Infection

I had to go back into Whiston hospital for half the day today, because my wide local excision site has become infected. It started yesterday morning with a really sharp pain in one side of the wound, then it started bleeding. I assumed a stitch had burst so I just mopped it up and whacked a couple of steri-strips on. It got really hard to walk though, and in truth was really painful, so much so that I was crying last night. All by myself. On Valentine's day. Poor poor me. 

It wasn't better when I woke up and it started bleeding a fair bit mid-morning so I thought I'd best phone. They told me to come in and go to the dressings clinic. I was really impressed that when I got there they had my file all ready and waiting. I had to wait an hour to be seen but they had appointments booked in so it's only fair I had to wait. The nurse said it was a lot redder and hotter than it should be in the area where it hurt (it had got so bad that just touching the skin made me do a deep intake of breath against my will) so the doctor came to have a look and said it was the start of an infection. They did a swab and started me on a broad spectrum antibiotic called Flucloxacillin. They don't know what the bacteria strain is, hence the swab, but hopefully the antibiotic will cover it. Otherwise it will be very painful til Tuesday when I'm back at the dressings clinic. In the meantime, I've got an iodine dressing then three big sterile dressings then a white wrapping, then a white tubigrip then a cream-coloured thick tubigrip. It is actually amazing how less it hurts with all that on. I can walk a lot better. 

I phoned the skin cancer nurse, Sue, in dermatology yesterday - she was given to me right at the start - and asked her if it was normal to have to wait 7 weeks for the lymph node biopsy results. She said no and will look into it then get back to me. So that will be good as seven weeks will test even my patience. 

Oh, since I had my dressings off today, I took photos of how it all looks:

Calf:

Lymph node site (feeling is coming back somewhat now):

A country called Cancer

Let me say first off that this post is in no way meant to denegrate individuals who have died of, survived, or are currently being treated for cancer. I know I have a lower than average tolerance for people who feel sorry for themselves or complain.

I am beginning to loathe terms like "Cancer Warrior", "Cancer Survivor", "Cancer Victim" and pretty much any other noun that comes after the word Cancer. I will make an exception with Cancer Patient, since that's what they (and I) are. 

Cancer is a shitty, shitty, unfair and pointless illness that causes untold pain, heartache and loss to a great many people. So too is malaria, HIV, pneumonia, TB and heart disease. But why don't we hear people call themselves "TB Survivors" or "Heart Disease Warriors"? What is it about cancer that makes people define themselves by it and wear it like a badge of honour? It seems like once you have a tumour, you're a citizen of Cancer Country where people speak a language of medical terms and platitudes.

I have told two people I have cancer - my husband and my boss. I told my husband because I know he would feel devastated and betrayed if I kept it from him, and I told my boss because this stuff requires a fair bit of time off work for appointments, recovery, operations and whatnot. If I didn't have to tell my boss, I wouldn't have, and I am adamant that I won't tell anyone else unless I really have to or else I go so far down the road with this that it becomes necessary and I can no longer hide it.

For me, cancer isn't something that defines me. People seem to think of it as a character trait, and you automatically become brave in their eyes. But there's nothing brave about doing what your doctor tells you to because otherwise you might die. Bravery is Aung San Suu Kyi or Wang Weilin:

It puts it in perspective, right? What pisses me off the absolute most about all of this cancer culture is the slushy, lazy sentimentality that accompanies this disease. Here is a prime example from Facebook:

Okay, since we have established that I am indeed a cancer patient, allow me to rip into this absolute crap that claims to speak for me.

Firstly, what a ridiculously ill-thought out generalisation of cancer patients that does absolutely nothing to differentiate between the different cancers and different stages. I am quite certain that somebody with a relatively easily treatable, early stage cancer like I have feels very differently to somebody who is nearing the end of their life with a cancer that medicine can't touch. Cancer is a catch-all term for over 100 different illnesses, all of which have very different stages and outcomes. Why on earth would one generalise to assume that all of those people would have the same outlook? 

Secondly, good lord, how stupid must one be to have only one wish in the whole world - that they themselves recover? Presuming I rub a tin of catfood and a genie comes out and offers me a wish, what sort of self-absorbed shithead would I have to be to say "I wish that I, and only I, will get better from cancer"? Who the hell would choose that over, say, no more cruelty to man or animal anywhere in the world forever more, or the end to all suffering, or enough food and clean accessible water so that no person or animal will ever feel hunger or thirst again. Hows about "I wish every human and animal would feel happiness for most of the time"?. Even "that cancer is eradicated as of now" would be valuable. At the very very least, make a wish that everybody who has cancer gets better. What moron would waste their one catfood-genie wish on themselves?! 

Thirdly, and this is my real gripe - you really care about cancer patients? Then stop writing sentimental shit with hearts on Facebook, and get off your arse and DO SOMETHING USEFUL. Lobby Government for more funding, better treatment and more accessibility to drugs regardless of postcode or social class. Learn and educate people. Dress up in pink tutus with your girlfriends if you have to, and raise money by running the Race For Life in memory of a Cancer Warrior. All of those things will help progress the 'fight against cancer'. Do NOT fool yourself into thinking that you have made a difference simply by clicking copy and paste on a networking site. I sodding hate laziness and sentimentality and shallow thinking, and this Facebook status has them all. I try very hard in life to be the change I want to see. I care passionately about animals so I am vegetarian (intending to become fully vegan at some point), I coordinate battery hen rescues and save lives in my spare time (around 5000 hens a year at the moment) and I try to educate and inspire people. I do NOT lazily applaud myself after writing "Be veggie to save the wuvverly cute animals <3 <3" on social media sites. I get off my arse and actually make a real difference.

I am going to conclude this post by saying that I have done a lot of research and reading whilst sitting with my leg in the air the last few days. Whilst I can't see myself become an interactive part of the cancer community, (although I may join some cancer forums at some point if I need knowledge and past experiences) I did come across this post on a forum which I found inspiring. It is the last words from a lady who died of breast cancer. Whilst I don't agree with all she's written, she clearly had some similar feelings about all of this to me, and is a lot more eloquent about it too. I hope, if it comes down to it, I can end on such a note:

Wide Local Excision part 2

The first thing I remember is a lady saying my name. I opened my eyes and everything was blurry - it didn't help that I wasn't wearing my glasses because my eyes are appalling. The lady asked me if I knew where I was and I did but I shook my head for whatever daft reason. Everything was white and there was a bloke in the bed opposite. I figured I was in the recovery ward. I remember taking two codeine tablets with a tiny vial of water and I didn't understand why no more water would come out of it. I was shaking it upside down and must have looked like a somewhat stupid toddler. I was wheeled back to my bed, although I don't remember it, and then I have a vague recollection of being congratulated on shuffling from the trolley to my bed. 

I had to wear an oxygen mask and I felt really hungover and lightheaded. A lady brought me a ham sandwich and I refused it because I am vegetarian, so she gave me a tuna sandwich instead. NO. I AM VEGETARIAN.

Although I hadn't eaten or drank since the previous night, I needed the loo. I asked the nurse if I could go and she said yes, if I could stand up. Easy, yes? No. I fell over. She said "I'll bring you a chair" and I assumed she meant a wheelchair. I'm not one for social urination so I felt a bit panicky when she brought a commode. I convinced her to let me try again and this time I made it across the hall to the toilet. Go me! I can walk to the toilet with only one person to help me. This is what old age must be like. 

Speaking of old age, the lady in the bed next to me, Gladys, was elderly and had an alarm attached to her cardigan which ran to the bed. Every two minutes, she would get out of bed, the alarm would go off and a nurse would come and guide her back to bed. Every two minutes, literally. Those nurses have the patience of saints, they really do. Also, there is much to be said for private rooms if you have to stay the night.

At some point, I realised I had a drain in my leg. I must have been told this but I don't remember it. The drain was placed below the surgical site, and drains blood and lymph fluid. Apparently it's standard procedure:

Only a few ml of fluid collected in mine the whole day but the lady opposite me had around 100ml in hers so she wasn't allowed home and she said Gladys was up all the previous night and she barely slept. Poor lady was at her wit's end.

After a couple of hours of zombification, I felt better and asked if I could go home. I was told no because my blood pressure was too low. Food and water would help, they said, so I ordered an evening meal and started slugging back water. My husband arrived at 3.45pm and did a good job of not seeming perturbed that I had a tube in my leg and an oxygen mask on. He stayed a while but had to go home and sort the animals out. 

My blood pressure was checked every half-hour and stayed low but then the meal arrived. I know hospital food is meant to be dire but this was bloody lovely! I had macaroni cheese, and apple crumble with custard. I considered staying in overnight just for the meals but my husband was going to Austria the next day for work meaning I really needed to get discharged so I could get a lift back home. Nobody else knows I have cancer so it's a bit hard to explain why you need a lift from the hospital...

After my lovely tea, my blood pressure was finally okay so I was discharged. I accidentally pulled the drain tube out of my leg when I got up to get dressed - job done! - so that was one less thing. The nurse gave me info about keeping the wounds clean, extra dressings, discharge papers, and bob's your uncle.

As soon as I got to my husband's car, I burst into tears and was immediately pissed off with myself because I hadn't cried the whole time. I think I was just tired and a bit emotional. So since Wednesday night I have been sitting on the settee with my leg elevated. I have discovered Nurofen works a treat at taking the edge off the pain and if I put my mind to it, I can walk without a limp.

I am utterly bored and have been reading other cancer blogs and I will be writing a diatribe about this tomorrow. What fun!

Wide Local Excision part 1

Having gone indoor skydiving at 9pm the night before and got back at 11pm, I was a bit knackered and running late but I got to the ward for admission one minute past 8am so that was pretty good going. Because I'd had the lymph node mapping the day before, I was first on the operating list - a bit scary but there we go. I answered some questions about allergies and the like, then I was shown to my bed in a ward with three other ladies and given a gown and some very sexy Nora Batty anti-embolism stockings:

Oh, remember the knickers situation? This morning I pulled out every pair I had. Some were too grubby, some were too sexy, some were too skimpy. But, then I found the PERFECT pair for surgery: black, silky lycra, not too skimpy and not too granny. Perfect. But as the nurse handed me my gown, she asked "are your knickers made of cotton?". "No" I replied warily. "You've got to wear these then" she says, and hands me some paper knickers. PAPER. And they were baggy and bulky, like a nappy. Oh my god, I am 33 years old and wearing a paper nappy!

 Not long after that, Mr Brackley came along to say hello and draw on my leg. He marked off the four centimetres he was going to take off my calf, and he checked the marking at the top of my thigh was still there. He was a nice chap, I liked him. Here was what he drew. It seemed like a lot of skin.

After him, the anaesthesiologist came along. I have to be honest, I didn't like her too much. She just didn't seem interested in my case and didn't really make much eye contact. I wanted to be friends with her so she would give me the good drugs but she wasn't having any of it. Maybe she's like Facebook and has a friend limit. After that, the lovely porter brought a trolley in and we were off. It was a bit like being in Casualty or something, although I told him I was capable of walking (I only said this after we'd gone up a floor and he joked that I waited til he'd pushed me there til I said it). All in all, he was pretty good at putting me at my ease; it can't be the easiest job pushing sick scared people around. We got to Operating Room 3 and into the anaesthesia bay which was bloody FREEZING! The nurse there was called Mary and was really lovely. She knew I was nervous (I think my fidgeting gave me away although I was trying to be cool) and she asked me about my pets and leisure time and whatnot to try and get me to relax. There'd been a mix-up because the anaesthesiologist didn't arrive in time so the surgical team was in with another patient doing a local anaesthetic procedure. Because I had to wait and it was so cold, Mary got me a heated blanket and tucked me up like I was a little kid. Half an hour later, the anaesthesiologist came in and they got to work. Mary needed to hook me up to the ECG heart monitor. She told me to untie my gown and lean forward...and then she noticed I was wearing my bra. It turns out you're not meant to, so off it came. This happened with my ECG the other week too. Rocks learn faster than I do...!

She put one of those clippy things onto my finger and then my heartbeat was up on the screen. It was hovering around the 80bpm mark so I passed the time by trying to make it go slower by willing it. It turns out I don't have that skill and in fact each time I'd look at the monitor it would actually speed up. Bloody hell, I am meant to be superhuman. It's bad enough my body has pulled this cancer crap and now my heart won't even comply. Mary took my temperature with the ear thermometer (interesting fact - it uses infrared which is how it measures so quickly). Lastly, she inserted the cannula into my hand:

and then the anaesthesiologist injected a syringeful of painkiller into it. To be fair, she did warn me that I might go lightheaded and good god, did I. Without wanting to sound whingy it wasn't a nice feeling. I don't remember her telling me she was injecting the general anaesthetic, although I was trying to think about my pet chickens so I must have known I was going under. I remember looking at Mary and it seemed to take ages and I didn't think it was going to work, but it clearly did. I woke up what seemed immediately but actually it was two and a bit hours later in a totally different place.

Radiology

It doesn't inspire confidence when you ask reception where the department of nuclear medicine is, and they look at you blankly then ask "pathology?". "No", I said, "the department of nuclear medicine". "Is that pathology?". After the intervention of someone who did appear to have a working knowledge of the hospital, I found my way to radiology, which contained the hallowed nuclear medicine department. There were lots of warning lights around and bright yellow warning stickers, which made it a bit exciting and like I'd walked into Spooks or something. A lovely nurse called Rachel explained to me that I'd be injected with a radioactive isotope in my leg which would then travel to the first lymph node and they'd mark it so the surgeons knew which to remove.

My scar was big enough that it needed 8 injections. The first six didn't hurt too much, the last two did but only for a minute. Then, I had to lie down on this big scanner and be shunted forwards into the cylinder so the camera could trace the isotope:

I had to lie very still on my back for 40 minutes which sounds easy, but after 20 mins, my lower back felt like it was snapping and I had a horrible itch on my foot. It was a very boring view but Rachel let me read my Kindle so it wasn't too bad:

After the time was up, they drew on my leg with a radioactive cobolt pen and marked the sentinel lymph node. I thought it'd be in the crease of where my leg meets my torso but actually it's just at the very top of my thigh.

I had to wait 40 minutes afterwards in case the isotopes went to another lymph node as well - Rachel, bless her, brought me a blanket because it was bloody freezing in the waiting room - then back onto the machine for another blast...only 5 minutes this time though. Apparently there was a chance there'd be a node in my knee that would also need removing - um, nobody told me that. But I don't have a sentinel node there so all well and good.

Here is a photo of it on the monitor. See on the right hand side, the white dot that looks like a star? That's the node, all radioactive and shiny.

My leg is aching now but oh well. It's a small price to pay and I won't be complaining. Right, off to indoor skydiving now! Then I need to pack my overnight case when I get back. 

Oh, last thing. This sign in the toilets amused me. I felt like I should be in the opening titles of The Simpsons - radioactive wee!

Pre-op

On Friday I had to go to Whiston for my pre-op. I was there two hours and it consisted of an assessment - a bunch of questions, urine sample, blood pressure, height, weight (don't look, don't look) and so on. After that, a magical mystery tour of the hospital! First stop, medical photography for a close up of my leg. 

Next, down two floors to phlebotomy for blood tests. The lovely nurse clearly does this all day because she took two samples and I barely felt the needle although I do have a splendid big bruise on my arm that looks a lot worse than it feels. 

Next, an ECG. This isn't a standard test, it came about because I said I'd had heart palpitation in the past. This is where things got awkward. The nurse told me to take off everything from my top half. Having seen Grey's Anatomy, I knew that I left my tatty but comfy old bra on. Ha! It turns out that the TV bra-on rule has something to do with no pre-watershed breasts because nope, the nurse meant take everything off. Whilst I know they see it all day every day, I do still have that childish fear that they will run giggling into the staffroom to describe my overweight flabby being to their equally amused cohorts. She must have sensed my embarrassment regardless of my try-hard nonchalance, as though I let strange women manhandle my breasts every day, because she said "don't worry, we all have them". As she stuck the little doodahs to my chest and legs, she asked why I was having an ECG as I was so young. I explained about the melanoma and she told me about her 18-year old daughter who had a cancerous mole on her foot but is fine now. It's hard to wear your sympathy face whilst freezing cold and topless in front of a stranger. 

Last stop, plastic surgery to see....someone (not sure if he was a registrar or consultant) who didn't seem to know anything about my case and asked me what surgery I was having and why. He then told me to drop my pants (in a nicer way) so he could see my leg and feel my groin. Is this what a porn star has to put up with? Alas I had only expected blood tests so I was wearing equally tatty but comfy granny knickers. And odd socks. The kind doctor pretended not to notice - or maybe he really didn't - but I was humiliated enough that each appointment from now on will see me in nothing but La Senza's finest. 

I'm just off now for my pre-op lymphatic system mapping. I know it has something to do with radioactive blue dye (or maybe just blue dye?) being injected into my leg and they can then see which is the sentinel lymph node but as to how? I'm not sure. I will dutifully report back later. Finest knickers on for this one.