Bobs Bowel 13 – Chemo !!!


It’s 19th May, 2025 and I have an appointment with an oncologist. This is to discuss potential precautionary chemotherapy following my hemicolonectomy at the end of March.

I am introduced to Dr Mutheramalingam, known as Dr Ram.

He seems to have done his homework, as he tells me all about the various conditions that I am receiving treatment or surveillance for, including Prostate Cancer, Type 2 Diabetes, and possible Non-Alcoholic Fatty Liver Disease (NAFLD). And, of course, not to forget the main event, T3 N1b Colorectal adenocarcinoma, the reason I am in his office.

Dr Ram procedes to explain the situation i.e. the positive results of the surgery and that the scan prior to surgery had not shown any signs of cancer elsewhere.

Interestingly, he mentions that the lesion on my lung seems to have disappeared. This lesion was strongly suspected to be Prostate Cancer, and is the reason I have been on course of regular Prostap injections. We discussed the possibility of my no longer needing the injections but he wanted to defer that discussion to my Urology consultant.

Dr Ram then went on to describe my chemotherapy options, which appear to one of two.

  • Option 1:
    Combined tablet and chemo infusion over a period of three months
    This option comes with a range of potential side effects which also include damage to my liver which is already under surveilance due to the NAFLD.
    This treatment offers a potential 12% increase in my survival prognosis.
    The chemo infusion would be administered at the hospital and therefore require multiple trips to the Queen Alexandra hospital, parking fees, and the time spent during the infusion.
  • Option 2:
    Tablet only treatment over a period of six months
    This option also carries the full range of potential side effects with only a 10% increase in my survival prognosis.
    The tablets would be self administered at home,each two week cycle being 4 tablets twice a day, followed by one weeks rest. During the weeks rest I would have a blood test and a telephone consult prior to starting the next cycle.

It seemed to me that option 1 only giving an additional 2% and also introducing the risk of liver damage was not a good deal. Also, the regular visits to hospital for the chemo infusion was not very appealing, given the many medical appointments I have had since diagnosis of the tumour.

I have therefore opted for option 2, the self administed tablet only chemotherapy.

Bearing in mind the positive results from the surgery we, the medics and me, don’t know for sure if I have any cancer in my body. This chemo, being precautionary, may not actually buy me any more time.

Since that initial oncology meeting I have started the chemotherapy regime having been prescribed Capecitabine. I have just completed my third cycle.

Capecitabine comes with a whole range of potential side effects which include the following:
Appetite loss, Diarrhea, Vomiting, Nausea, Stomatitis, Abdominal pain, Fatigue, Weakness, Hand-foot syndrome, Oedema, Fever, Pain, Headache, Hair loss, Dermatitis, Indigestion, Shortness of breath, Eye irritation, and Myelosuppression.

So far, after nine weeks, I am only experiencing fatigue which manifests itself by me dropping off into a deep sleep with little or no warning, usually when sitting quietly reading of watching the TV. Thankfully, this does not happen while I am actively involved in something.

In the first week or so I did notice, thanks to my smart watch, that my heart rate was spiking quite high. That is I was hitting over 130 beats per minute with no apparent cause whereas prior to commencing the chemo it was rare for my heart rate to go over 80 bpm. I contacted the oncology department and they told me it was probably my body getting used to the chemo. Certainly, the spiking has reduced, both in frequency and magnitude.

So here I am, cycle three completed. What now?

Well, due to a family issue I have had to travel and will be away from the UK for three months. This means that continuing with the chemo is problematic. Because of the type of drug that Capecitabine is and the need for regular blood tests, they cannot prescribe sufficient doses in advance for me to continue the regime.

Apparently taking a short break from the chemo is OK but two to three months may be too long for me to restart when I am back in the UK.

So I am exploring getting access to the local medicare here in Australian so that I can then see a doctor and hopefully get prescriptions for Capecitabine and also the requisite blood tests. There is a reciprocal health insurance arrangement between the UK and Australia but this might just be too complicated to manage.

I have applied to join Medicare and I am hoping that having been previously been accepted it will be pretty much a rubber stamp exercise.

We shall see!

Bobs Bowel 11


So here we all are, on the other side. I survived the procedure. I guess that I should apologise for leaving you all hanging. Since leaving hospital I have had a few things going on with friends and family. And, keeping a blog going does require a degree of concentration and effort. Of which I have had none.

My procedure, I am very pleased to say went well, took place on Monday 31st March. Originally estimated to take 4 – 4.5 hours, actually  took six hours. On regaining conciousness, in the recovery room,  I was given two pieces of news.

Firstly, that they, the surgical team, had taken more than was originally planned. Originally, I was supposed to be having a “left hemicolectomy” but in the end I had an “extended right hemicolectomy”.

Secondly, a bit of very welcome news, was that I did not have a stoma and therefore would not be having to deal with a colostomy bag.

The Hospital Stay

After a brief sojourn in the recovery room I was wheeled along to ICU to spend my first night in hospital. But before I could contemplate sleep I was given a full body bed bath. That was a first for me.

I was also starving, not having eaten since Sunday evening, the day before. But at this time I was restricted to clear fluids.

How noisy are hospitals ? Staff banging cupboard doors, clattering of trolleys and trays and let’s not forget talking at elevated levels. At one stage there was a guy strutting the length of the ward, and back again, speaking into a phone which he held away from his face.

Don’t they realise there are sick people in ICU, trying to rest and recover ?

1st April – Operation Day +1

At around 10:30 the staff in ICU got me out of bed, had me sitting in a chair and brought me stuff to have a wash. To be fair I didn’t stay in that chair for long. It was too upright, not very comfy, made my back ache and my tummy was a bit sore.

But there was a nice view away to the south and west looking out over Portchester, the Isle of Wight and down to Southampton Water. All with blue skies and sunshine.

Still no food, just clear fluids, black tea, black coffee,  water !!! and I’m starving.

Later, on the evening of the same day, they moved me out of ICU and shipped me off to the surgical ward. Sharing the ward with six other inmates and no view.

If I thought ICU was noisy, they had nothing on this ward. I couldn’t see what it was but there was something at the far end of the ward making a sound like a diesel truck on a fast idle. Thankfully after about thirty minutes it stopped. Rumour has it that the noise was from an air bed being inflated !!!

Apart from the noise, another issue I had was the temperature of the ward. On arrival I broke into a sweat and I know, when at home, I  break out at around 25°C. One of the nurses very kindly brought me a fan which improved things but, under cover of darkness, someone snuck in and turned it off.

How Rude!

2nd April – Operation Day +2

A nurse brought me a bowl of warm water for a wash and a change of gown. Ablutions completed I tried to put on the fresh gown which was way to small. When I flagged the size issue I was told that they had no gowns my size and offered me a “shirt”, i.e. an NHS pyjama jacket which was even smaller. The nurse said she would order a larger gown.

Order ? How long was that gonna take?

Anyway, thankfully, someone turned up with a large gown. I should point out that I did have my own pyjamas but due to the various tubes attached about my person there was no way I could get into them. At this time I was catheterised and also having a saline drip.

Time in hospital can pass very slowly. I had prepared for this by bringing in a book to read, also a book of crossword puzzles. I also had my phone on which I do soduku and read via Kindle. The problem was that I couldn’t focus on anything. In fact trying to focus took so much effort I kept dozing.

I had a very pleasant visit from my granddaughter in the morning and, later, my wife and daughter arrived to break up the afternoon.

At last, I was told I could have something to eat. My first meal for three days was a supper of chicken soup, yoghurt, jelly, and vanilla ice cream. Not very substantial but you would not believe how good that chicken soup tasted.

Throughout the day, with each and every visit from a nurse or doctor, I was constantly asked if I have moved my bowels, or if I  have broken wind. At this time my answers were all in the negative.

After supper I was asked what I wanted for brekky. Options were orange juice and/or yoghurt. I opted for the yoghurt.

3rd April – Operation Day +3

I had a visit from the surgeon.  Nice guy. He introduced himself and I promptly forgot his name. He said he wanted to try me on real food, with more substance. He also said they were planning to remove the catheter… yay!! Also, there was mention of the possibility of me going home, either today or tomorrow. This is all sounding good. All of this was discussed while he tapped, squeezed, and generally fondled my belly. Oh, I didn’t mention the gaggle of other medics, around half a dozen, gathered around the foot of my bed. Any privacy or dignity I had rapidly flew out the window.

I was given some of my own daily blood pressure meds. I’ve not had any since before the op. I was also given a dose of liquid paracetamol.  It is thick in texture, very sweet and it tastes of strawberries, Yuuukkk !!!

I don’t remember lunch but supper was Pea Soup with an awful bread roll.  Think the roll was made without any fat, it fell apart when I tried to cut it so that I could butter it. Tried eating it but it just clagged up my mouth. There was also an egg mayo sandwich. I only ate half as it was on some strange, strongly flavoured, malted bread, and again a weird texture. I tried dunking it in the soup but it didn’t help. Obviously my tastebuds had become confused. Hospital food isn’t really that bad. or is it?

During the day I have been getting an acidic feeling at the back of my throat, like indigestion. I mentioned this to a nurse who got me some Gaviscon. It helped a bit.

4th April – Operation Day +4

Bad news, I’ve been sick!! I was told that if I  am sick twice in the day I will be aspirated i.e. have a tube put up my nose and down into my stomach. This sounds unpleasant, and definitely something to be avoided.

Now they are taking bloods to see if I have an infection, and are concerned about the low volume pee. So, I definitely won’t be going home today.

Supper time arrives and I was feeling sick and requested another anti-sickness pill. Supper was chicken soup but I don’t recall eating it.

Even though I’m just drinking water it seems to be sitting high in my tummy. I’m not feeling comfortable at all.

5th April – Operation Day +5

So, I was sick during the night and as a result I was intubated. That was not a pleasant experience. As the tube goes in it causes you to retch and then once inserted you can feel the tube in your throat every time you swallow. The nurse siphoned out nearly a litre of dark green fluid. It appears that my vomiting is due to Ileus, a not uncommon post operative complication after abdominal surgery. In essence the bowel goes on strike

So now I have two bags hanging on the side of the bed. One for  my catheter and one for my nasal tube. I also have a saline drip attached to the cannula in my right arm. It’s almost like being at the centre of a spiders web.

While the tube is in I am nil by mouth,  just sips of water. So back to my starvation diet.

6th April – Operation Day +6

Due to all my attachments I had to call for the commode last night. And, whilst sat on the commode,  my nasal tube took it upon itself to sneak out and fall on the floor. I buzzed for the nurse who got a fresh tube and installed it which again caused me to retch and vomit. Just wonderful. That was at 03:00.

During the day they disconnected my nasal tube from its bag and told me I could go on free fluids. So I had an ice cold glass of milk, and boy did that hit the spot. The milk was, later,  followed by a cup of hot chocolate.

I was told that I can stay on free fluids but they will reconnect the tube to the bag at night time. Some good news, it was confirmed that Bovril is allowed under the free fluids plan so have asked Gerry to bring some in.

Bad news, the blood tests have shown some negative markers, and so, they think I might have developed an infection. Therefore, as a precaution, I have been moved to my own room. Bonus, I have my own window with a view and can open said window, so plenty of fresh air.

In the early evening I had a lovely video call  from my granddaughter and her kids. Jax, who is autistic, saw my nasal tube and immediately wanted to know what it was. We told him I was in hospital. His response was “go get Grandad, bring him home” Unseen by me, Jax trotted off downstairs, let himself out the front door and was trying to get into his mums car. Their dog, Milo, alerted my daughter and she caught him outside. Cute.

7th April – Operation Day +7

Thankfully the nasal tube has been removed and so, it appears, I’m back on the free fluids diet which is some kind of progress. Lunch today was tomato soup, orange jelly, and vanilla ice cream, bliss!!!

In the afternoon, friends, Eric, Mary, and Mo visited for a couple of hours. It was nice to have someone to talk to. Eric and Mary left after an hour which left Mo to entertain me. Unfortunate for Mo, she was soon treated to the sight of me sliding out of bed clutching the back of my gown, carrying my bag of urine (golden handbag) and shuffling across the corridor to the loo. She took it all in good heart.

Todays supper treat was mushroom soup, more jelly, and ice cream. The soup was, once again, very tasty.

After Mo’s departure and having nothing better to do, I read the ingredient list for the orange jelly. Shock, horror, there is no orange in it. There is carotene, I assume that’s for the colour. I had thought that the flavour was a little odd, now I know why.

8th April – Operation Day +8

Finally, I got a decent night’s sleep, the first since the surgery. Also, my tummy is feeling less bloated which, I guess, means some of the gas used during the operation is beginning to dissipate.

Brekky today was rice crispies, orange juice, toast, and marmalade. Actually, to call it toast was a bit of an exaggeration. I think the slice of bread had seen a photo of a toaster but not actually been in one. Still, after being starved and then only getting liquids to eat this was definitely a step up and in the right direction.

After breakfast I was asked to select my lunch, so I chose Beef Lasagne,  scallop potatoes and gravy. More solids … yes!!!

The lasagne was blooming marvellous although, surprisingly, I had to confirm that it was beef, to me it tasted like the best herby pork sausage. So that has triggered the idea that I will try making a lasagne with italian pork sausage meat, when I get home.

I also had a bit of a revelation today. I had a shower, my first since prior to my surgery, and I was so pleased to get my hair washed. The whole shower thing was a bit weird as I still had the catheter in place and so I had to take my golden handbag along with me. But sitting on the provided stool and just letting the water flow over me was superb.

I also had lots of visitors today, so it was a good job that I had that shower … lol.

Todays supper was Lancashire hotpot with extra mash. The hotpot was very nice but the mash was very dry. And, I  didn’t get the recommended extra gravy I requested. However, I did get two Vanilla ice creams. They really are very nice, smooth and creamy.

Finally, my catheter has been removed but, unfortunately, I haven’t pee’d since. So I was given an ultrasound of the bladder and, apparently, there wasn’t much pee in there so retention isn’t an issue. Bottom line, I have to up my fluid intake, then if I don’t pee they will catheterise me again. And we don’t want that.

With the catheter gone I am now in my jim jams which are much more comfortable than those horrible hospital gowns. And finally, at around 21:00, the dam burst and I managed a pee. This was followed by several others during the night. All were captured so the nurses could check the volume and, apparently, all is good.

9th April – Operation Day +9

Hallelujah, the surgeon has told me that I can go home, shook my hand and wished me well. I asked a nurse what the discharge procedure was. I was told that getting meds from the pharmacy was usually the thing that dictated when I could go, but that I should expect late afternoon or evening.

Shortly after this the ward sister came to see me, told me my meds had been requested and the indications were that they would be available sooner, rather than later. She told me to order lunch just in case it actually was later. In fact meds and lunch arrived together. I was told to have lunch and then the discharge process could be completed.

Wow, lunch was a celebration. Roast turkey breast, roast potatoes, sprouts, carrots, and, wait for it, banana stuffing!!!! Who ever heard of banana stuffing? Certainly not me, and it wasn’t for my palate.  Apparently, it is a carribean thing.

Anyway, food eaten, sister returned with my meds, my discharge papers and one last bit of education. New news to me was that I was going to have to inject myself with an anticoagulant.  She had a syringe and rolled up pad to simulate my tummy. I was directed in the correct use. The two carrier bags of meds contained, primarily, several boxes of preloaded syringes. I am to inject myself twice daily, for thirty days.

So, formalities completed, the porter arrived and I was soon loaded into a wheel chair and propelled to the main exit where my son-in-law was waiting to drive me home.

And there we have it. My hospital experiences around my robotic laparoscopic right side hemicolonectomy.

Bobs Bowel 7 – Outpatients Anaesthetics


Thursday 13th February, and another appointment. Once again, at the Queen Alexandra Hospital. I’ll soon have my own allocated parking space if my visits carry on at this rate.

This time my appointment is with an anaesthetist in the Outpatients department.

My appointment was at 10:00, and right on the button, I was whisked away for some observations. I had my blood pressure, weight, and height measured, again. I was also given an ECG.  And then it was back to the waiting room where I had time to make friends, playing peek-a-boo with a toddler.

After a short while my name was called by the anaesthetist wearing an amazing pair of electric blue shoes.

After the usual pleasantries she revealed that we had met before. Ten years ago, when I went in for the brachytherapy treatment for my prostate. She was the anaesthetist who drew the short straw for my procedure. As a patient I was not very cooperative, not on purpose. With me sat on the table in theatre she attempted to give me an epidural. Three times!! My body just refused to play ball, would not give up my spinal fluid so no further attempts were made.

Once the procedure was underway it was time for me to misbehave again. I unconciously decided to vomit. She unfortunately had to deal with that, and call in Dynarod to suck out my tubes.

I apologised to her as in my head I was to blame, having had rather a lot of cheese as my last meal the night  before the procedure. Nobody told me that they tilted you head down to insert the nuclear seeds. She showed me the copious notes taken following that little episode but she was quite magnanimous. Noting my, as yet undiagnosed, type 2 diabetes which apparently can have the effect of slowing down your stomach process, causing “pooling” which in turn can cause regurgitation.

After reminiscing about old times we got down to the business in hand. We had the inevitable chat about my health in general and specifically focussing on weight, fitness and diet.

I was given a thorough but gentle arse kicking. Likening preparing for the operation to an athlete preparing for the olympics. Apparently the procedure will last about four hours and, although I will be unconcious laid out on the table, for my body it will be akin to running against Usain Bolt. So, as she put it, I need to be in the best possible shape to deal with the procedure but also the fitter I am the faster I will recover.

Exercise and weight loss are the order of the day, supplemented by plenty of practice with my spirometer. She wants me to up my daily walking. That shouldn’t be hard since it is negligible at the moment.

We also talked about diet with regard to my diabetes which can have a negative impact on my post op recovery. And right there is where I get into trouble.

In general the medics extol the benefits of a balanced diet, with plenty of fruit, vegetables, nuts, seeds and so forth. Quite often promoted as the mediterranean diet. Below is a typical chart promoting a balance diet. All stuff that I like.

Due to the location of my tumour which is partially blocking my bowel I have been advised to stay on a low residue diet which conflicts with the idea of a balanced diet. Which in turn also conflicts with a diabetic friendly diet.

What that means is that the only food that I can eat from the green zone is carrots which have been peeled and cooked until they are soft. I can have cucumber but I have to peel it and scoop out the seeds. From the yellow zone I cannot eat any of the wholegrain items. I can have potatoes cooked without their skins and not shown I can have white bread, rice and pasta.

Hang on a bit, actually, for my diabetes I should not be eating any quantity of carbohydrates as this gets turned into sugar, bad for diabetics. So between the diabetes and my tumour everything in the yellow zone is pretty much a no-no.

Things do get a little better when we look at that strange pink zone. I can eat the tinned tuna, chicken, fish, eggs, and mince. Although my tumour says no to fish skin and bones like you might get with sardines and pilchards. Meat is fine but no gristly bits, no bacon rind etc.

And on to the blue zone where I am allowed small amounts of cheese and milk.

And so, I am resigned to eating a mainly protein diet, not quite leaping into the full carnivor diet. Supplemented by squidgy overcooked root vegetables.

As if meal preparation wasn’t already difficult enough.

Ah well, as the anaesthetist says, it is only for a few weeks.

Sad to say, I still don’t have a date for my op.

Bobs Bowel 6 – Iron Intravenous Infusion


Monday 10th February and, as I stated in my last post, although I don’t have a date for the surgery the NHS is hell bent on keeping me busy.

Following my colonoscopy I was informed that I was borderline anaemic and that I would need an Iron Infusion before my surgery.

Today is the day and my appointment was scheduled for 10:00. However, my iron prescription has not arrived.

So, sitting waiting. It is 10:30 !

It’s now 11:10, and after much searching, the nurses, three of them, have managed to cannulate me. Apparently, my veins were playing hide and seek. Not helped by my not having had a drink before arriving in hospital.

I did make a cup of tea, but traffic news indicated problems, so we left early. My tea is still sitting on the kitchen counter.

I am now hooked up to the iron  juice,

and literally, it has just entered my arm.

The infusion should take about an hour.

Job done in just under an hour. I’ve been unplugged, given a cup of coffee and an egg mayo butty. Thirty minutes to check there are no ill effects.

Thirty minutes was up. Took my blood pressure, blood gas, and temperature. All good. The canula was removed, and I was discharged.

It’s now 13:30 and I’m sitting in the hospital cafeteria having a proper coffee. I’m killing some time before heading up to visit a friend of mine who has been a patient here for the last few days.

As for me, I have go and get a blood test in two weeks to see if the iron juice has done its job.

More later ….

Bobs Bowel 5 – Surgery School


Monday 3rd February and the preparations for my impending surgery continue apace. The latest adventure was a two hour class at Surgery School.

I know the NHS is constantly strapped for cash but putting me through a crash course in surgery doesn’t exactly fill me with confidence that my outcome will be positive.

Of course the aim is not for me to carry out DIY surgery. No this session was all about preparing me for surgery and getting me as fit as possible both for the procedure and the recovery period after.

Getting fitter, they say, will help reduce the risks associated with the surgery. Risks such as chest infection, blood clots, kidney problems, wound infection / healing.

To this end the speakers were focusing on exercise and nutrition, the importance of a balanced diet. Unfortunately, my cancer is such that it is partially blocking my bowel. Because of this I am continuing on a low residue diet which means I cannot eat many of the “healthy” foods. No wholegrain breads, no high fibre vegetables such as onions, leeks, cabbages, and cauliflower. Also many of my favourite salad vegetables such as tomatoes, peppers, radishes, celery and baby corn are excluded. In addition to the low residue diet I am also on a course of laxative, Molaxole. To help keep things moving.

Thankfully I am not a smoker as that is definitely a no-no. Apparently smoking can have detrimental effects on ones ability to heal and also the well publicised impact on the respiratory system.

Similarly, drinking alcohol is frowned upon. My consumption in general has reduced dramatically over the last few years, to the point where I might only have a pint of beer or a glass of wine every week or two. Total abstinence won’t be an issue for me.

Preferably they like patients to totally abstain from drinking and smoking on the run up to surgery and offer help to those who need it.

And finally, that brings me to the contraption in the photo below. No it isn’t some kind of sex toy. This beast is an Incentive Spirometer.

Incentive Spirometer

All folks attending surgery school were given one of these. The purpose is to reduce the risk of lung complications following surgery.

Use of the incentive spirometer is part of the iCOUGH process a program implemented by hospitals nationally and internationally. The acronym ICOUGH stands for: Incentive Spirometry, Coughing and deep breathing, Oral care, Understanding, Getting out of bed at least three times daily, and Head-of-bed elevation. The program emphasizes deep breathing exercises to keep lungs healthy and prevent lung problems. Oral care, patient and family education, getting out of bed, and head-of-bed elevation are also important components of the program.

We were instructed to use this device three time per day prior to surgery, and every hour following surgery.

I still don’t have a date for the actual surgery but the medics are focussed on getting me fit and also preventing me from getting bored.

Bobs Bowel 4 – NHS Healthcare


After years of paying National Insurance there is no doubt I am getting my moneys worth from the NHS. After playing the poo sticks game I have had a Colonoscopy, CT Colonography, a session with a colo-rectal consultant and have been booked in to Surgery School.

My home phone seems like it is a hot line to the QA (Queen Alexandra Hospital).

Following the consult I received a text message informing me that a call had been booked by the Care Coordinator !!! No explanation of why. Obviously I could make a pretty goood guess. But I still had to confirm back to them that a call before midday on the 31st was acceptible. I also took the opportunity to ask what the call was about. The response was almost instantaneous. Lisa, the Care Coordinator from my GP Surgery, having seen various letters between the hospital and my GP, was making a courtesy call to see how I was doing with the ongoing investigations.

So Friday 31st arrived and it turns out that Lisa had very little information. I have since seen the letters that my GP was sent. Not very enlightening. So I brought Lisa up to speed, giving my history so far, up to and including my consult on Tuesday.

She in turn told me about the services that were available to me leading up to the surgery and what support they can provide after I return home. This includes councelling, assistance with obtaining benefits etc. After a very pleasant chat we agreed that she would call me on 28th February to see how I was going. Hopefully I will be home recuperating after the operation.

As I said my phone has been very busy. On Friday morning I missed a call from Julie, one of the colo-rectal nurses. She left a message inviting me to call her back. I returned her call and retaliated by leaving her a message in her voicemail. After one round of answer phone tennis she called me.

She asked if I had heard from the anaesthetist, which I had not. She told me that they had spotted that I was borderline anaemic and that I needed to be scheduled in for an iron infusion/transfusion!

Two weeks ago, the doctor that did my colonoscopy had told me about this. I had forgotten but I am glad that the anaesthetist is on the ball. Julie told me that I should probably expect to be contacted early next week, and that if I didn’t hear from them by Wednesday, to call her.

Later that day I received one of those neutral NHS appointment invitations. Informing me that an appointment has been made for 10:00 on Thursday 13th of February. What is this for? Is it for my iron infusion, or just a face to face with the anaesthetist? There is no information about what if anything I need to take with me. Nurse Julie told me I should arrange a lift for when I have the infusion just in case I’m not fit to drive after. There is nothing in this invite to clarify so I will have to call them on Monday.

One thing I will say for the NHS, once you are in the system they do look after you. So far, I have nothing but praise for the staff that I have been involved with. With the one exception, the CT Colonography, they have ensured that my experience thus far has been reasonably pleasant.

Bobs Bowel 3 – The Consultant & More


Tuesday 28th January, and my first meeting with the consultant. It was quite intense and a bit of a good news, bad news scenario.

First up the bad news, the results of the biopsies taken during the colonoscopy  confirm that the tumour is cancerous. I guess I was expecting that and was already resigned to the fact that surgery was required. Confirming the cancer was just detail.

On to the good news. The results of the CTC show that the cancer seems to be contained within the colon and hasn’t spread elsewhere. Apparently, there are a couple of polyps but nothing to be concerned about at this time. Some time after the surgery, I will likely have a colonoscopy, and the polyps will be dealt with then.

I was told that I should get a surgery date within the next three weeks. The surgery itself will be of the keyhole variety. The consultant ran through some of the issues / risks. Obviously, all surgery comes with risks. It is invasive, and the body wasn’t designed for easy access. In my case, proximity to the spleen was of concern.

Given that my tumour is causing a partial blockage, surgery is the only option. It is what it is.

Prior to that, it seems they have a lot of fun activities planned for me, so I will be visiting the Queen Alexandra Hospital …. a lot.

I have already been booked into surgery school.  This two hour classroom session is on Monday, 3rd January, to be held at the Oasis Centre. The purpose of the class is to prepare the patient, me, for the surgery and after. To tell about the process, the time on the high dependency ward, and preparation for going home and what to expect in the time following the procedure.

Another treat will be a session with the stoma nurse. Although it isn’t planned, the surgeons won’t know until they go in and may decide that a stoma is necessary. This may be temporary to allow my bowel to heal or, worst case scenario, permanent if they can’t repair the bowel. Apparently, all bowel surgery patients are taken through this possibility and the ramifications.

Finally, there will be a consultation with the anaesthetist. If they can glean enough information from my notes, then it should be just a telephone consult. Otherwise, a further trip to the QA will be required.

Once I have had the operation, I can expect to be in the hospital for about a week or so. Escape will be dependent on my how fast my bowel starts to function. I was told that some patients have gone home after three days, but typically, it is a five day stay.

The things I’m prepared to do to get out of cooking and housework.

And then it’s on to recovery, i.e. back to normality. Again, everyone’s different, but they were talking three to six months.

I’m coming to realise that this is a big operation. Nobody has actually vocalised this fact, but I’m picking up on the odd words that were dropped by the consultant and one of the colo-rectal nurses.

I have no idea if there will be any after treatment, i.e., chemo or radio therapy. This was not mentioned, and I forgot to ask, but perhaps that is a discussion for after the operation, when they know what they are dealing with.

In the meantime, I have been having a lot of discussions with Gerry about preparing for my time in the hospital and immediately after. These are non medical in nature.

Gerrys mobility is OK around the house, but she can’t stand for long. So preparing meals for herself could be problematic. There are a number of companies that make and deliver ready meals so we are considering getting some to put in the freezer. Gerry should be able to manage those.

Of course, after I return home, my capabilities are a bit of an unknown quantity at this time. There are likely to be restrictions on lifting and carrying. Simple things like lifting a kettle to make a cuppa may not be allowed.

I won’t be allowed to drive for a while, and although Gerry still has her licence, she hasn’t driven for a couple of years. So we are going to have to rely on family to provide taxi services for any appointments etc..

Sadly, this bloody tumour is causing a lot of disruption, impacting others’ lives too.

At the back end of February we have tickets for two concerts. The first is for Uriah Heep, a band that I started following in the 70’s. This concert is part of a 50th Anniversary and farewell tour. Missing that will be a bit of a blow.

The other concert is for Brit Floyd, a Pink Floyd tribute band. We got tickets to this show as a Christmas present for Summer,  our great-granddaughter. She is always saying how she likes Pink Floyd, so we thought a tribute band was the nearest she would get to the real thing.

We are already trying to arrange for others to take the tickets

Two further events are possibly in jeopardy.  The Goodwood Members Meeting in April, which usually entails a whole day on my feet. And then there is an Andre Rieu concert at Wembley in May. We will just have to see how my recovery goes.

That’s it for now.

Cretins, Morons, Imbeciles


A nurse, who works at Queen Alexandra Hospital, has suffered a panic attack, following an attack against the hospital bus on which she was riding.

https://www.portsmouth.co.uk/news/people/queen-alexandra-hospital-nurse-suffers-panic-attack-after-hospital-bus-attacked-youths-portsmouth-3106179

The bus was attacked by youths throwing stones. One of the windows alongside the nurse shattered, bringing about the panic attack.

One can only imagine the thought processes going on inside the heads of these morons. They certainly have no concerns about the potential consequences of their actions.

This is yet another example of the same moronic behaviour that sees youths attacking all of our emergency service workers.

Who on earth thinks its a good idea to attack our firemen while they are trying to save lives at risk in fires and road accidents. And who thinks its a good idea to attack our ambulance crews and paramedics while they are attending those same incidents.

And then we have the police having to stoically endure interference on a daily basis, whilst putting their own lives at risk, going about their business, to protect us from these same idiotic morons.

Presumably, these are the same thought processes that make firing fireworks at peoples houses. As was happening, in Portsmouth, only a few weeks ago.

This imbecilic behaviour isn’t restricted to the Portsmouth area, rather it is endemic to the whole country.

I don’t understand the whys and wherefores and I don’t pretend to have a solution. What I do know is that the ASBO scheme isn’t good enough. Some youths see being awarded an ASBO as a badge of honour.

When I was a youth, the older folks used to say “they should bring back National Service”. I find that I am now of the opinion that is a good idea.

Going further back in time, to the 16th and 17th centuries, there were the stocks and pillory. Now the idea of these really appeal to me.

Throwing rotten fruit and veg at these miscreants would give some instant feelings of retribution to their victims. And, just maybe, these morons would be too embarrassed to offend again. They would certainly be a very visible reminder to other would be offenders.

I think today’s society could learn something from our ancestors.

My Prostate and Me – Part 10,


So at the end of my last post I had just escaped from the QA following my Brachytherapy procedure. This was to be a temporary escape as I had to present myself back at the hospital for a CAT scan.

So the following Monday I dutifully presented myself for scrutiny. Unfortunately it was organised chaos due to a lack of availability of notes. This is not the first time that my notes have not been available although it is more usual for them to not be available for an appointment that has been set up for weeks.

I did press the radiographer as to why it was necessary for my notes to be available when they knew that the scan was to confirm placement of the radioactive seeds in my prostate. I said that I assumed they knew where the prostate was and therefore where to target the scan.

She, very patiently, explained to me that having a scan 3 days after brachytherapy was not normal procedure. The norm is to have an MRI after about a month, so they needed to know if there were any other issues that they needed to be aware of. They did their best to find my notes, even going up to the ward to search on the assumption that they, my notes, were “in transit” due to the weekend.

My consultant must have foreseen this as he had provided me with an extension number on which he could be contacted, even though he was in surgery. I passed this number over to the radiographer and after a short chat with my consultant we were good to go.

So after nearly two hours pfaffing around I had my ten minutes of scanning and we were out of the hospital. Of course there is then a period of trepidation, waiting to hear if I was going to have to go back in for more seeds. As time passed I relaxed, no news is good news after all.

A month after the procedure I had the MRI. This was a much quicker visit than my previous MRI. I guess because this time they were only interested in checking the prostate itself and the immediate surrounding area.

Once again, there is that trepidatious period of time where you wait for the bad news phone call. And, once again, as time passed I relaxed.

The next check point in all this was to be a visit to the consultant preceded by a visit to the vampire clinic.

Which brings us up to date.

Last week I gave the blood sample required to check my PSA levels and yesterday I visited my consultant. After all the pleasantries, how is your bladder, how are your bowels, etc. etc. we eventually got round to the important business i.e. talking about my PSA.

Brilliant news !!

Prior to the brachytherapy my PSA was up at just over 13. Now my PSA reads just over 1. Which, in the words of my consultant means that the seeds are doing their job. My next check point will be in six months when I will have another blood test and another consult.

My thanks to Clotho, Lachesis and Atropos, the three fates (Moirai) for watching over me. I think they were watching over me last December when my operation was cancelled due to a lack of hospital beds. When I think about all the possibilities I am so, so glad that I have taken this path. 

See you all in six months !!!

My Prostate and Me – Part 9


For those of you who are following this saga you will remember that my last post was shortly after attending hospital for surgery. That the surgery was cancelled due to a lack of availability of beds.

I think the fates intervened and the cancellation of the operation was a blessing in disguise. There were just too many risks with the operation and the potential impact to my lifestyle for the following year (at least) were just too much to consider.

So, surgery, which was always my first choice, has now been kicked into touch, and became the option of last resort.

Since December 2014 I have had follow-up appointments with Mr Wilkinson, my consultant. We have discussed fully, my  reasons for not going ahead with the surgical option. As a result I was referred to an oncologist, Mr Nagar who talked me through the alternative radiotherapy options.

  1. External Radiotherapy
    Given in the hospital radiotherapy department,  as daily sessions from Monday–Friday, with a rest at the weekend. The course of treatment would last for just over 7 weeks.
  2. Low-Dose Rate (LDR) Brachytherapy
    This type of radiotherapy is sometimes called internal radiotherapy, implant therapy or seed implantation. This uses small, radioactive metal ‘seeds’ that are inserted into the tumour so that radiation is released slowly. The seeds are not removed but the radiation gradually fades away over about six months. There is no risk of it affecting other people.

So after a full and frank discussion with Mr Nagar I was left with a lot of thinking to do, along with more discussions with my wife. The net of this was that I decided that LDR Brachytherapy was the right treatment for me. The following images show the basics of the procedure.

Image from http://www.oncolink.org

Images from http://www.oncolink.org
Images from http://www.oncolink.org

And so it was back to Mr. Wilkinson who scheduled me for a Flow Rate Test. I mentioned that this was somewhat less than successful last time so he suggested that the fall back plan would be a visit to Urodynamics.

Flow Test

As preparation for the Flow Test I had to keep a diary, over three days, of how much liquid I took on board, the type of liquid (tea, beer, wine etc.) and how much pee I produced. On the day of the flow test I thought I would help things along by arriving at the hospital early and drinking lots of water. I spent nearly an hour walking the grounds sipping at my bottle of water. Twenty minutes before my appointment my bladder started to indicate that it would need emptying soon so I headed up to Urology. I let the receptionist know that I might have an urgent need to perform. I was directed to take a seat and to let her know when things became truly urgent. So I sat there and my bladder went to sleep.

At my allotted appointment time I was called through to another waiting area asked to sit, offered tea and told to shout when I was ready to do the test. My bladder snoozed on. It was perhaps another thirty minutes before my bladder woke up. So I looked for the nurse. No sign. Well she said to shout so I did. After all I didn’t want to waste this opportunity.  Thankfully the nurse appeared and we dashed to the flow test equipment. Basically it looks something like this….

Flow Test Machine - How much over what period of time ?
Flow Test Machine – How much over what period of time ?

After successfully performing I was given a quick ultrasound check to see what was left in my bladder and there it was, job done. Although I had a second appointment set for a visit to Urodynamics it was deemed not to be necessary and was cancelled. Instead a new appointment with the consultant, Mr Hodgson, was set.

Time flew by and once again I presented myself for the scheduled appointment with Mr Hodgson. Sadly, not for the first time, there was a distinct lack of notes. At least the computer was working this time and he was able to access my notes that way. However, what was missing was the flow rate test results. Two sets of print outs were found from that date and I had to choose the chart from my test. Thankfully the graphs were very different and I could easily identify mine.

The results were deemed good and I was informed that I would need another rectal (digital) exam as well as having my prostate vital statistics taken.

So there I was again, trousers round my ankles, up on the couch, laid on my side with my knees under my chin. Different room but the scenery hadn’t changed just a blank wall painted in that neutral paint that all hospitals seem to choose.

First up was the rectal (digital) exam and for the first time since this whole process began I actually felt some discomfort, though not for very long. This was followed by an Ultrasound Scan during which measurements were taken of my prostate. These help to determine the shape and mass of the prostate and would be used during the Brachytherapy procedure.

Soon the scan was finished and I was back in the vertical plane. I almost had my trousers secured when I was informed that some of the data from the scan had not been saved. So it was trolleys round the ankles again, back on the couch and staring once again at the blandly painted wall. This time the scan image was saved and once fully dressed we were back to discussing the procedure and timing.

Apparently hospitals don’t keep a cupboard full of these things around and the seeds have to be procured. I wondered if they went to Suttons, Fothergills or perhaps our local garden center to obtain the seeds. I did not vocalise these thoughts. They implant 80 – 100 Iodine 125 seeds @ £30.00 each. That’s dearer than a packet of Impatiens seeds.

When my consultation was over I had to visit with the nurse for  nasal & groin swabs. She was less than amused when I suggested that I had saved the NHS money by using one swab for both areas. Either she’d had a humour bypass or had heard it all before.

On 13th May I presented myself for my Pre-Op Assessment and was duly measured, weighed and gave up a blood sample.

Before I knew it a date had been set for the procedure, May 15th. This was sooner than anticipated and I will admit to going through a moment of panic.

On the day I presented myself at reception and was shown through to a consulting room. I was measured and weighed again, blood pressure taken and given some premeds, antibiotics etc.. I was visited by the anaesthetic and the consultant and signed the consent forms after having everything explained to me. Thankfully, this time, the wait was not very long between these consultations and being taken through to theatre.

Preparation for the procedure was a surreal experience, what with me being dressed in the wonderful hospital smock and stockings, also the jokey disposition of the theatre staff. We were actually having a good time and that was before I had any anaesthetic.

It was about this time that I started to misbehave. As usual they inserted a canula, except that they had two goes at that. Then they informed me that I was due to have an epidural, which had not been discussed previously. At the same time they administered something through the canula that they said would make me feel like I had consumed a couple of  G & Ts. I remember feeling a little woozy and then nothing more until came to in the recovery area.

I was subsequently informed that the anaesthetists assistant tried on two occasions to set up the epidural. They are supposed to see spinal fluid  come out of the needle and on each occasion I wouldn’t give any up. The anaesthetist  then took over and tried herself, three more times, and still I wouldn’t give any fluid. At this point they decided that they would give up on the epidural and put me under with a general anaesthetic (GA). Once they had me under, and the procedure was underway, that’s when I really began to misbehave. I decided to vomit.

From what I have heard vomiting whilst under a GA is not good. This required the use of dyna-rod and a vacuum cleaner to clear out my tubes and the upper reaches of my lungs.

As a result of this the procedure took much longer than the estimated two hours which would  be normal. A further consequence was that I had to stay in hospital overnight, when I had expected to go home, and I was wheeled up to a ward where I was connected to an oxygen supply with attached humidifier. This was so that they could monitor me and make sure that I hadn’t inhaled any of my stomach contents and didn’t suffer an infection.

So there I was stuck in hospital. Hungry, I hadn’t eaten for over twelve hours. Thirsty, no fluids other than a few sips of water prior to the procedure. Catheterised, for the procedure and for the duration of my observation. Sore throat due to the GA and subsequent rodding out and suction due to my vomiting session.

The nurses brought me a sandwich to alleviate the hunger. A cheese on wholemeal sandwich was the only choice and was so dry that it was very hard to swallow, especially kind to my sore throat …. NOT !!

This was only the beginning of the fun night. Did I mention that I was catheterised ? Through the night I was subjected to hourly obs. Just as I was drifting off to sleep along would come the nurse to take my temperature and my blood pressure. Then, just as I was drifting away again, she would come back and I would feel a pulling at my penis. This was specifically related to the brachytherapy and the catheter. She had to use a Geiger counter type device and scan the contents of bag attached to my catheter then along the length of the tube up to the old fella. Required to ensure that none of my seeds had escaped. Any found would need special handling for disposal. Seeds can escape from their implantation point and move around the body. Supposedly this is not harmful.

Saturday morning arrived and I felt a bit fresher after a strip wash and some breakfast. I was scheduled to go down for an X-ray but someone cancelled it which meant a new booking for later in the day. Hospitals are the most boring places to be when you are waiting to be released.

I was visited by the consultant who informed me that I would need to go for a scan on Monday. This was to ensure that the seeds were implanted in the right place and the right quantity. He also said I could have the catheter removed. Yippee !! His female assistant performed the removal saying “this might feel a little strange”. Decidedly unpleasant would have been my description. Mind you, after my first few pee’s following catheter removal I would have gladly had it back. The sensation is as close to burning as I can imagine and it seems like you can feel it all the way back to your bladder. Thankfully that sensation slowly faded away over the next couple of days.

The consultant also gave me a little blue card, which I have to carry for the next three years. This card informs people that I have “received a permanent radioactive iodine seed (Iodine – 125) implant to the prostate”. This is not because I glow in the dark, but the seeds will show up on various scanners and may even set off alarms at airports.

Back in the hospital, the consultant said he was happy for me to go home but that the final decision was down to the anaesthetist. And he wouldn’t give the go ahead until I had an X-ray.

Well it was nearly 16:00 when I was taken down for the X-ray and it was gone 17:00 before I was finally released. At this time I was given a box of Tamsulosin capsules.

Tamsulosin is used to relax the muscle around the Prostate which, not unexpected, can be a bit irritated following the implants. How would you feel after 80-100 foreign bodies were inserted about your person. Add to the facts that they are radioactive too. The irritation / inflammation can cause the Prostate to swell and constrict the urether making it difficult to pee.

So home I went. What a relief it was to get out of the hospital.