatre entrance and discover they are budding gardeners like myself. I realise later that this is a subtle ploy to divert my mind to discussing the Chelsea Flower Show whilst the general anaesthetic is injected. I drift into slumberland with pleasant dreams of perfectly formed dahlias.
1.00pm ish: I awaken on a trolley in large Recovery Room to hear two nurses discussing Cameron’s proposals for a 7 day GP Service – a World’s First! I try to join in the discussion, aware that my speech is slurred. But we all manage to agree on the unlikely success of this venture, due to lack of funds and intransigent GPs. As the anaesthetic wears off the nurse gives me a codeine injection to relieve the pain from the rods recently placed in my prostate – I later discover there are 22 of these thin tube-like rods! I am told not to move to avoid the rods moving out of position. There is no need for such advice, as by now I am desperate to avoid the pain stabs arising from even the slightest movement of my bottom. I then discover I also have a catheter thoughtfully inserted through my ‘whats-it’ to avoid my making urine related trips - this provides more discomfort, but nothing compared to the 22 rods!
2.00pm: Wheeled on trolley from theatre down the 500m of road and pavement back to the Cancer Centre. But this time every bump and crack in the road causes shooting pains in my bottom. I try to arch my back as the porter warns me of each upcoming bump. I curse the NHS for not creating a smoother pathway for the sake of the many brachytherapy patients using this route every week!
2.15pm: Taken first for a CT scan, and then to another room for an MRI scan – the purpose is to determine if the 22 rods are in the correct position for the brachytherapy. I’m not sure why two scans are needed. For each scan NHS staff have to go through a well rehearsed routine to move me from the trolley to the scanner bench and then back to the trolley. Despite their gentleness and skill the pain in my bottom area is excruciating with each transfer!
3.15pm ish: Taken back to my Ward 10 bed. More pain as I’m transferred from my trolley. My reward is NHS hospitality in the shape of an egg mayonnaise sandwich and drink. This is my first bit of food for almost 20 hours, and I feast!
4.40pm: The same porter, the one with 25 years NHS Service, returns with a trolley to take me to the brachytherapy radiation room for the last step. Here I meet my designated oncologist at last. He has come to oversee and control the radiation process, assisted by two radiographers (who seem to be almost exclusively female right across the Cancer Centre). I am informed that the earlier scans have revealed that three (of the 22) rods are out of position in the prostate and need adjustment. I groan inwardly at the thought of more movement, and I am not disappointed by the ensuing pain which is akin to when I had three kidney stones passing through my urinary tract 4 years ago. I am now yelping with pain - and for some reason apologising each time, even though it is hardly my fault. Then the radiographers attach tubes carrying the radiation source to each rod. As I am still flat on my back I cannot see anything but I hear them talking – “A2 to rod1, C3 to rod7 etc”. After the rods are all attached, the staff vacate the sealed radiation room informing me that radioactive iridium pellets will be moved through the inner part of the 22 rods, one at a time, taking about 20-30 minutes to complete the whole course of treatment. I hear a whir and the sound of a ‘shot’ each time a pellet is fired. The resulting vibration in the rod causes me to wince with discomfort and halfway through the process I find myself shouting again.
5.30pm ish: The door of the radiation room opens and the two assistants say that it is all done! But is it hell? One of the assistants announces that she is going to take out the plaster holding the rods and quickly pull out the rods from my prostate. I have to give the radiographer credit for nimbly taking out each rod in 1-2 seconds, but the total 30-40 seconds feels like a lifetime, and my pain and yelps escalate cumulatively. My oncologist appears and makes a joke about some strange noises heard from me – ha-bloody-ha! But with the rods removed, there is now relative peace in my nether region. The radiographer lady tells me someone will be in touch in 2 weeks to discuss today’s procedure – but I am now confused as I have variously been told that I will not be contacted till 3 months time and even 6 months. I am hoping someone will clear all this up soon!
6.10pm: The trolley carrying my weary body arrives back at Ward 10. I am transferred back to my bed for the last time, and this time almost painlessly.
6.30 pm: My wife and two sons arrive. The wife later tells me later that I looked quite knackered.
7.15pm ish: I am somewhat recovered from the days trauma, with only the relatively minor irritation of the urine catheter which needs to remain in place overnight. I can now eat the food brought by my family – as I think I had missed the NHS dinner trolley. Shortly afterwards the family return home.
9.00pm: I have an unexpected, but very welcome, visit from Professor Beard who led today’s team inserting the rods into my prostate. I ask him when I will know if the procedure has been a success. He laughs and replies “When I meet you in 30 years time!” I laugh too – as its the best joke I have heard all day. He waves goodbye and says “Enjoy our NHS Hospitality for the rest of your stay”. I have been cheered up to bits by his visit!
10.30pm: I go to sleep quite soundly on this second night, as I am now accustomed to the snoring around me. My guardian angel from the Phillipines reminds me to take my prescription medicines which I had completely forgotten about. I am vaguely aware of the night nurses putting on endless fresh bottles of saline drip needed to “irrigate” my bladder via the catheter throughout the night – the purpose being to wash out waste blood and any residual blood clots in the bladder from the day’s brachytherapy process.
Day 3: Tuesday, 19 May 2015
6.20am: My now favourite night nurse ‘J’ wakes me up to empty the urine bag, syringing out the remaining pinky coloured urine from my bladder before deftly removing the catheter from my “whats-it”. A bit of a sting was followed by some relief. I am instructed to keep drinking water continuously to refill my bladder, as I am required to pass two lots of clear urine ‘tests’ before I can be discharged.
7.00am: I have a shower, and change into a shirt, jeans and shoes. I feel almost normal again.
8.00am: The breakfast trolley arrives and I am pleasantly surprised by a genuinely tasty peach yogurt – that NHS hospitality again!
9.30am: As I have plenty of time on my hands, I send the following email message to my family & friends: “Just to say this will be my last message from hospital. I am expecting to be discharged before noon after I have passed a couple of No 1s. The procedure yesterday was a very long one, finishing last evening about 6pm, so quite tiring but at the same time exhilarating as it was over. But I can’t tell you how amazing our NHS is - we may not have the top equipment that the Americans have, but the standard of care is second to none. It also been an emotional rollercoaster and I have been humbled by the other cancer patients who are mostly in a much more critical space than me. I can only admire them for all their resilience and positivity. Anyway thanks for all your good wishes and support. I couldn't have done without it. Expect to be almost normal by the weekend, and then the world will be my oyster again!”
9.40am: My brother responds with an email 10 minutes later from the other side of the world: “So glad to hear. Sounds as if you metamorphosed into ‘OysterMan’. Good one. Stay well”. I thank God for smart phones and for the 10 minutes of free WiFi bursts thoughtfully provided by the NHS without which I could easily have died of boredom!
11.00 am: A ward nurse has checked up on my pulse, blood pressure etc as well the two urine samples I have submitted. A junior doctor goes through his checklist and makes a note about my confusion as to when I will be contacted next. They agree that I can go home – whoppee! The nurse hands me a pre-prepared package with two packets of painkillers and a huge box of 30 laxative sachets which leaves me wondering about the ‘bunging-up’ powers of a single enema! I ring my wife who has been waiting to hear from me.
11.30am: The family arrives to take me home. I feel sad to be leaving my neighbour MN who is not going home till after the May Bank Holiday – we exchange telephone numbers. I thank the NHS staff (my heroes) who are now busy making beds and other duties.
jjk24/ 20 May 2015
