Regular readers may be aware that one of the headings in my blog is Cancer http://www.georgeemsden.co.uk/?cat=13 where I have written up my experiences as they happened over the last year or so. This is a summary – all in one dose.
It really all started with a sore throat, but the background is relevant here. A business life which had been pear-shaped for some time, stayed that way which meant that I eventually hit the buffers. This meant selling my house, settling my second divorce finally and moving into rented accommodation in November 2006. Not nice at the time, but Muswell Hill is more central, closer to my children and has a sort of buzz about it which I and a lot of other people like – clouds do have silver linings.
But back to the sore throat. Illnesses often have triggers and mine was emotional. A big promise did not happen and in the second week of December 2006, my voice went hoarse. At the time, I put this down to exhaustion but as I had a 3 and half week holiday coming up in Thailand, I thought this would fix it. Thailand is a country which has been very good to me and it was great to be back after over 30 years but no change in the voice.
Two weeks after my return in January 2007, I am tired and one morning when walking to the bus stop, I stop and think. My chest is basically telling me that I am exhausted and that I should go back to bed. I take most of the next two weeks off but still have a gravelly voice. Friends and family are telling me to go to the doctor. Finally, I listen to one of my friends from ecademy and visit his GP in Wimpole Street where I phone for an appointment in the morning and get one at 3.30 pm that afternoon. Time from ringing the doorbell, going to reception, telling the doctor the background, being examined, collecting the prescription and being back on the pavement again – 10 minutes and £105 please. The Wimpole Street doctor said he knew my previous GP in Tufnell Park and that I should return after a week, if no change.
Thinking I might as well kill two birds with one stone I visit my former GP who does not recall this colleague in Wimpole Street and I am seen by his new lady colleague. She has no hesitation in referring me to the King’s Cross ENT hospital and after 10 minutes aggravation on the telephone as that hospital is not part of her area on-line booking system, gets me an appointment two weeks later.
The examination there by another lady doctor is my first with a nasendoscope or the worm as I have come to know it, and tells me that my vocal cords are slightly swollen so they want to do a biopsy. They promise to take only one teeny weeny sample and this event is scheduled for 5th April 2007 – the end of the fiscal year, normally a very busy time for IFAs. Two days before this, a nurse from the ENT hospital phones me and goes through a questionnairre – do I have any allergies, take any medication etc and have I had any implants? For what? is my first thought, but managing to avoid falling of my chair laughing, I inform her that the answer is No! On the day, my youngest daughter comes with me and I change into a disposable smock. There seems to be a lot of paperwork and I sign that I have understood what they are doing, might get a broken tooth with the long metal tube that they are going to shove down my throat etc. all cheerful stuff.
Lying down on the trolley (gurney) I am taken away from my daughter, and wheeled into the next room where a needle is put into the veins on the back of my left wrist and taped. Just as they say, the first anaesthetic feels cold as it is dripped into my veins. Next I am told that I am going to be given some Oxygen. No problem here as I am used to this flying gliders at 25,000 feet http://www.georgeemsden.co.uk/?p=21 A hairy hand holds the clear plastic mask over my face. First breath, this Oxygen smells a bit funny; second breath, are they really giving me Oxygen? third breath, oblivion and I wake up with a raging thirst 40 minutes or whatever it was later. A cup of warm tea and sandwich are placed in my hands but even with a mouthful of tea, I cannot swallow all the mouthfulls of sandwich and spit a couple of them out. The dryness goes over the next few hours so I am able to enjoy the planned dinner with my daughters and their partners.
Two weeks later, I am back at ENT. A Chinese doctor sees me this time and my file is on his desk. He seems busy with other stuff, a nurse comes in quietly closing the door after her and leans against the wall. She seems to be examining her fingernails and the doctor turns to me and there is a funny drawing of a “A” shaped thing in my file. It’s squamous cell carcinoma. You mean cancer? Yes, it’s in the mucous of the vocal cords – we took 3 samples and in 2 of them the cells are invasive. The tenor of the delivery is more or less “What else did you expect it to be?” The drawing is of my vocal cords or vocal folds as they are also known and there is a tumour on one of them about the size of my fingernail. Treatment? surgery or therapy – other doctors will go into more detail about the options. Reflecting for a couple of seconds, I mention that in a way I am not surprised – there has been a little voice in the back of my mind saying that it might be the Big C. I do not lose my composure as several members of my family have had it including my mother who died of it when I was 19. Two of my cousins had died of it before 50 and with all of them, their courage and dignity up till the last, made a big impression on me. The nurse leaves quietly and I am told that I will be looked after the University College Hospital UCH in future.
Now I have to tell my family and colleagues, but occasionally the reaction is such that I end up reassuring the other party that things are OK. Visits at UCH involve CT scans – a kind of X-ray that is better for soft tissues and ultrasound. There are two options for treatment. Quickest will be surgery involving an overnight stay or a course of Radio Therapy (RT) lasting about 6 weeks. The tumour has been spotted early so, thank heaven, I will not need chemo. The late comedian Roy Castle had described it as paint stripper being injected into his veins when I heard him in 1992 at an LIA Conference in the Barbican. Within my own family, squabbling stops and a rota is worked out so I will not go to the RT sessions alone – hence the title for my earlier blogs The Positive Side of Cancer.
Before treatment can start, I need to be fitted out with a mask which will keep my head and neck immobile while I am zapped with X-rays. This is formed from green thermo-plastic mesh which is soaked in warm water and then draped over my face till it sets. First one does not fit so after an hour wait we do another one. Later, I am taken to one of the treatment rooms in the Basement of UCH and they set about calibrating it so it the tumour will be hit “spot on”. This can be done to within 3 mm and means that the left-hand vocal cord which has the tumour will be zapped more than the right one. A computer generated image of me is in my file looking as if I had been done by a giant bacon slicer and yes, the black + showing the focus, is off to one side. My daughter does not quite recognise this at first and asks what the fuzzy shadow in the middle is which is of course, my windpipe.
Calibration takes sometime and on one occasion I seem to be strapped down on the table for 20 minutes. It reminds of Gulliver’s Travels by Jonathan Swift where he is in Brobdingnag and was tied down so he could not move. Fortunately, claustrophobia is not a problem with me but at the end of the long sessions, I begin to see what claustrophobia might feel like to some people. The tattooed spot that I was promised on my chest to help targeting the X-rays, does not happen, so selecting a something more decorative like an evil eye or target image to carry round on my chest for the rest of my life, becomes a might-have-been.
Treatment is scheduled to start late-May but after internal quality checks reveal a vagueness in targeting, it is back to the basement to calibrate everything again. Only one irritation arises when my eyelashes get caught in the plastic mesh when the mask is put on and I am clipped down to the table. There is no pain here but it is like having a mote in one’s eye – very annoying and distracting, but fortunately easily remedied with a paper tissue over my face underneath the mask. Now treatment will start after the May Bank Holiday and finish Friday 13th July 2007 – someone has a sense of humour!
A routine is established. Every afternoon, I meet one of my daughters at the hospital and we get the lift down to the basement. When called from reception, we have a long walk down the corridor usually to the farthest of 5 brand new machines, to another waiting area. Previous patients come and go. There are smiling children with no hair in wheelchairs, a distraught young man in a wheelchair with a plastic tattoo transfer on the front of his neck being comforted by his girlfriend, a sad young Asian girl being comforted by her family that occasionally I can cheer up a bit, ladies with no hair and headscarves, ladies with dark pink patches on their cheeks from the treatment that they cover up when talking to me, people who sit in front of you one minute, start coughing up white sputum and disappear into the loo where you can hear them wretching – all human life is there.
Treatment at first produces no visible effect. I am going to have a radiation dose of 64 Greys over 33 sessions every weekday spanning six and half weeks. My office is very understanding so I can have my sessions in the afternoon when it is much less crowded and my time is usually around 4 p.m. – the latest possible.
To avoid repeating myself you might wish to see an earlier blog describing a typical day under treatment http://www.georgeemsden.co.uk/?p=85 which did indeed finish Friday 13th July 2007. Two weeks afterwards, I have a few relaxing days in Germany with my brother and when I do a bit of sunbathing the radiated patch on my throat goes yellow. Shortly after I return, the worst part of the whole episode happens which is of all things constipation. Five painkillers are being prescribed by this time and three of them – codeine, paracetamol and morphine all list the other big C if you like, as a standard side effect. This all comes to a head one weekend when I am due to have a Sunday lunch with my daughter but I am too uncomfortable to go. All sorts itself out 14 hours later, but it is the last place I expected effects to appear. My voice is a whisper by this time but I am able to perform my lodge duties as Senior Warden at the Neptune Lodge No.22 250th Anniversary meeting in United Grand Lodge in August 2007 but my party piece, the Charge after Initiation has to be done by someone else. E-mails can still be answered from home but I do not go into the office for about six weeks and do not see any clients for months.
Voice therapy starts at this time and as these are in the afternoon and on the 14th floor of the new UCH building, often take place when there is a glorious gliding sky visible a few miles away. For my most read blog in this whole episode, see http://www.georgeemsden.co.uk/?p=103
Come September, the tissues in my throat are less tender so the doctors can have a look inside me again and the first post-treatment visit is quite memorable like a roller-coaster ride inside your head see http://www.georgeemsden.co.uk/?p=96
Treatment has left me with a hairless patch under my chin which I no longer need to shave and where the skin is baby- smooth and if anything, younger looking. Below that, a two inch strip looks 20 years older and unconsciously I find myself wearing a tie more often rather than have an open-necked shirt. I no longer bother with skin cream and the redness on my neck is fading. The voice is still a bit gravelly if I do not sip water regularly and in another example of clouds having siver linings, a couple of ladies have said that the occasional huskiness is quite attractive…..
Six sessions with the worm show no trace of the tumour but I do not believe one is ever really free of cancer. Compared to many others, I feel I have got off lightly and in a strange way the timing was perfect, as I had moved further into London and had my treatment in a brand new hospital where 5 new scanners had been installed. A more common remedy 20 years ago would have been surgical removal of the voicebox and two people I saw on my last visit had had this procedure – indicated by white plastic plugs in their throats. Having avoided chemo, I have no problem returning for check-ups with the nasendoscope whereas other people I know whose chemo-treatment finished 2 years ago, dread returning to their hospital for a check-up. A curious small change is that I now find myself reading the sports pages which were of zero interest previously and which I usually gave or threw away, unread – perhaps I like reading about winners now?
One year on, I can really thank the friends and family for their support but the same issues in business, life and everything else are still there and have to be faced and dealt with. It feels like I have come full circle, and life goes on….