PS!

Just a quick ps.

Mr Abbadi has just phoned to say that lots of anaesthetists and cardiologists have been talking about me today and none of them will consider the big op with my heart in its present state. BUT they will allow the exploratory laparoscopy to see how things are in there!

Not much but a start. But it won't be until the week after next...in the Bristol Royal Infirmary, which is the hospital from hell from what I hear.

A Kafkaesque situation!

I think I've been playing so far, marking time, with this blog. The meeting with the surgeon last night made us realise hard choices have to be made.

 Mr Abbadi is a nice, clear, reasonable doctor, but cautious. As is his anaesthetist. He was hoping to do a preliminary laparoscopy today to look inside to confirm that the cancer really is contained (apparently scans don't always show everything) but they are fearful of my aortic stenosis, that my heart might not be able to cope with surgery. They will not do anything until a cardiologist gives the go ahead. I may even have to have heart surgery first!

He will not countenance any chance of my dying on his operating table. As I see it, this is a (probably) closing window of opportunity to remove the cancer and give me a chance of return to health. I am far more afraid of the cancer spreading and having to cope with a painful decline, with futile chemo and the knowledge of cancer eating its way through my vital organs. I have NO heart symptoms  and I shall be heartbroken if, while they're pussyfooting around, the cancer spreads. I would prefer to take my chances on the operating table. Obviously I don't want to die but I would prefer the dignity of a quiet, quick death to the prolonged alternative. And bugger his operating record.

So now we're waiting for a cardiologist to give his opinion, and it may take a few days. Last night was not a good one as you can imagine. We just want to get on with it! To add insult to injury, for those of you who know the hellishly large city of Bristol, the main access and escape road is the M32...Last night, without any warning that we saw, it was closed for repairs.. All traffic was diverted...and then all signs disappeared. We were left in the pouring rain to find an alternative route home, which took nearly 2 hours instead of the usual one. Last straw!

The irony is that if we were still in Singapore I would have already had the op!

Sorry for a tale of gloom. I would welcome your opinions...

Another week!

A quiet week, enlivened by visits from Chrissie on Thursday and Phil who stayed on Friday night. Lovely to have some quality time with them. Saturday was so sunny that we pottered down to the canal, escorted by the farm dog Amber. The daffodils are glorious this year, though taking a battering from this chilly wind. Geoff, of course, when he's not being a carer (cat, fish, birds, house and of course me) is busily planting, mowing & wall mending.

I've been trying to prepare for the meeting with the surgeon on Tuesday with a little research into him and into the human liver! Mr Reyad Abbadi is a Kings man, so he must be good... He calls himself a hepatobiliary and pancreatic surgeon, which I found interesting as hepatobiliary is a new word for me, and is not in the Oxford dictionary! Can work out hepato as in hepatitis so liver and biliary which refers to gallbladder and bile ducts. Anyway, he lives and works in Bristol so that is where I shall go. The waiting for an op date is hard, though.

The human liver is big, up to 2 kilos (largest organ after the skin! is that an organ?!) And it can renew itself, which I find encouraging. Anyone sensitive should miss out the rest of this paragraph as I'm going to talk about symptoms of liver cancer. I won't generalise as this cancer is different from the more usual one caused by hard drinking! Mine appears to be, as I think I've said, from a infection in the gall bladder which is joined on to the liver. My original symptom was the daily temperature fluctuations ranging fom 35.5 to 37.8, which left me feeling confused and miserable. And exhausted, with no energy, poor concentration, inability to make decisions and loss of interest in life! I have quite a lot of nausea and stomach ache, presumably because the liver is squashing other organs. Recently I've had the delightful treat of excreting bile - sorry, nothing nice about cancer!

Really most of the time I'm not too bad but exasperated by having no energy to do the things I want to do to put my life in order. So I fall back on reading, mostly delightful escapist rubbish. I did however yesterday read our Book Club choice for April: Being Mortal by Atul Gawande which is by a doctor facing the current impasse between medecine (which can do extraordinary things to save and prolong life) and basic human requirements to choose what matters at 'the end'. He deals with both very old age and the way safety seems to be society's main concern not individual human need to do what makes one happy and with terminal illness where we should decide our priorities before we get locked into rounds of difficult treatment. A kind, moving and sobering book.

Now back to a nice Peter May bit of escapism... Antiques Roadshow on TV tonight. Maybe we'll have a walk at Avebury tomorrow...

 

 

As you can see we are enjoying the important things in life! Simon and Ruth took us out for dinner last night at the local Bistro. The chef, Peter Vaughan, and his team are very adventurous with their food ideas and last night were offering an Arab Spring menu, which was not an exciting idea but ultimately disappointing as Chrissie suggested but a delicious mezze sharing platter, very tasty lamb, chicken, fish and veggie mains and then of course things like baklava and pistachio ice cream for pud. The main part of the restaurant is in one of the many cellars with which Devizes is honeycombed, a survival from smuggling times.

Well, when I told the doctor that I had little appetite, he said I must keep up the calories! Today, Ruth, chef, and Si, sous chef, cooked a delicious roast lunch. We've really enjoyed their company over the weekend. This is definitely a bonus result of being ill: delightful extra family time. And Si helped Geoff paint the greenhouse and gazebo as well as sorting a couple of computer glitches.

So we haven't missed Cartagena at all....  

Good news!

The good news is the consultant and the liver surgeon looked at all my results today and agreed that the cancer started in the gall bladder before moving up to the liver and so is contained and operable. The nearest lymph nodes are apparently swollen and so have been doing their job of catching cancer cells and will be removed.

The modern way is lots of warnings about the seriousness of surgery but I will be seeing the liver surgeon the week after next and then hopefully get a surgery date.

There is a bit of a joker in the pack: my congenital heart murmur in a heart valve has deteriorated into severe aortic stenosis. I will need a cardiologist present during the op! I do not have any heart problem symptoms so am hopeful things aren't too bad.

So we feel much more cheerful after a tense couple of days. Geoff is smiling for the first time in a while. It is almost (not really) worth having a serious illness to get all the lovely sympathetic responses to the news and the blog. I am really impressed with the variety and originality in the messages. And heartened.

Tonight I shall gave a celebratory glass of prosecco and we'll (re)watch a couple of episodes of West Wing. I'm even enjoying my food a little more. This is the one good thing that has come out of all this: I've lost 10 kilos! There's always a silver lining! 

I 'd rather be in Cartagena de Indias!

That's where we should be this week, in the north of Colombia, where the Pacific meets the Caribbean, if we hadn't had the cancer diagnosis. We had to cancel everything, get earlier plane tickets and scuttle home, after very hurriedly packing up the flat in Singapore, with eight years of stuff in our luggage.

I haven't been feeling well since the end of November, with my temperature going up and down, and feeling generally without energy or interest in anything. At Christmas my UK doctor had a blood test done but nothing seemed terribly wrong. So we returned to Singapore where I saw the Uni doctor who clearly thought I was some sort of elderly, attention seeking hypochondriac with too much time on her hands. She suggested that I was suffering from hot flushes! To get rid of me she referred me to the local hospital where I saw a very switched on Belgian doctor who set me up to have a series of scans and tests.

The last one was the CT scan which clearly showed my trashed gall bladder and a nasty lump on my liver. They whisked me straight into hospital and started to pump antibiotics into me as they thought it was an abscess. Sadly it was not, but instead a cancerous tumour.

The Singapore doctor, Mr Daniel Tan, is convinced it is an infection up from the bile ducts, through the gall bladder and then into the liver, self contained and operable. Back in the UK, I've had blood tests and a MRI scan to add to the discs and reports we brought back with us and now we're waiting for the consultant's decision. There will be a case study session on Friday when all the specialists meet, so we shall see.

As you can imagine this has come as a bolt from the blue in the life of someone who thinks of herself as happy and healthy! A week in a Singapore hospital was an experience! I've never actually been ill in hospital before, only for planned, mainly gynaeological reasons. Just being in hospital, with little sleep and with various tubes in your arms, makes you feel ill and querulous.

The Ng Teng Fong General Hospital Jurong was very impressive, brand new, three towers with lots of shops and restaurants on the ground floor, ample parking below ground and on the first floor bridges linking to the MRT and bus station and various shopping malls. One tower is for clinics, one for wards and one for the Community hospital. Nothing is free in Singapore, but there are levels of charges and different degrees of comfort (single rooms, four bed and I guess bigger wards). The facilities are state of the art and nursing impeccable (with a range of nationalities as in the UK, but many from the Philippines and Vietnam) English is of course the admin and main communication language.

What took a little getting used to were the regulation pyjamas, pink for girls and obviously blue.... And as well as an identification bracelet, with a (gps?) tracker on one's arm, in case you go awol in the shopping malls?

The Chinese ( both ladies I shared with were Chinese) take hospital visiting very seriously and go loaded with bowls, chopsticks and all sorts of food and proceed to have a party round the bed. It's charming but not so good for adjoining beds. I haven't had much appetite for months and the antibiotics made me too nauseous to enjoy any food, even by proxy. There was an impressive choice of menus, Chinese, Malay or Western, but too much!

Another very different thing is the presence of the maid or carer. In my first ward, where the poor old soul had had stroke, her carer was with her 24 hours, sleeping on a kind of window bench. What a hideously boring life. She helps with the hospital care and is trained in what to do when her lady goes home. And while the lady slept, she talked to friends on her phone and watched tv.

An interesting experience, but not to be repeated if possible!

Well, all the family has rallied round, bringing food, flowers, books - I have read about 50 novels this year- and it has been lovely to see them all. Phil was all set to leap on a plane to Singapore. Poor Geoff has been doing everything and spoiling me. He was seriously unsettled when I fainted in our room at the Paddington Hilton just before Christmas, something I've never done before or since! I was more upset that we had to cancel High Tea at Browns Hotel, and I missed the Paul Nash exhibition.

So we are now waiting for the verdict of the doctors. I'll let you know!

Sorry to be a party pooper, Cherry