The joy of ongoing appointments

I was talking to someone the other day who was saying that going back to the Macmillan Cancer Centre for appointments is something she fears and finds upsetting. And I get it, there can be a certain sense of PTSD with these things, and constant reminders of the trauma isn’t necessarily what you want.

But my views could not be more different.

I remember the first time I walked into that building. Hanging from the ceiling in the foyer is a colourful art display of things picked up on beaches across the UK. From toy spades to flip flops to plastic straws to plastic crates and any other number of things. You could sit for hours gazing up at all the things hanging there, and collectively, I have.

I remember the first time I met all the smiling people who told me they would look after me. The oncologists who said they knew how to treat me. I remember the joy I felt at being in safe hands.

I remember going back every treatment week to catch up with everyone and start another session to cure me. All the people who were working together to give me the best chance at living. The laughs I had with my pharmacist, the smiles from Ambulatory care when I showed up for my chemo. We would debrief on our weekends.

I remember finishing chemo and being transferred over to my surgical team. The same building, but clinic was over the other side. You would think it would mirror the oncology clinic since it was the same floor but it didn’t. It was similar but not the same. But the pattern on the floor was the same – a colourful mosaic designed by the man who designed the Sgt Pepper Album cover. Can you imagine?

Even after surgery I didn’t feel on my own, despite being cast out into the big wide world – I had appointments to come back and see everyone. They still cared, they were still looking after me.

These days I get to come back for Oncology clinic every two months, and a chest xray to check it hasn’t spread to my lungs. I know some people would use that as an opportunity for anxiety that their cancer has come back and they will therefore soon die. I approach these appointments with excitement. I’m so glad and grateful that they keep monitoring me so closely and I quite enjoy getting told every couple of months that everything is ok. And if there is a day when it isn’t, well I couldn’t be more happy that they had kept checking.

The Macmillan Cancer Centre is also where I have access to my psychologist, as well as complimentary therapy (e.g. Massage and reiki *eye roll*). It’s where I can pop in to the ‘Living Room’ to make a cup of tea and probably make some new friends if I feel like it. It’s where I could attend support groups if I needed them.

This is the place that has taken me in, looked after me and hopefully saved my life. That keeps providing love and support, even now. That has somewhat been my second home over the past 18 months. That is filled with people who care about me and my well-being. What an amazing place to have! Why would I fear going back? Why would I get anxious each time they show they are still looking out for me? Why would I be angry at the smiling faces of people who’s job is to help me?

Every time I go back I am reminded of how lucky I am and I smile. I smile for all the good I have experienced over the 18 months, thanks to this very place.

Happy 70th birthday NHS

It is the 70th birthday of the NHS.

Where to start? I suppose with something that’s obviously close to me.

Looking at cancer alone – 50% of people get cancer. That means you, and your mum. Or your partner and your dad. Or your sister and your best friend. I know of people in the US who couldn’t afford treatment, or who have gone into hundreds of thousands of dollars of debt. I wouldn’t be able to afford that, would you? Even in Australia, when my father got an MRI checking his prostate cancer, he had to pay $600/go and that’s on top of private health care.

Even just looking at MRIs… I have to have one every 2 months. No way could I afford like £400 2 months, and that’s just for maintenance scans! Who even knows how much everything else would (have) cost.

Thanks to the NHS, I’m not forced to go into ridiculous amounts of debt just to have a chance of staying alive. The beauty of us all paying that bit of tax to the NHS means that anyone can get the treatment they need regardless of whether they manage to have a job that gives them lots of money. Their fate will not be sealed by their pay check. And it’s there for when the rest of you need it.

And I haven’t had to settle for a sub-par surgeon or someone who isn’t a specialist in my area, I’ve been able to get the surgeon I need, in fact one of the best.

When I was diagnosed, some people asked me if I would move back to Australia for treatment. This confused me a lot. Why would I decide to leave my life and the country I want to live in just because I have cancer? There’s no need to necessarily give up on life just because you have cancer (not for me anyway, I know everyone’s cancer is different)! What a depressing thought that I would suddenly quit everything of the life I have built and want to live.

But that aside, why would I want to go back to a country where you’re not looked after? Where you have to fend for yourself and if you’re not rich you must go into a lot of debt to have a chance of life? I say this with not a lot of knowledge how it would be to have my cancer in Australia, maybe you can get some funding to help and maybe Medicare can help with some. But going off my dad’s experience, it is no NHS.

And the people who work for the NHS… they are the most heroic people. The doctors and surgeons are making miracles happen, the physios, anaesthetists, radiographers, therapists (ok, I’m not going to go on naming all the types of professions in the NHS, if you’re one, you are the best) are irreplaceable, the nurses are absolute angels, even the people cleaning my room when I was in hospital brought me so much joy.

Sure I’ve had moments where things haven’t been great. I’ve had blood work lost, I’ve waited in a room in A&E until 3am waiting for a bed in a ward whilst in the absolute worst of my neutropenia and illness during chemo (but they did manage to find me a private room eventually), I’ve had dentists ignore my cancer (though to be fair they were NHS but made me go on private to get an appointment quickly), I’ve had doctors forget to come around and discharge me from hospital, I’ve had doctors in hospital causing me unnecessary pain and discomfort when they thought they were doing the right thing but didn’t take a moment to think… but it takes time to go through my memory to find bad moments, and they are only a small handful of thousands of fantastic ones.

I feel like people who complain about the NHS are those who haven’t needed it yet. Or even if not, I know there can be bad experiences in anything. But the amount of people I know who the NHS has saved…

The NHS makes me proud to be British. Growing up in Australia, I never felt Australian, I knew I was British. And from the first time I stepped off that plane in London 3 years ago, I knew I was home. I don’t feel like I could ever leave. There are many things that make me proud to be British, and a few things that don’t, but above everything is the NHS. This is something so important, special, necessary to our lives here. It underpins everything, looks after us, and it’s something we’ve helped create. What a fantastic thing. I know it struggles, I know more needs to he done to help it out, I have no suggestions of how to help it, I wish someone did. But I do know we need to protect it, to keep it alive.

Happy birthday NHS. I think everyone who has ever worked for the NHS in any capacity can really take this as their own personal celebration too. From the people who used to drive blood donations around from the donor to the receiver whenever needed before refrigeration existed, to the clinical trials which ended up saving lives, to the doctors working long shifts to make sure everyone gets seen and we all live.

We thank you all. So many of us are here because of what you’ve done over the years.

Happy birthday. Have a champagne, NHS, you deserve it. But don’t let your hair down too much, because we need you, every second of every day.

The final bits…

With the trachy out, it was time to start breathing through my mouth. My nose was entirely blocked so there was no chance of it helping me out. My mouth got so dry. Night time was the worst. I already wasn’t sleeping much, but now my mouth and throat were dry and burning. And I couldn’t swallow. I could use little pink sponges to moisten my mouth but it didn’t really help. So I grabbed a syringe and syringed water into my mouth to properly coat it. Then I realised I could swallow my saliva and I could put water in my mouth and I may have cheekily combined the two a little. It didn’t make my mouth any less dry during the night, it didn’t stop me waking up constantly, but it did bring me some relief.

The Trachy was out on the Friday. On Saturday Dr Claire came to visit me and said I could start trying to drink clear liquids. I sheepishly said I had been experimenting with it a tiny bit. I showed her and her two doctor friends in tow how I had been syringing water into my mouth and swallowing it.

I had to do it over the sink because there was always a chance I would spill it. I couldn’t close my mouth so it was hard to make a seal. But I managed to seal my bottom lip with my flap. It had been almost 2 weeks since I’d had anything to drink, and a lot had changed in my mouth. But I practiced.

When Mum and Dad came to visit that day we went down to the cafe and had a peppermint tea. I shared it with my jumper, but I did get to enjoy some of it. Dad also popped out to get me some Ribena. The Ribena was amazing. It got rid of the horrible taste in my mouth, and it was pretty nice to taste something sweet and cold and delicious.

The following day I was allowed to progress to REAL TEA and we went down to the cafe again and I had my first cup of tea in 2 weeks. I don’t think I have ever gone that long without tea. I hope to never do it again.

On the Monday I had an assessment with the speech therapist Lucy to assess my swallow. I like her. She was the one I met before the surgery, and seeing her in hospital felt like meeting up with an old friend. She was amazed by how well I was doing considering my lips wouldn’t meet and I had just had this massive surgery! My swallow was not compromised, though my mouth was being a bit tricky. We tried a syrupy chocolate supplement drink and then custard. Using the spoon was difficult because I didn’t have a top lip available to scrape the contents off it but I quickly found I could use my bottom lip for that job. So I would put the spoon in my mouth, flip it, scrape it off, and say ‘mmmm custard’. (I like custard).

I was spurred forward by this and that afternoon I was given the ok to move to puree food. I ordered pureed salmon for dinner. But they ran out. So I got puree roast beef. Um… why is that a thing? It was horrible. I struggled to get it in my mouth, I struggled to get it off my spoon, and I struggled to swallow it as it was like dry paste. Not to mention it was yuck. The soup and the yoghurt I was fine with though. It was messy, and I had to cover myself in a towel, but I got through it. They would be assessing me to see if I would have to go home with the feeding tube or not, and it seemed likely I would. I’d had my training, I had the pump etc. I was ready to feed myself at home. I wasn’t looking forward to it, but figured it was better than staying in hospital for too long.

The next day Deepti came in for the Doctor’s visit. The first thing she said to me was ‘how would you feel if I told you that you could go home today?’

I was in shock. ‘I would feel very good!’ I finally exclaimed.

It was Tuesday. Two weeks and one day after first surgery, one week and three days after second. There had been talk of me going home near the end of the week, but I had just been saying to my parents the day before that I didn’t know how I’d last many more nights in there. They were starting to take their toll.

Deepti asked how I was going with my eating. I said it was difficult, but I was fine with the soup and yoghurt, custard etc. and drinking, but I found the puree food tricky. She said she trusted me to sort out eating and promptly took out my feeding tube. I can’t explain how happy I was. I had not been feeling very well with the feed they’d been giving me and I hated being hooked up to it. I wanted to be mobile and zoom about the place.

I was freed from my shackles and about to be freed from my incarceration! I couldn’t believe it!

The rest of the morning was spent packing, getting loaded up with supplement drinks, dancing around the room with Clarence, saying goodbye to nurses and Kat the physio (I was going to miss her the most) and waiting for my medication so I could LEAVE. I was excited to tell my parents when they turned up for their daily visit that I would be leaving with them!

I was exhausted when I got home. I hardly had the energy to say hi to my housemates. But I did. Then went to bed. I had a long way to go, but I was home. No more being woken up every few hours. No more having to buzz and wait and ask every time I needed something. No more freezing cold dry room. No more having to appear perky for every new visitor. I could just lie on the couch, drink smoothies and feel sorry for myself. Things were looking up.

Little adventures

On day 13 of my hospital stay, Kat the Physio said I was allowed to go for a little adventure, so I actually got to leave the ward and we went up to Level 16 and looked out at the view. UCLH has a tall tower, and is situated pretty in the middle of London, it therefore has a pretty decent view! The big window looking out from the corridor as you leave the lift faces West.

I wore my hospital sock/slippers, and we carried box of tissues, and off I wobbled.

I also had a pretty decent view from my room for that matter. It was nice, especially when it snowed. In the afternoon I would sit in the chair by the window and watch North London finish its day.

We went up to level 16 quite a few times. There was something calming about looking out over the tops of the buildings, watching the buses traverse the streets, watching the world go by. One day as we were getting into the lift to head back down, I ran into a Physio I had seen in ICU briefly. ‘Jen!’ She exclaimed! It took me a minute to place her, but I got there. We had a quick catch up, it was nice to run into her.

One day we even went out the bottom of the building and stood in the sun. Its rays soaked through me and recharged my batteries a little.

Once my Trachy was out and I got the OK to have clear liquids, we started making trips down to the cafe for peppermint tea, and then the next day I was allowed proper tea. That first cup of tea was heavenly. I had been desperate for it. Most of it ended up down my front (I couldn’t close my mouth, so keeping liquid in there was an interesting challenge) but being able to sit in the café and have a cup of tea made me feel a bit human again.

Mum and Dad visited every day. This was amazing, it made me so happy. I looked forward to their visits and was sad when they had to leave. Ma would read me a couple of chapters of a book each time. It brought me no end of warmth and comfort. Da would pop out and get me things like wet wipes and Ribena once I could start drinking.

My days consisted of a few highlights – visit from the doctors, visit from Kat the Physio, visit from my parents. Occasionally I got other visits too.

Near the end of my stay in the ward, I had a visit from the Sister I had met during my first time in ICU. It was so nice to see her. Once again, the people I am meeting along the way are amazing. These poor people who work in ICU – they deal with people just coming out of anaesthetic, and people in their first few days after admission… basically they see everyone at their worst. And a lot of them saw me at my worst. And the amount of love and support I got from a lot of them regardless, was amazing. But it must get disheartening to never see the stage when people get better! You just get them to a stable point and then ship them off to the ward. Anyway, it made my day that Erika came to visit, it was nice to see her again, have a catch up and get a hug.

On my final day, as I was packing up, who popped in to my room but my bestie Rebecca! I was sad it was looking like I wouldn’t see her again, so I was ecstatic when I saw her and gave her a huge hug. We had a bit of a catch up and a chat before she had to run back to work and I had to talk to a nurse about discharge details.

I can’t quite explain how much I like and appreciate these people. I know I only met them for a short period of time, but some nurses (and doctors, nursing assistants, etc.) I felt like I really connected with, and when I was feeling so low, that meant everything. It’s something that’s hard to explain if you’ve never been in this situation. But these nurses were my lifeline. And the fact that they came to visit me after I had left their care will stay with me forever.

View from T16:

View from my room:

Out in the sun (note mum carrying the arsenal for dribble and blood catching. Also note trachy is out):

The second trip to the ward in 3 days…

When I was transferred to the ward for the second time in 3 days, I was back in a shared ward. Thankfully this time there was no one wailing all night like there had been the time before (I remember writing to my nurse saying ‘just give her sleeping tablets and give me sleeping tablets and all will be well. I’ll meet her in my dreams and calm her down’).

My doctors came to visit me and they said I would be moved into a private room the following day. Aah thank goodness. They checked the flap and I thought Deepti looked concerned so I asked what’s wrong. She said there’s no concern, she was just tired. Poor thing, I can imagine. My goodness these guys work hard.

Once again I thought my trachy was choking me. I was struggling to breathe and I was coughing a lot (it really irritated me, have I mentioned?!!). I wrote down a long note to the nurse, Rose, about how it was my first night and I was feeling stressed about the blood running from my nose and mouth and thought I might be being choked. She was amazing. She put my mind at ease immediately about the choking. And she taught me all about ‘suctioning’ which involved sucking the saliva out of my mouth that I couldn’t swallow (the trachy didn’t allow swallowing). Since at this point my saliva was pretty much just blood, it was nice to suction it for a bit instead of waste another box of tissues.

When it was bed time, I tried to get comfortable and sleep but I couldn’t deal with letting the blood just go everywhere so I was trying to catch it all the time. This meant no time for sleeping. After a few hours, Rose came in and suggested some sleeping tablets. YES PLEASE!

I think they managed to get me about 2 hours of sleep before a cleaner decided to burst in and started trying to clean the floor at about 4am.

When my doctors came to see me the next morning I was a mess. I had cleaned up my face but my gown and bedding were covered in blood and I was feeling pretty damn low. They ordered the nurses to clean everything, as well as change the dressing on my trachy. They also told me that at around 11 I would move to my own room.

I can tell you, by the time I was settled in that room, I felt like a different person to what I had been that morning. I even had my own bathroom! Amazing.

I was so happy to find out Rose was my nurse again the following night. In my mind she was my guardian angel. I knew she would protect me, put me at ease if anything was wrong, help solve my problems. She was also just one of the sweetest, loveliest, most awesome people… I am very grateful I had her that first night in particular, but also for two other nights too.

Last day in ICU

I had a very odd nurse that last day in ICU. She kept grabbing me by my painful cannula arm (like literally grabbing my cannulas) or grabbing me by my shoulder injury. At some point she managed to hit me in my swollen face and instead of just trying to apologise she tried to grab my face. I pushed her away. I feared slightly for my life.

I asked if I could go to the bathroom. I don’t know why but they wouldn’t let me walk there. So they brought me a portable one. She insisted on getting me sitting on it and said ‘would you like me to leave and give you some privacy?’ I nodded profusely. She then proceeded to keep pottering around my room doing things. After about 5 minutes I grabbed my book and wrote ‘are you going to leave and give me some privacy for a bit?’

‘Oh not now…’ she replied.

I didn’t get it.

After about another 5 mins she left.

I’m a very private person. I really am not ok with doing these things in front of people, which I think is fair! Though I did manage to deal with the fact that more people than I feel comfortable with saw me naked in this time but there wasn’t a lot I could do about it.

Apparently I was getting moved out of ICU that afternoon. We took final bloods from my arterial line and then took it out. One less thing in me to worry about!

We packed things up and I waited. As we were finishing gathering things, someone poked their head through the door to ask my nurse something.

‘Jen?’ I heard through the door and looked up.

It was Ronnie! I didn’t think I would get to see her again!

She came and sat next to me and held my hand. I felt like crying, I was so happy to see her face!

She was confused as to why I was back in ICU, as last time we had seen each other, it was Friday morning and I was heading out of ICU and into the ward. It was now Monday, and I explained how between then and now it had all gone downhill and I had ended up back in surgery. She got worried it was because of the Doppler going missing during her shift. I assured her it wasn’t.

What a fortuitous accidental re-meeting! It was seriously like a breath of fresh air seeing her again. Ronnie, you made my day!

As she was leaving, someone else came in and informed me that the blood taken that morning had been lost. This isn’t even the first time I’ve heard this. Unfortunately now, my arterial line was gone and this meant that I was going to require needling. Great. My favourite. And it was necessary to get these bloods in order to to be allowed back into the ward.

Amazingly, after about 5 attempts, we finally got some blood. Phew. 5 attempts is stressful and painful though.

And right on time, the porter turned up and it was my time to go zooming down the corridor and back up to T6. Back into the ward. I could only hope that this time I would be there longer than one night.

At this point it was Monday. 2 days post surgery #2. The swelling was starting to come up.

A few of the amazing nurses on my first trip to ICU

The first thing was to work out a way to communicate with people. How else would I make friends?

The first notebook Dad got for me said on the front ‘Be your own kind of beautiful’. Seemed fitting, since I would definitely be challenging the normal ideas of ‘beautiful’ for some time (someone did just tell me I was totally rocking the look hehe – the ol swollen face look).

The scribbles start to make sense after a few pages, as the initial anaesthesia wore off. I was never far from my felt-tip pens or notebook. In fact everything was covered in pen – my arms, my sheets, my gown, at one point I even managed to draw on my Physio.

After the first couple of days of confusion, things got a bit clearer. I was helped through by some amazing people as I was recovering in the ICU.

Anna was the Portuguese nurse from Porto. I promised her that once I was better I would prioritise visiting her home town. She said to drink their special ‘Porto wine’, I of course agreed. I realised later we were talking about Port. Yes please, I will drink it all.

Then Maria took over. She was lovely. She had a brilliant knack of explaining things to me really well as she was doing them, putting me at ease and making sure I was informed about everything that was going on. This appeals to me so much. Looking through my conversation book from Maria’s shift, it appears I finally managed to work out the reason as to why my neck was sore – something that had been plaguing me – of course, they made quite a big cut in my neck to connect the blood supply, I’d known his all along but for some reason this was when my re-realisaion epiphany happened. I also wrote ‘Elephant’ and underlined it, so I’m sure that was important. The lovely Maria also came and popped in at another time, a few shifts later, she crouched by my bed and held my hand. She was great.

Then there was the amazing Rebecca, with a pixie haircut that gave me massive hair inspo, beautiful straight teeth, a great smile and very pretty eyes. It was Thursday, day 3 post surgery. My memory of my day with her is surrounded by sunshine. We put the radio on in the morning and had it going all day, managed to find a station that was just playing an awesome mix of retro songs. We boogied through the day and she would pop over to come have a chat/write with me. She also knew Sydney, which was fun. When she went on her break, she had a tea on my behalf because we drink it the same way. I got up and danced to the radio as my bed was made. Kat the Physio came by and decided it was time to go walking! So I got all my lines and drains bundled up and with Kat on one side and Rebecca on the other, Clarence under one arm and my parents as cheer squad/photographers, my support crew and I went thundering down the corridor. I, of course, was certain I was fine and was trying to do everything myself and quickly. It became a common theme of my friendship with Kat that she would spend a lot of time telling me to slow down, calm down. I appreciated that. I need these sorts of reminders when I’m not well. Later in the afternoon after everyone had left, Rebecca and I went for another walk. We danced down the corridor, and she took me on a short tour of the floor outside of our ward. We recommended each other our favourite Ramen places (Kanada-ya: mine, Koya: hers). I told her my legs were randomly itchy and she said it’s a side effect of the morphine and that I had a drug on my file that would counteract that! Brilliant! I was sad when her shift ended, I’d had such a fun day.

I was lucky however, as it wasn’t long until I met Ronnie, who took over from Rebecca, and had actually been there that first night with me in the ICU as I was coming out of anaesthetic. I didn’t really remember of course but I wanted to know all about it. Well, I was distressed and thought I was being choked (start the 11 day obsession with getting rid of the thing hat had been choking me – my tracheostomy). Apparently I was so stressed they got someone in to have a look if there was something wrong with it. Nope nothing wrong, but my body did think this new invader was trying to kill it. Anyway, we chatted and learnt about each other as she pottered around doing her work tasks (entertaining me was obviously the number 1 task). I wrote out my ‘list of demands’ that I wanted her to fill for me before bed (cheeky). In the morning, she cleaned my eye for me and put ointment and drops in it, and for the first time in 3 days we saw my left eye!

During this whole time I was in a shared ward, though our bays were big. The room felt so different with each person who was looking after me in that time that in my mind, each time the shift changed, I also changed location. This of course didn’t happen, but it could have! Someone could have been trying really hard to mess with me!

At some point someone described me in this time as a ‘big personality’. Just goes to show that you can be dopey and not able to speak and still get yourself across.