fortewinks

It started with an abdominal pain. The ache had been there for a while but as I had taken up Pilates and was using my core muscles more intensively, it became more intense too.

It feels like a twisted bowel I told the GP. He gazed at his computer screen. It says here you have fibroids and an ovarian cyst. We’ll get them looked at by the Gynaecologist. Despite my noting that this was the wrong place (like all women, I know the diference between In and Out) I was sent for scans, screens, ultrasounds, MRIs, bloods, you name it. We’re looking in the wrong place I told the Consultant Gynae at Barts. So you keep saying he said. And eventually: you’re fine. He did as I asked and wrote to my GP asking him to refer me to the Bowel folk at Barts.

While all this was going on I returned to my GP twice with fresh and strange bowel-related symptoms but was sent away with: you’re too young for this to be anything sinister. It’s probably deep piles. Don’t worry about it. Keep seeing the Gynae.

Almost exactly twelve months from my initial GP consultation, I explained the evolving symptoms to a sympathetic Registrar at the Royal London Hospital. Baffled by my GP’s inactivity and without a moments’ hesitation Colonoscopy! he cried.

In the hands of a very kind Dr Gareth Parkes, the two hours of that procedure were bearable although after removing five polyps, the last defeated him; at 6cm and stuck to my bowel it was too stubborn. Later, in the recovery room he advised very gently that I should prepare myself for what may be something cancerous, possibly. The biopsy would reveal more.

This only really sunk in when the discharge nurse gave me a card adding that I could call her or her colleague any time: Clinical Nurse Specialists – Colorectal Cancer it said. As I boarded the bus to work the world blurred to slow motion. I found myself on a strange and muffled lunar surface, a sensation that remained with me for days.

I saw my GP in March, and asked about my scan results. You’re seeing the people at Barts tomorrow, he said fixed on his screen, not meeting my eyes. They will clear things up. Ignoring his odd demeanour, I remained in good cheer, after all, he seemed unimpressed with whatever he read on his screen.

At Barts Colorectal Outpatient Clinic I found a friendly faced man and a handful of students whom he explained were learning his craft, did I mind them being there? Of course not, my brother is a medic and he too had to be taught somehow. The friendly man smiled, observed that I had seen my GP the previous day then assuming the diagnosis had been given … pointed at his screen and said do you want to see where the cancer is? Shocked to the core but staying calm I turned to the students and quipped: Come and look. I grew this especially for you so make sure you pay attention. The picture on the screen was not pretty. Cancer. The word buzzed around the outside of my head looking for a way in but found no access. I remained outwardly cheerful and stoic; inside my head a pressure took hold.

It was explained that I could have further colonoscopies to scrape away the offending cells, or I could opt for major surgery to remove them together with a good margin of bowel either side. I must be in hospital for a week and then at home for at least two to recover. I’ll have the operation. Who is going to do it? I asked. I will, is that alright? said my Consultant. You seem to know what you’re doing said I. Who are you? A collective intake of breath from the students. He smiled before writing his name for me and adding with gentle expression that he had one concern to be allayed prior to surgery: I must have an MRI to tell us whether or not the cancer had spread to my lymph nodes.

The low pressure became more intense and the same muffled lunar bus journey followed. Cancer only happens to other people and I had become one of them. I called BB and my family from the office but stoicism gave way to shaky and shocked tears; I cut my losses for the day and went home to Google the Consultant in whose hands I found myself.

Mr Shafi Ahmed was Barts’ very own Coloproctological God. He was appointed as a Consultant General, Colorectal and Laparoscopic Surgeon at The Royal London and St Bartholomews Hospitals in 2007. He is the lead clinician and Multi Disciplinary Team lead for colorectal cancer at Barts Health NHS Trust; he did indeed know what he was doing.

The MRI took place ten days later and I was told the results would follow soon. In the interim limbo I drank. I drank copiously every night to numb the thoughts: Cancer in my lymph nodes? What does it mean? What about My Girls? What if …?  Blurry days followed, hours at the office pushing along as if everything was normal; nights pacing the house scotch in hand, trying to escape from the heavy noise in my head. BB remained calm, never chiding and in his rock-like way helped me not really cope.

The MRI shows no spread, a voice came over the phone. Mr Ahmed wants this to happen soon. We’ll give you a date for the operation in the next few days.

It transpired that Barts could not fit me in for longer than Mr Ahmed was happy with. I was transferred to the private sector and admitted to the London Independent for an operation on 14^th April. On the way we stopped at The Royal London to see My Nurses who marked the place where a colostomy bag may go should the surgeon deem it necessary. I stood, sat, bent, lay, sat again and a black spot was inked onto my skin.

You really don’t need to do this, I said. I’m not having a bag. I flatly refused to engage with the process; instead, with the help of photographs and instructions they explained to a more accommodating BB what the bag would involve. If I know what to do with it, I thought, it’ll happen. If I behave as though it won’t happen, it won’t happen.

We arrived at the BMI London Independent at 3.30pm and before long I was gowned up and waiting for Mr Ahmed. He arrived in ebullient form. What are you doing here? I asked. Shouldn’t you be sharpening your knives? He delegates such things he said, but assured me that the knives would indeed be sharp. He ran through the risks I was already acquainted with. No bag! I demanded. He promised to do his best: very few of his patients end up with one.

At the operating theatre the anaesthetist approached, my nerves soothed by his soft Irish accent and very blue eyes blinking slowly behind round spectacles. Make sure it lasts I murmured as I passed out.

Some four hours later, I awoke in the process of being transferred onto a bed in ICU my voice crying pain, pain, pain! Something cold went into my neck and the agony abated. Next to me a concerned and handsome BB held my hand. No bag he said. No bag. No bag.

As I became more aware of my surroundings and the scaffolding that supported the drip and other lines feeding the veins and arteries in my neck arms and hands, I came to know the faces of those to whom the wellbeing of patients like me falls. Sunny but serious these nurses and doctors came from places like Ghana, Nigeria, Greece, the Czech Republic.

They cared with efficiency and empathy; whatever was being pushed into my veins made me sick so they administered an anti-nausea concoction which made my blood pressure rise through the roof. They changed this to another, which produced a blinding migraine. I continued to be sick. Something is reacting with you and I don’t know what it is! cried Dr Greece. I’m sorry, I offered. It’s not your fault! he exclaimed and strode away, puzzled.

The female nurses were fascinated by my apparent lack of wrinkles: We’ve seen your age in your notes! With great amusement I found myself that night holding a facial massage class. Nurses everywhere; tell your patient she is beautiful and see her pain fade … in those dark hours these women made me feel good about myself and yes, it helped.

The following day the Physio arrived to get me walking. I eased out of bed and clutching the drip trolley shuffled to the end of the ICU ward and back again muttering obscenities under my breath whilst attempting a semblance of cheer to the other, far sicker inmates.

Day three saw a transfer to the ward. FirstBorn arrived just in time to assist, chatting cheerfully and almost masking her concern at my obvious discomfort. A fresh attack of nausea meant I was wheeled to my room where I lay exhausted. A new team of nurses introduced themselves. My abdomen was examined; a very neat scar above my pubis and four laparoscopic puncture points looked in good shape. Everyone was pleased.

The week that followed was sleepy, BB regularly by my side chatting about his day and his desire to have me home again. Checking and responding to business e-mails left me drained and no more than two hours a day had to do. Otherwise, I drifted and slept; my shuffling round the ward floor still clutching drip trolley, graduated into a slow walk.

I needed big knickers; well, huge ones that would surf over my wound without constricting a sore and puffy midriff. An old school friend duly arrived with a three-pack of colourful and patterned M&S cotton size 14s. These were beyond Bridget Jones, and truly not a good look but for the task in hand, absolutely perfect.

Of my lovely nurses the brisk nurse-nun combo Sister V was great fun and always had a tale to tell. Serendipitously, sparkling Nurse Tia was on duty when my very own sister Maria was visiting: I feel a cocktail coming on, don’t you? What were the chances, really?

Mr Ahmed visited regularly, bursting into my room like a ray of sunshine. He was delighted with my progress although concerned with a pain that developed around the area of the internal bowel join. I was sent for a CT scan to check for leakage and put on a strong antibiotic for good measure. Slowly everything settled, except the nausea.

Please take all this stuff out of my veins Mr Ahmed, I begged. It’s making me sick. He concurred and they removed all but one line into my hand, just in case it was needed again. It wasn’t and the following day the Ray of Sunshine approved my discharge from hospital.

Chauffeured by BB in his cranky camper van, I felt like a princess as we lurched the short distance from Whitechapel to Bethnal Green. I went straight to bed under instruction to wake him should I require anything at all. At two in the morning I craved and received mashed banana and brown sugar. My diet had been sketchy in hospital; they simply didn’t seem to cater for cases like this and I was limited to tiny morsels of mashed potato or scrambled egg; both sat unhappily with my raw system.

The following days seem hazy now. I shuffled around the house never far from the bathroom. My life revolved around the demands of my newly stitched bowel, eating very little and often, nothing that would excite the digestive and evacuation processes.

Visitors came every day, friends who looked tentative but pleased at my progress. O brought cupcakes I tried to find one that had Alive! written on it, but you’ll have to make do with these. Another sent a gift inscribed: Happy not dead. Thanks Boys.

It transpired that my abdominal pain was caused by adhesions around an old appendix scar, much of it removed by Mr Ahmed. Had that ancient scar tissue not grown into a painful problem the cancer would have remained undetected despite visiting my GP with reports of other unusual bowel related activity. I wrote to him: what exactly would the outcome have been of undiagnosed bowel cancer had I not insisted on further investigation after your dismissal of my symptoms? He met with me to apologise. He reported his failing to the CCG and revisited other patient records to check for oversight.

I returned to work after two weeks, sooner than I subsequently realised I should. Tiredness prevailed and I slept for eight or ten hours a night. I arrived at the office late morning so that my system could do its thing in its own time. Rushing or ignoring the process resulted in a painful day and the needs of my body must come before anything else.

A recent follow up appointment confirmed that the cancer was isolated to the point where polyp and bowel conjoined and the good margin wisely removed by Mr Ahmed was free of the disease. I am healthy; I escaped The Bag and any sort of chemo or radiotherapy. My encounter with cancer was less of a battle, more a brief skirmish.

The experience could have been far more traumatic than it was. My luck was to land in the lap of Barts, an NHS exemplar. From diagnosis through interim care, pre-assessment screening and post-operative diligence I could not have received better or kinder attention. Dietary detail apart, the London Independent was excellent. About 60% of private hospital capacity is taken up with NHS patients; while some of their counterparts provide inferior accommodation for public sector customers, my room and treatment were on par with the private intake. My NHS status made no difference to the teams of doctors and nurses who set me on the road to recovery; their job they said, was to provide excellence no matter what

Family and friends were abundant with care and reassurance; people I did not know well demonstrated unexpected support and affection. Life is sweet. Nothing matters more now than to be here for My Girls and a beautiful future with BB.

I may not have the self-discipline to treat my body as a purist temple; a small and happy chapel I can manage and it will be worshiped accordingly.