Weird cloud formations as seen over Queen Alexandra Hospital yesterday afternoon.
Update: Apparently this kind of formation is known as Mammatus, also known as mammatocumulus (meaning “mammary cloud” or “breast cloud”), is a meteorological term applied to a cellular pattern of pouches hanging underneath the base of a cloud. The name mammatus is derived from the Latin mamma (meaning “udder” or “breast”).
Monday was one of the longest days of my life. I was scheduled for a “Template Biopsy” which for the un-initiated is described thus …..
The template biopsy is carried out using an ultrasound probe which is passed into your back passage and samples of the prostate gland are obtained through the area of the skin between your scrotum and back passage called the perineum. The procedure is similar to a trans rectal biopsy which you will usually have had.
Let me tell you, from the recipients perspective, it is nothing like the TRUS (Trans rectal biopsy).
To start with my TRUS was carried out fully conscious by a specialist nurse, the lovely Vanessa. The main difference though is that I was in and out of the hospital within an hour or so. But that was 18 months ago or more.
Mondays procedure was to be carried out under general anesthetic, for which I am truly grateful. But lets scroll back the clock a little.
I was awake, some time in the wee small hours. Either I am worrying about the procedure, or this is the residuals of jet-lag acquired on our return from Oz just over a week ago. Perhaps a combination of both. I checked the clock at 04:00 and thereafter approximately on the hour until I got up just after 07:00. I was not allowed to have anything to eat but was allowed clear liquids to drink and had a black tea around 08:00. The taxi was due to pick me up at 11:30 so I was pottering around in the house killing time. It’s amazing how often I found myself by the bread bin thinking “I’ll just have some toast” or over by the cupboard staring at a packet of peanuts. My last eats had been around 21:00 the previous evening. Going without food for that length of time is not natural for me.
Eventually the taxi turned up, although not at my house but three doors away. Luckily I saw him out there. It could have been worse, the dispatcher at the taxi office misheard my address as Sistine and, had I not corrected him, the taxi would probably have been well on his way to Rome and the Vatican. Still, having ascertained that he was there for me I boarded and we set off. Twice I had to correct his directions back to the main road before I was sure we were going to the hospital. Mentally I was crossing my fingers, hoping that the surgeon had a better sense of direction than my erstwhile pilot.
And so, at 11:50, I checked in at the QA Day Surgery Admissions Reception. And thus began the long wait. It’s a bit like being on a long haul flight, hours of tedium broken up by announcements from the flight crew. In this case there was no food or drink.
After thirty minutes or so I was taken along to a small room. Here I was visited by the anaesthetist who interrogated, sorry, checked my details and gave me a brief summary of what to expect. He also arranged for some initial meds.
Shortly thereafter, around 13:00, a nurse arrived with my lunch. A cup of water and four tabs, 2 x paracetamol / 1 antacid and 1 stop you feeling sicky pill.
While I was downing this feast another nurse arrived, interrogated me again and checked my blood pressure and heart rate. My heart rate was right down at about 55 which I queried but is apparently normal for “someone of our age”. She later demonstrated her own readings which were similar, so that was alright then.
I was then left alone to my own devices. I read for a while, played hangman on my phone, read some more, got up and walked around my room, looked out the window , read some more. Well you get the picture. I believe I even had a nap for a few minutes. The window looked down on the back dock but there was nothing happening down there.
Around 16:00 a yet another nurse informed me that I was Mr. Hodgsons last patient and that I would be seeing him soon. Well I saw his registrar who introduced himself but I have no idea what his name was. His accent, he was English I think, was as indecipherable as his signature on the forms that he got me to sign. He went through the now familiar interrogation, during which Mr. Hodgson popped in, shook my hand and disappeared again.
Twenty minutes later I was invited to go and get changed, by yet another nurse, who led me down to a room full of changing cubicles. This is where all dignity ends.
I am not a small guy at just over six feet tall and way over twenty stones (280lb / 127kg). The nurse threw me a smock and left the room. Needless to say the smock, of the tie at the back variety, did not fit well and I struggled to secure it. Although there was no mirror available I could tell by the cool air that most of my back and all of my bum was pretty much fully exposed. The nurse popped her head in and asked how I was getting on. When I explained that the smock didn’t fit and I was having trouble tying it she assumed a sympathetic air and replied “I shouldn’t worry, the first thing they’ll do is undo it”. I then settled down to fight with the compression stockings which when battle was over were rolled up to just below my knees. Wonderful!!
So there I am with my pale blue smock reaching from just below my chin, down to about two inches above the knee. Struggling to meet my sage green stockings, some two inches below my knees. All with my bum exposed to the rear.
The epitomy of sartorial elegance ? Nope, not a pretty picture.
Not to worry, I thought, I have my dressing gown which should bridge the gap. No such luck. To make sure that I was all bright and shiny for the hospital, my wife had washed and tumble dried it. I hadn’t worn it until now and yes, you’ve guessed, it had shrunk. At least it still closed at the front but the length was a sadly lacking being just a tad longer than the hospital smock. At least my back & bum were covered and therefore a little warmer.
I gathered my stuff and found the nurse, who then gathered up another guy (John) and led us through the hospital. Imagine my feelings as we passed through the first doorway into a public waiting area. I’m dressed like a freak and as we entered the waiting area all heads turned to see who had arrived. I thought later that it must have looked like me and John got dressed in the dark and swapped dressing gowns. His gown reached from neck to ankles and wrapped around him properly while mine was way too small. So, we made it through the waiting area without the gales of laughter I was expecting. Next we traversed the hospital to a stairwell where we descended to the floor below and were left in a new waiting room with one other guy and a TV. Here we waited for what seemed like ages but must have been about thirty to forty minutes. John and the other guy got the call and then eventually so did I.
Kim, not sure if she was a nurse or a doctor, arrived to lead me to the Operating Theatre suite. Once again I had to traverse the hospital through the public corridors and climb to the upper floors via the stairwell. At this point a cold draught, not Guiness, reminded me about the negative aspects of my attire as I climbed the stairs. The stairs with the open railings to the centre, the railings that gave a not so glorious view of my nether regions to the several people descending these same flights of stairs. One glance up by any of them and they would be scarred for life.
On arrival I am sat in another waiting area, just for few minutes, but my apprehension levels are rising. This is not how I imagined the process would work. All this walking and waiting followed by more walking and waiting. And then an assistant anaesthetist comes and interrogates me one more time and I am on my way. One more surprise was that I had to walk into the theatre and get on the table myself. A green bag is held out for me to dump my shoes and dressing gown into. As I take off the gown a nurse rushes across the room to shut the doors to the outside, to prevent my blushes or those of any outsiders I’m not so sure. Then I am on the table.
When I entered the theatre there was a group of folks gathered in the corner. Presumably they were in a pre-scrum huddle discussing my procedure. Or maybe they were just discussing Pompeys abysmal record. As I hop on the table I suddenly become the centre of a hive of activity as the anaesthetist and his assistant close in to prepare me. Cannula in the back of the hand, heart monitors etc. then the anaesthetist is telling me that I will feel a coldness in my hand as he injects the first of two concoctions. I felt nothing and then he informs me that I may feel a little dizzy. I’m staring at the ceiling and the light panels suddenly seem to displace and the next thing I know is a voice over my shoulder is speaking and inviting me to cough.
I open my eyes and I am in a different room, apparently job done. This is like taking a shot with an SLR. You look through the lens, focus, shutter release, view goes blank as the mirror lifts, then the view is clear again when the mirror drops. All in the blink of an eye. I’m not feeling dopey or dizzy, just wide awake. Once the nurse is happy that I am OK I am wheeled through to a recovery area.
As I enter the new waiting area I pass John and the other guy from the pre-op waiting area. They are sitting up in their respective beds eating toast which they both wave at me.
After a short time and a cup of water I was invited to get dressed and was led outside to a seating area. The nurse asked if I had eaten anything or had a drink to which I responded “No”. I was offered coffee or tea and I was expecting toast but was in fact offered eggy or corned beef butties. John was already out there so I sat alongside and we compared notes as he had the same procedure. When my coffee and butties arrived he was rather envious since he was only offered toast and like me he loves corned beef. My wife was brought in and she eyed my butties hungrily too. She had been waiting outside since just after five and, as it was now gone seven, was very hungry.
The purpose of this little tea party is to ensure that you are OK, that you can keep down food and drink and most importantly that you can have a pee. If you can’t keep your food down or you don’t make water they won’t let you go home. Worst still an inability to pee can mean catheterisation and / or an overnight stay. Luckily I was able after a short while to produce a dribble. Oh but it burned. I’m guessing that I was catheterised during the procedure although nobody said.
Anyway, based on my meager performance I was allowed to go and my daughter came and drove us home. Once home it was more tea and everyone seemed amazed, not the least of which me, at how alert I was. Also that I was in no pain. Well apart from when I had a pee which I was having to do with ever-increasing regularity.
Well the good news is that I have not had any pain. Two nights sleep, although still not sleeping all the way through so blaming the jet lag.
It is now nearly forty-one hours since the procedure. Any residual pain blocking by the anaesthetic must have worn off by now. The burning sensation has all but disappeared and I have a slight soreness in the perineum, like when you have a bruise, which only makes itself known when I sit on something hard.
Now I have to wait for approximately four weeks to hear the results. That brings us to Christmas week I think, so it is likely that my appointment will be after the holidays. We shall see.
Some of you may have read my previous post on this subject. I realise that I left it as something of an open-ended, cliff edge item. I had intended to follow-up fairly quickly with the following but for some reason I found I couldn’t seem to find the time ??? Yet I managed to post on other matters. Go figure.
Since I am on the cusp of the next stage I felt I should bring this up to date, so here goes.
….. after informing me that I did in fact have Prostate Cancer, Dr Hodgson proceeded to give me the details. The results of the biopsy and so forth. I think I am taking it all on board but in reality the enormity of my situation is quite overwhelming. Its only when he gets up and leaves the room in search of some leaflets that I really feel something. I’m not sure what it is but I have the sensation that something has just come down over me, like a sheet sliding over me. Not heavy but just there.
Dr Hodgson returns and we talk over things for a while longer. The net of this is as follows:
My biopsy has shown that I have Prostate Cancer, this is not good news, however you look at it.
I have a Gleason figure of 6 (3+3) 1% on the left side & 7 (3+4) 8% on the right side. This is relatively good news. Gleason figures in the 1 to 5 range are better. It is later explained to me that 3+4 is better than 4+3 even though they both add up to 7
I am 60 and, apparently, this is a good thing too as, with a following wind, I have maybe 30 -35 years ahead of me.
My options are :
The last was not offered as an option and I had to ask if it was available because I had read about it on the web. Dr Hodgson said that it was an option but he hadn’t offered it as at my age it was more likely that I would eventually have to take one of the other options.
So, I pondered a while then opted for option 4.
My main reasons are a strong fear of people cutting in to my bod. Well that one aside I am also concerned about possible side effects of surgery. After all the Prostate Cancer, isn’t causing me any pain or other symptoms at this time. Whereas, surgery could introduce me to a few negative issues. i.e. infection and damage to surrounding body parts including the bladder. Both of the Radiotherapy options come with potential negative effects which include bladder control which I am not about to give up just yet.
Nope, on the whole, I preferred the idea of Active Surveillance. And that is what we have been doing for the last eighteen months or so. Every six months or so I have had a blood test to measure the PSA and after each test I have had an appointment with a consultant. Each test, other than the last, has shown a slight increase in the PSA. The last showed a 0.1 decrease which in my book is negligible. At the last consultant review we discussed that part of the Active Surveillance regime is a regular biopsy.
And here we are. I am about to go into hospital for a “Template Biopsy”. Instead of grabbing their samples via the back passage, using an ultrasound probe with local anaesthesia, they will knock me out with a general anaesthetic and take many samples using a “template” grid to give them a more accurate idea of what is going on with my prostate. These samples are taken through the skin between the back passage and my undercarriage.
Personally I am really pleased that this will be carried out under GA.
So there you have it. I am about to go into hospital to be shot blasted in the gusset region with 20, 30 or 40 needles.
I will update you on how I get on, if and when I am able to sit down again. And here is a pretty flower for those of you traumatised by the idea of a template biopsy.
Here I am in my 60th year. I have made it through most of my adult life without suffering anything worse than the common cold and the occasional bout of flu. A couple of years back I was diagnosed with hypertension and have been taking tablets ever since to keep things under control. All has been well until earlier this year when I was asked to provide a blood sample as part of the regular monitoring. This time my GP said he noted that I hadn’t been checked for prostate cancer so he added it to the list of things for the lab to check out. Part of their preventive maintenance plan I guess. He told me to call in a couple of weeks to find out the results. and me being me, I forgot all about it and did nothing.
Until ……
Some time later I decided to go and see the doctor about a couple of moles on my shoulder. During the exam I mentioned the blood test and asked about the prostate element. After he pulled up my notes and following some chin rubbing he said “Your PSA is up a bit, perhaps we should book you in for an examination”.
Don’t you think that someone might have said something when my blood test came in ?
After all “No news is good news ….. Right ?”
Did they check the other stuff pertaining to my blood pressure ?
So I was left to go and make an appointment. While I am at the reception desk he calls me back in to the examination room. “Since you are here we might as well do it now” he says. A few minutes later he’s got a rubber glove on and I’m laid down on the couch, facing the wall with my knees tucked up under my chin.
After what can only be described as a “strange and unusual experience” he informs me that his exam was inconclusive, that he really isn’t an expert and feels it would be better if I was examined by someone with more experience. Personally I would rather that he had chosen someone else to practice on.
A week or two later I am up at The QA (Queen Alexandra hospital, Portsmouth) and I’m laid down on a couch, facing a different wall, with my knees tucked up under my chin. This time it is the lovely bubbly Vanessa with the rubber glove. This time I’m told that because I am tall, my prostate is quite high up and perhaps this is why the GP couldn’t feel my prostate. There then ensues a discussion about the length of my GPs fingers, me saying I hadn’t noticed from my position at the time if he had pianists hands and comparisons with Elton Johns chubby pudds. Meanwhile back on the couch… Vanessa thinks that we, I, should have another blood test to compare with my earlier one and that, based on that comparison, a decision would be made as to the need for a biopsy.
An appointment date is set and I am left to arrange a visit to the vampires at my GPs practice. I manage to fit in a fortnights French holiday in between times, get the blood drawn and await the results.
On Thursday, July 26th, I have a short but bubbly telephone call with Vanessa who informs me that my PSA is once again elevated, that it is probably nothing, but why don’t we, meaning I, have a biopsy just to be sure. You can guess how enthusiastic I am about that. I haven’t been sitting idle, wasting my time. I’ve been on the interweb and found out how these biopsies are performed.
An appointment is made for Tuesday, July 31st. All too soon I am sitting in the Urology Dept waiting room and my name is called. They hadn’t warned me, but en-route to the torture chamber, they ask me to provide a urine sample. If I had known I would have made sure that I had plenty to drink. Needless to say I could not perform. Not a drop. “Stage Fright” says Vanessa.
Once again I find myself with my trollies down round my ankles, laid down on a couch, facing yet another wall, with my knees tucked up under my chin and my bum hanging over the edge. Now that’s an image to scare the kiddies don’t you think.
So the procedure gets underway, cold lubricating gel and the ultrasound wand is put where the sun doesn’t shine, anaesthetic is applied and the numerous biopsy samples are taken with the device clacking away with the sound of an industrial stapler. Job done, my bum is wiped and a man-sized pantyliner applied and I am packed off home, advised not to do anything strenuous. As if.
Thursday, August 30th, and I am once again at the QA. The Urology Dept. waiting room isn’t any more attractive. My name is called and introductions made. This time I am seeing Dr Dominic Hodgson. Where is the lovely Vanessa ? After the pleasantries I am sitting waiting for Dr Hodgson to give me the “All Clear”.
So it’s all a bit surreal when he tells me that the biopsy has shown that I do in fact have Prostate Cancer.
No wonder the authorities keep trying to skim the QA skills and move them to Southampton.
QUEEN Alexandra Hospital’s heart attack unit is the best in the south, the latest figures show.
Patients have a better chance of surviving than any other hospital in the area and victims from as far away as West Sussex and the Isle of Wight are being taken straight to the Cosham super hospital because of the advances services available.
Of course this means that the work levels have risen.
Figures revealed in the South Central Cardiovascular Report show since QA was given permission to use the helipad 24 hours a day in September the number of heart attack victims admitted has gone up.
There were 288 admissions between April 2011 and December 2011, compared to 269 in Oxford, 229 in Southampton and 165 in Reading.
Despite the increased workload the QA shows that patients have a better chance of survival than if they are treated in any other similar hospital in the region.
The death rate for patients treated for severe heart attacks is 5.8 per cent at QA compared to 9.1 per cent at Southampton, 5.7 per cent at Oxford and 6.4 per cent in Reading.
WrAnTz 