Getting back to the everyday ...

It really is quite hard to get my head around what has happened this year sometimes. It was the middle of February when Donna and I noticed a lump on the side of my neck. It wasn't large, it just wasn't something that should have been there. The next day, I saw my GP, Andrew, who poked and prodded, and muttered that he couldn't say what it was but given my history, we'd better get it checked out (I think he knew, actually, but he was probably right not to expand on his suspicions at that point).

A week later, I saw the ENT consultant, who arranged a biopsy and this confirmed that I had Hodgkin's Lymphoma (Stage 1a, very early in it's development, thankfully), and I was then bounced to the oncology consultant, Dr Tueger, who then took charge. Well, he'd probably sayhe did, but his specialist nurses did, really (*GRINS*), and just over a month after investigations had begun, I started ABVD chemotherapy on March 31st.

I'd kept working up to that point, trying to tie things up with cases and clear my desk for what I originally told people would be "a month off while I reviewed how I coped with chemo" (oh, I am such an optimist, did you know that?). Though I had good weeks when I still felt well over the three month course of chemo (and even kept running on the good days), the chemo regularly wiped me out for 7 or 8 days at a time, so returning to work justdidn't come into the picture at all.

It was hugely frustrating, as anyone who knows me will know that I don't like "not doing". I always seem to have something I'm working on or planning - I'm not on-the-go all the time, and I can veg on the couch with the best of them, but I always have some project or other bubbling under. And during this period, it was really difficult to motivate myself for days on end to do very much at all (other than watch the World Cup, which, conveniently filled the latter part of my treatment cycle).

And when the chemo ended, on June 16th, that still wasn't it, because it took about another 2 - 3 weeks for the main effects to wear off. Then, on July 7th, I met with Dr Tueger to be told that I was in complete remission. So, in just under five months, I went from finding a lump on my neck to the bleakness of a second cancer diagnosis, through the trials and tribulations of the treatment, to being in complete remission!

Head-spinning, really, don't you think? I mean, just how great is modern medicine, and how brilliant a service is the NHS when you stop and think about it? I have to stop and pinch myself sometimes as I try to make sense of what's happened over these past few months. The relief we (Mrs 365er and I) feel is huge, obviously. While I am still having radiotherapy (another 2 weeks of this needed, just to be sure, you know), the reality is that the cancer is gone, history, just another story to tell - how amazing is that!

Now, it's time to get my life back on track. I started back to work again in the middle of July (almost three months after I'd optimistically expected i would!), but I am determined to move a little slower than maybe I have in the past; taking things easier and saying "no" to things more often that I have done in the past. I know the work will come in, so I don't really need to panic, the bank balance will grow again in time, and I'm sure that before too long, I'll be back in the swing of things on that front. Soon, it'll be the old routine again, and I have to say, I'm kind of looking forward to that.

As for my 2nd 365challenge, well, having over four months "out", with very limited running has really put paid to me completing the challenge of running 36.2 marathon distances in a year, but I haven't completely given up on it. I have been trying to get back to running - it's been VERY hard this last couple of weeks, maybe the radiotherapy has something to do with that! - but as I build up again over the coming weeks, I plan to continue with my effort and just keep going until I've hit my target miles. It may take me 18 months instead of 12, but I will complete it.

And while I'm doing that, I'll continue to support any 365ers who come on board to join me in raising as much as we can for the fantastic work of Cancer Research UK. I know that if they were not out there funding research and developments in cancer care, these last few months might have been very different for me, so if I can raise more money that ultimately means other people's experiences of cancer prove as positive as my own, then that's what I'll keep doing. Care to join me anyone? Anytime ...? 

5 down ...

The penultimate chemotherapy session: DONE!

So Wednesday saw me at my current second home, the Countess of Chester Hospital, for the fifth of my six chemo sessions. It's hard to believe that I'm just one session away from completing this course. Do I get a certificate for being a good patient? But what, I hear you ask, does it all entail?

Well, it's a very long day, having chemotherapy treatment. The hospital is just a 15 minute walk away, fortunately, but I've noticed the last couple of times that as I approach it, there has been something of a feeling of dread sitting in my stomach. More poison coming into my body ... however, it IS for a reason AND it does seem to be doing it's job. but it still sits heavily with me. I guess also there is some trepidation that my white blood count won't be good enough to allow me to go ahead with the treatment that day, and I'll be sent home, to come again another day, and so have even longer to go before this thing ends.

But I go in and take my place in the waiting area to be called to be weighed (so they can match my drug dosage to my size), then, with the form in hand, announcing that I've not exactly faded away over the past fortnight, I wander down to the treatment suite and select my chemo chair for the day. Because it does tend to take ALL day.

First, there is the game of "Where'll we stick the Cannula today?" Sometimes this is a direct hit, but three, four and five goes are not unheard of (ouch!). Then there is the interminable wait for the blood test results to come back, which determine whether or not the treatment can go ahead.

Actually, after speaking to my consultant the other week, as he seems quite pleased that I've been so healthy throughout the treatment, he is no longer particularly worried about my white blood cell count, and he's just going to plough on with the treatment, which is fine with me!

Then, once the treatment can begin, there are six different, shall we say, "infusions" to be administered that these can take three to four hours sometimes. So by the time the last saline flush has gone through and they release me from my chair, am I ready for home ... well, yes, if you must know!

The end in sight ... well, sort of ...

But with 5 treatments down, it feels so good to have the end of the treatment in sight. Or is it? Well, yes and no. Because after the chemo comes, guess what? The radiotherapy, of course! It's a case of "belt and braces" here ... the plan is to hit the Hodgkin's lymphoma hard with the chemo, then follow that up with what looks like being a three week course of radiotherapy, just to be sure (to be sure!). But once all that is done, then so will I be ... well and truly, I suspect. No, really, once all that is done, I'll be chomping on the bit to get back out there and resuming my 365challenge again. And that day is getting closer all the time *GRINS*

Wish me luck!

And so it begins ...

Wednesday March 31st 2010: the day I started my chemo. Quite a momentous happening, if you're sitting where I am, but just another day at the coalface for everyone else, I suppose. 

Donna (Mrs 365er) and I arrived at the unit at 8.50 am for a 9.00 start (oh, little did we know). I have to admit to feeling some trepidation about what might lie ahead for me. The thought of having serious drugs pumped into me, with a wide range of potential side effects likely, was not something I was looking forward to. I'm one of those generally lucky people who rarely gets sick (I save myself for a couple of bouts of cancer, none of this namby-pamby man-flu rubbish *GRINS*), so offering myself up to a treatment that is likely to make me feel ill when I've had no symptoms at all seems really odd, and not something I'm particularly looking forward to (who would?), but this is what has to be faced, I guess.

So the process is, it turns out, a long and slow one. After being weighed (so they can calculate how much of each drug I'll need), we were called through to the chemo suite at around 9.30. This is a large room with about large 12 adjustable chairs spread around the walls, each with a drip stand set up beside it. A few of the chairs were already occupied, and I was invited to choose where I wanted to sit and make myself comfortable. Donna initially perched on the side of the chair with me, but then one of the nurses, Sam, located a spare visitor's chair for her. And then we settled in for "the wait". 

After a while, Nurse Sam came over and put a cannula into my arm and took a couple of blood samples. She explained that as it was my first visit, I had to wait for Nurse Dee (see previous post) to sort out my consent to treatment, and she'd be through to see me "in a while". 

The other chairs gradually filled up over the next hour, and everyone had their cannulas inserted and bloods taken. Some of the people there ahead of me seemed to be having blood transfusions, while others were just waiting, like us. It gradually dawned on us that most of the group were not yet receiving their medication and we realised that everyone was waiting for the blood sample results to come back. These determine the individual's white blood cell count, as best I can work out, and this result will determine whether or not the patient can have treatment that day or not. The labs were running late today, so there was a LOT of waiting to be done by everyone. It was also very disheartening to see about three people being told that their blood count was too low today, so they couldn't have treatment and would have to come back another day (and if it felt like that for me, I can't imagine how it felt for the people this happened to)!

After about another hour, Dr Lee, the main consultant, came to see me and have a chat, as we'd not met before. He again explained the nature of my Hodgkins, and what the treatment would involve. Nurse Dee began sorting out my consent, and she got Dr Lee to write the full diagnosis into my notes, as this hadn't been possible before the second opinion had been received last week, and without the detail specified in my notes, my treatment couldn't start.

More waiting required, and I was getting a little frustrated until I realised that many of the others were waiting too. It seems this treatment-lark is going to need me to learn patience, something I can show with others usually, but am not always good at for myself :). 12.00 came and went, and with it, a very mediocre hospital lunch. Donna and I just sat there chatting and waiting, just wondering what was going to happen and when, and just when I might actually get out of here today?

Finally, Nurse Sam came over with my meds - the four drugs that make up ABVD: Doxorubicin, which was originally called Adriamycin®; Bleomycin; Vinblastine, and Dacarbazine. She explained that she would inject the first two slowly into my cannula, and then the last two would be given via the drip. And so, at about 1.15 pm, we were off. 

Sam chatted away with me as she gave me the first couple of drugs over about a 20 minute period, very gently and slowly pushing the drugs into me. She also gave me some anti-sickness medication via this method as well as a small steroid dose which helps counteract the effects of one of the drugs on the lungs. Once this was done, she hung the Vinblastine and started the drip, leaving me while this ran through. At about this stage, we decided that there really was no point in Donna staying much longer, so she went off home, taking my take-home meds (a range of tablets I would have to take over the coming weeks between treatments) with her, with me promising to call her when I was done. 

Finally it came time for the Dacarbazine. Sam explained that this drug was light sensitive, so they had to hang it in a special bag. She also told me that many people find having this drug a very uncomfortable experience, as they often report pain in their arm. This can be counteracted by putting something warm on the arm and/or slowing the speed of the drip right down - delivery of the drug therefore could take anywhere from 40 minutes to a couple of hours, but as everyone is different, and it was going to have to be "try it and see what happens", though she added that as I seemed to have good, large veins, this could help as the relative volume of drug to blood in the veins would be less. 

This was the drug I'd been most anxious about, as I'd heard about the potential problems, and I'd seen one of the other patients (a big strapping guy across the room) really struggle with it, in obvious discomfort. So when Sam started the drip off, and I felt nothing unusual, that was really positive. She decided to set the drip feed to its fastest setting, telling me that if I noticed any discomfort, I should tell any nurse and they would adjust it for me. And then she went to lunch, telling me she'd check back with me on her return! 

After a few minutes, one of the other nurses checked I was still okay, which I was. It had been a long day up to this, and much to my surprise (and delight), I then drifted off to sleep, waking only to the bleep of the monitor on the drip that announced that the Dacarbazine was finished! 40 minutes, on the nose! No discomfort, no itching, RESULT! Another nurse came and disconnected me, removed my cannula and sent me on my way ... home. As I passed through the outpatients section, I found Nurse Sam doing some paperwork. She was amazed to see me, saying that she had been just about to come through to see  how far along I was. She checked I was feeling okay (I was) and I was done.

I was feeling quite good, actually, especially after my snooze, so I called Donna and told her I'd walk home (it's only about 10 minutes away). It was great to be out in the fresh air, and so good to have started on this treatment, just seven weeks to the day since I'd gone to my GP to have him look at the lump on my neck. Things feel like they are moving forward positively now; one treatment down, just five to go. Here's hoping they all run as relatively smoothly as this did.

Some days are better than others, but today wasn't one of them ...

Today I learned that I have cancer again.

The type has yet to be finally and definitively identified and labelled, but it IS cancer, and I am going to have to have another course of treatment, whatever the final label might be. And, sod's law, the likelihood that this cancer is in any way linked with my previous cancer is just about nil. So lucky old Colin's only gone and gotten himself a second, different type of cancer 'cos beating one cancer just wasn't enough for him. The Pratt.

The ENT consultant today (this new lump is on my neck) didn't want to speculate too much because all of the test results are not back and so he didn't want to misinform me, but he did venture that he thinks it's most likely Hodgkin's Lymphoma, and, as he put it, if I had to have cancer there, this was about the best one to get, as the outcomes for treatment are pretty damn good! I'll hang on to that, because positive messages, wherever they can be found, are going to part of my armoury again as I take on this next fight.

But there are different stages to Hodgkin's and until all the results of the CT and MRI scans I've had over the past week are in, its not possible to say just what stage this is at or quite how it will be treated. My next step is to meet with the Consultant Haematologist (possibly not until next Thursday!), who should then have those answers, and hear from him just what treatment I have to look forward to. It could be radiotherapy, chemotherapy, or a combination, I believe, and the goal is to shrink the growth and kill it, rather than excise it, as they were able to do with my old adversary, my soft tissue sarcoma.

However, as I said, I need to hang onto the positives, and those are that this WILL respond to treatment ... so, whatever that might have to be, I'm ready and willing to have it ... as soon as you like, nice Mr Haematologist man ... please!

One thing that I do know is that, as a result of my 365challenge for Cancer Research UK (all that fund-raising better bloody well pay off now, CRUK; a fix wouldn't half be welcome right now!), I am probably now fitter than I've been in many years, so that is only going to help me in this fight. So that, clearly, is another positive to hold on to.

And so, oddly enough, is the fact that I have had a tumour before! Because, had I not had an unexplained lump on my arm three years ago that turned out to be that tumour, I might not have looked to have had this lump investigated anything like as quickly as I have had this time. And who knows what that might have meant over time? Getting stuck in now is certainly the best thing I could have done, I'm sure, and without my "prior knowledge", I'm unlikely to have done so.

So let's hope that we've spotted and caught this one good and early, but whatever the case might ultimately be, the fact is that treatment is on the horizon, and I am already looking beyond that horizon to the day I write another blog update to say that yet again, Colin has kicked cancer's arse!

I know I'll be fighting this day by day, but I also know that I have all of you lot out there cheering me on and offering me the amazing support I've enjoyed from you once before, all over again. And believe me, that means a hell of a lot to me, so ... from the bottom of my heart, and in advance ... my heartfelt thanks. C'mon, let's kick cancer one more time for Colin!